14 May 2023
During an inspection looking at part of the service
About the service
Two Trees Caring Home ‘hereafter; referred to as Two Trees is a residential care home that provides personal care and support for up to twenty-eight people with a learning disability, autism or who have complex needs associated with their mental health. At the time of the inspection there were twenty-six people living at the service.
People’s experience of using this service and what we found
Right Support:
People were not always supported to have maximum choice and control of their lives and staff were not always supporting people in the least restrictive way possible. The service could not always demonstrate they were acting in people’s best interests.
Managers and staff were committed to supporting people in line with their preferences. People had fulfilling lives and staff supported people by focussing on their strengths and encouraging people to be as independent as possible. However we found more work was needed to ensure people were protected from the risk of harm as systems and process did not always provide staff with all the information needed to meet people's needs safely.
Right Care:
Risks such as those associated with people's complex health and / or medical needs had been assessed. However, staff did not always have access to all the information they needed to meet people’s needs safely, due to technical issues with the electronic care planning which were continuous and ongoing.
Staff respected the people they supported and provided care that was caring and compassionate. People were encouraged to take positive risks to enhance their wellbeing and support plans reflected their individual needs and preferences.
Right Culture:
The ethos, values and attitudes of staff helped to ensure people using the service were enabled to lead confident, inclusive, and empowered lives. Staff understood their role in making sure that people were always put first, and their care and support was tailored to their individual needs and preferences. The management team had created an open and transparent culture, where constructive feedback was encouraged.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published on 28 June 2018)
Why we inspected
We received concerns that potentially indicated a closed culture where concerns relating people health care needs were not being appropriately shared with families or escalated to medically professionals. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.
You can see what action we have asked the provider to take at the end of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Two Trees Caring Home on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to safe care and treatment, need for consent, deprivation of liberty safeguards (DoLS) and good governance. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.