This inspection took place on 22 May 2016 and was unannounced.

Treetops Nursing Home is registered to provide accommodation for up to 24 older people some of whom are living with dementia or who have needs associated with mental health. There were 24 people living at the service when we inspected. The service has several communal areas which include a conservatory and bright, airy lounge. It has a lift, and is fully accessible to wheelchairs. It has specialist equipment to assist people with mobility problems and is close to local transport links.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Medicines were safely handled and risks were well assessed to protect people.

Staff were able to tell us what they would do to ensure people were safe and people told us they felt safe at the service. The service had sufficient suitable staff to care for people and staff were safely recruited. The environment was safe for people and monitoring checks were regularly carried out. People were protected by the infection control procedures in the service.

Staff had received training to ensure that people received care appropriate for their needs. Training was up to date across a range of relevant areas.

Staff had received up to date training in Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood that people should be consulted about their care and they understood the principles of the MCA and DoLs. People were protected around their mental capacity.

People’s nutrition and hydration needs were met. People enjoyed the meals. Specialist advice around people’s health care was sought and followed.

People were treated with kindness and compassion. We saw staff had a good rapport with people whilst treating them with dignity and respect. Staff had knowledge and understanding of people’s needs and worked together well as a team. Care plans provided detailed information about people’s individual needs and preferences. Records and observations provided evidence that people were treated in a way which encouraged them to feel valued and cared about.

People were supported to engage in daily activities they enjoyed and which were in line with their preferences and interests. Staff were responsive to people’s wishes and understood people’s personal histories and social networks so that they could support them in the way they preferred. Care plans were kept up to date when needs changed, and people were given opportunities to take part in drawing up their care plans, their reviews and to give their views which were acted upon.

People told us their complaints were responded to and the results of complaint investigations were clearly recorded. Everyone we spoke with told us that if they had concerns they were always addressed by the registered manager who responded quickly and kindly.

The service had an effective quality assurance system in place. Treetops Nursing Home was well managed and staff were well supported in their role. The registered manager had a clear understanding of their role. They consulted appropriately with people who lived at the service, people who were important to them, staff and health care professionals, in order to identify required improvements and put these in place. Records around good governance were clear and accurate and led to planned improvements.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary, please read the full report.

This is a summary of what we found.

Is the service safe?

People were treated with dignity and respect by the staff. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. Systems were in place to ensure that the registered manager and staff learnt from incidents such as accidents and incidents. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act (MCA), 2005 and Deprivation of Liberty Safeguards, (DoLS). All staff had been trained to understand when an application should be made, and how to submit one. Documentation was available in people's care files to support this.

Staff had received up-to-date training in all mandatory areas, as well as those specific to their job role. Staff recruitment procedures were thorough and in accordance with the provider's policy. Policies and procedures were in place to make sure unsafe practices were identified and people were protected.

The home had policies in place for the effective control of infection and the environment was clean, tidy and odour free.

Is the service effective?

Staff had the skills and knowledge to meet people's needs. The registered manager gave effective support to staff including induction training, supervision and appraisal. This was supported by a comprehensive training programme. The care home worked effectively with other agencies and health care services to ensure a co-ordinated approach to people's care was achieved.

Is the service caring?

People living in the care home were supported by kind and attentive staff. They were cared for sensitively and given encouragement. People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

The complaints procedure was understood by staff, people living in the care home and their relatives. The registered manager had encouraged relatives to have greater involvement in the care offered.

Is the service well led?

There was a quality assurance process in place. Records showed that any adjustments needed were actioned promptly. This enabled the quality of the service to continually improve. Staff told us they were clear about their role and responsibilities. The staff we spoke to felt they were strongly supported by the registered manager. Staff had received ongoing training in order that they may continue to provide effective care.

There was a calm and relaxed atmosphere within the home throughout the day and staff spent time interacting and chatting with people. When we spoke with people who used the service they told us they were happy with the support they received. One person told us “I like it here. The staff are respectful and they listen to me. They also respect my privacy”. Another person told us “They really look after you here. Being looked after and well cared for is the best thing about it”. A relative of a person who used the service told us “My relative is very happy here. He seems well looked after”.

We saw that there was a robust system in place for monitoring nutrition and hydration and people were able to access a choice of food and drink at any time throughout the day. The environment was maintained to a good level and the upkeep and repair of all areas of the home was appropriate.

There were appropriate staffing levels in place and sickness and absence were usually covered effectively by existing staff.

The service held resident and staff meetings to gather feedback about the service. Questionnaires were used to gain further feedback. The manager had quality assurance systems in place to ensure that areas such as infection control, medication and care planning were effective and timely.

During our inspection we found that Treetops Nursing Home was providing a good level of care and support for people.

People who used the service had been asked for their consent regularly, and were able to express their preferences and wishes regarding their care and support. While on our inspection we saw that people were engaged in various activities, and the staff interacted often and positively with people living in the home. One relative told us “My relative feels very relaxed living here, and is as happy as she can be in a nursing home”.

We looked at records for people using the service and found them to be accurate, up to date, personalised and regularly reviewed. Paperwork was dealt with appropriately by the provider. The service had a robust complaints procedure that was followed effectively. The recruitment and employment of staff was found to be effective and appropriate.

People who live at Tree Tops Care Home told us they were very happy with the care and

support they received. Visitors commented on how efficient, competent and caring staff were.

Some agency staff who were employed at the home during the site visit told us that they thought that Tree Tops was 'one of the better homes' they had worked in. They said they had been given a brief induction and the senior person on duty had explained exactly what they expected of them whilst working at the home.

Staff said that they felt supported by the manager and that they felt the home was well

managed and people's best interests were always taken into consideration.