CQC report explained · a residential care home
What the CQC found at Ball Tree Croft
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Safeguarding, risk assessments, staffing, medicines and infection control were found to be managed safely.
- Effective?
- Good
- This question was not included in this focused inspection.
- Caring?
- Good
- This question was not separately rated in this focused inspection, although inspectors observed kind and caring interactions.
- Responsive?
- Good
- This question was not included in this focused inspection. Inspectors did note that people did not always receive personalised care.
- Well-led?
- Requires improvement
- Management was open and supportive, with systems for monitoring quality. However, the service model and layout did not always support people's choice, control and independence.
What inspectors found, December 2021
Rated Good overall; inspectors found safe care, but the home’s leadership and support for choice and independence require improvement.
This was an unannounced focused inspection on 11 November 2021. It began as a targeted inspection of infection prevention and control during a COVID-19 outbreak, then widened to look at Safe and Well-led. One inspector spoke with people, relatives, staff and a health professional, and reviewed care, medicines, staff and management records.
The home was rated Good for Safe. People said they felt safe. Inspectors found suitable safeguarding, risk management, staffing, recruitment, medicines and infection control arrangements. Staff were kind and caring, and accidents and incidents were reviewed to reduce risks.
The home was rated Requires Improvement for Well-led. Inspectors found open and supportive management, but people did not always have maximum choice and control. The layout and care model meant people usually travelled to the main building for meals, while medicines were taken to the houses in a trolley. Care was also not always personalised to people's needs.
The overall rating remained Good, but Well-led had fallen from Good at the previous inspection in 2017. The respite service was paused during the pandemic. CQC said it would continue to monitor information and could inspect sooner if concerns were received.
People felt safe
People told inspectors they felt safe and knew who to tell if they had a concern. Staff understood safeguarding procedures.
“People told us they felt safe and knew who to tell if they didn't.” from the report
Safe medicines practice
Medicines were received, stored, given and disposed of safely. Staff who administered medicines were trained and assessed as competent.
“Medicines were received, stored, administered and disposed of safely.” from the report
Kind staff
Inspectors saw kind interactions. Staff showed genuine regard for the people they supported.
“We observed kind and caring interactions between people and staff. Staff showed genuine regard for the people they supported.” from the report
Learning from incidents
The management team reviewed accidents and incidents and used the findings to reduce risks and improve people's experiences.
“There was a culture of listening to people and positively learning from events so similar incidents were not repeated.” from the report
Infection control
Inspectors were assured about the home's COVID-19 measures, including testing, PPE, cleaning and staff training.
“Hourly high touch area cleaning was in place in addition to a robust general and deep cleaning schedule.” from the report
Choice and independence
needs fixingPeople were not always supported to have maximum choice and control or to gain more independence. Inspectors said the current model did not meet the relevant guidance.
“People were not always having maximum choice and control in their lives and being empowered to gain more independence.” from the report
Layout and daily routines
needs fixingPeople normally travelled from their shared houses to the main building for meals, and medicines were transported there in a trolley. The manager was reviewing these arrangements.
“The current practice of people traveling from their shared houses to a main building for meals and having medicines delivered to them in a trolley from the main building does not meet the guidance for Right Support, right care, right culture.” from the report
Personalised care
needs fixingInspectors found that people did not always receive care personalised to their needs.
“People did not always receive care that was personalised to their needs.” from the report
- 01What has changed to give people more choice and control over where and when they eat?
- 02How are you improving the small shared-house kitchens so people can prepare food with support?
- 03What is being done to store medicines securely in each house rather than moving them in a trolley?
- 04How do you make sure each person's care is personalised to their needs?
- 05What action has been taken since the Well-led rating fell from Good to Requires Improvement?
This was a focused inspection that covered Safe and Well-led, after a targeted COVID-19 infection control inspection; the other key questions were not inspected or newly rated. This explanation was written from the published report of 7 December 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2017
Ball Tree Croft was rated Good; inspectors found safe, kind and personalised care, with previous nutrition-recording concerns addressed.
This was an unannounced comprehensive inspection on 27 June 2017. One inspector spoke with people using the home, staff and a visiting healthcare professional. The inspector also checked care records, medicines records, staff files, complaints, incidents, audits and feedback.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably skilled staff, safe medicines management, clean premises and good safeguarding arrangements. People were supported with their health, food, drinks, activities and daily choices.
At the previous inspection in April 2015, staff had not always recorded people's weights or the action taken after healthcare advice. This inspection found that weights were monitored and healthcare guidance was recorded and followed. The home had maintained its previous Good overall rating.
Safe staffing and medicines
The home had enough suitably skilled staff, and staffing was adjusted when people's needs changed. Trained staff managed medicines safely, with checks to identify and correct errors.
“People continued to receive support from sufficient numbers of suitably skilled staff to keep them safe and to meet their needs.” from the report
Nutrition and health support
The home improved its monitoring of people's weights after the previous inspection. Staff recorded healthcare advice and supported people with suitable food, drinks and healthier lifestyles.
“Staff monitored and recorded people's weights regularly and as required by the SALT, and the action taken when they had concerns.” from the report
Kind and respectful care
Staff understood people's histories, preferences and communication needs. People were supported to make choices, develop daily living skills and maintain privacy and dignity.
“People continued to receive care that was respectful, kind and compassionate.” from the report
Personalised activities and support
Care plans reflected individual wishes and needs. People were supported to take part in activities they chose, go out and make decisions about their daily lives.
“People received the support they required to do the things they wanted to do such as going out for shopping and walks in the park.” from the report
Open management and improvement
Staff and people described the management as supportive and approachable. Regular meetings, audits and feedback were used to improve the home.
“An open and positive culture encouraged staff to learn from incidents and to discuss ways to continuously develop the service.” from the report
Care plan redesign was unfinished
minorA care planning audit had identified that care plans needed redesigning. This work was still in progress when inspectors visited, so ask what was completed afterwards.
“a recent care planning audit had identified a need to redesign care plans; this was ongoing at the time of the inspection.” from the report
- 01What changes were made to the care plans after the redesign identified in the 2017 audit?
- 02How do you now monitor people's weights and make sure healthcare professionals' advice is followed?
- 03How are staffing levels adjusted when people's needs change or staff are absent?
- 04How do you check that medicines records remain accurate and that any errors are corrected promptly?
- 05How are people involved in choosing their activities, daily routines and care?
This was an unannounced comprehensive inspection covering all five CQC questions, and the home maintained its Good rating from the previous inspection. This explanation was written from the published report of 17 August 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ball Tree Croft
3 rated inspections over 7 years: the service has held its Good rating throughout.
- December 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
28 live-in carers within about an hour of West Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,170 a week. 23 can care for a couple. 11 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.