This inspection took place on 14 October 2015 and was unannounced. At our previous inspection in October 2014 we found the service did not have suitable arrangements in place for obtaining, or acting on accordance with, the consent of service users in relation to their care and support. This was a breach of Regulation 18 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which since 1 April 2015 is Regulation 11 of the Health and Social care Act 2008 Regulations (Regulated Activities) Regulations 2014. We required the provider to make improvements. We received an action plan about how those improvements would be made. At this inspection we found that the necessary improvements had been made.
The Trees is a purpose built home for people with learning disabilities, situated in a residential area of Hinckley. The home is run by Leicestershire County Council. The service provides care on a short and long term basis for up to 19 adults who have been diagnosed as having learning disabilities, mental health conditions, and physical disabilities. At the time of our inspection 11 people were using the service.
The service had 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. The registered manger was absent at the time of our inspection and their absence was expected to last more than 28 days. An interim manager was running the service in the meantime.
People using the service were safe because staff understood and practiced their responsibilities for protecting people from abuse and avoidable harm. There had been lapses in the security of people’s finances in January and May 2015. Actions were taken to improve security after the first theft, but these proved to be ineffective. A further review took place, with police involvement after the May 2015 theft.
Staff supported people to be as independent as they wanted to be. Where that involved activities that carried a risk of harm, risk assessments were in place to minimise the risks. Risk assessments were also in place in relation to people’s care routines.
Decisions about staffing levels were based on people’s needs. People using the service felt enough staff were on duty and staff also felt that. Our observations were that there were enough suitably skilled and experienced staff to meet people’s needs.
People received their medicines on time. We found one lapse in the accuracy of a record of medicines administration. The provider told us they would take action to ensure that use of `as required’ medicines was reviewed. The provider had safe arrangements for the storage and disposal of medicines.
People using the service were supported by staff with the necessary knowledge, skills and experience. Staff were supported through training and supervision.
Staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Every person using the service had an assessment of their mental capacity to make a range of decisions about their care and support. Applications for DoLS had been made for people using the service.
People were supported with their nutritional needs. People were supported with their food preferences and dietary requirements. People who required support with eating and drinking received that support. People were supported to access health services when they needed them.
Staff understood people’s needs and provided care and support that helped people feel they mattered to staff. People were involved in decisions about their care and support. They were supported to access independent advocacy services when they needed them. Staff treated people with respect and dignity
People received care and support that was centred on their individual needs. Their care plans included information for staff about how they wanted to be supported. People were supported to maintain their hobbies and interests and to participate in activities that were important to them. They were able to do that at an activities centre and at The Trees. They were also supported to take part in social activities and days out to places of interest.
People had opportunities to express their views at reviews or their care plans, at residents meetings and through everyday dialogue with staff. They and relatives e had access to a complaints procedure. The provider used complaints as an opportunity to identify where improvements could be made to the service.
People using the service, their relatives and staff had opportunities to be involved in developing the service. Their suggestions and ideas were listened to and acted upon.
The service had a registered manager. They were absent at the time of our inspection but interim management arrangements were in place which ensured a continuity of management. The provider had procedures for the monitoring and assessment of the service.