CQC report explained · a residential care home
What the CQC found at Dove Tree House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found suitable safeguarding, staffing, risk assessment, infection control, recruitment, emergency and medicines arrangements.
- Effective?
- Good
- The home had addressed earlier concerns about mental capacity and best-interest decisions. Staff had relevant training and people received suitable health, nutrition and specialist support.
- Caring?
- Good
- Staff were kind, attentive and respectful. Care was personalised, relatives were welcomed and people's privacy, choices and relationships were supported.
- Responsive?
- Good
- Care plans described people's preferences and staff responded to changing needs. There were many activities, but no organised outdoor trips had taken place that year.
- Well-led?
- Good
- The managers were described as open and approachable. Audits, surveys and other checks were used to monitor care and plan improvements.
What inspectors found, January 2019
Rated Good; inspectors found safe, kind and personalised care, with limited trips out the main shortfall.
The inspection was unannounced and took place on 3 December 2018. The inspector spoke with people living in the home, relatives, a health professional and staff. They also observed care and checked care records, medicines, training, complaints, accidents and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People appeared comfortable and happy. Staff knew people well, treated them respectfully and supported their choices, health needs, medicines, food and activities.
The Effective rating improved from Requires Improvement at the previous inspection in August 2016. Staff now understood how to protect the rights of people who could not make some decisions for themselves. The report found no serious risks or concerns.
Personalised care
Care plans were detailed and personal. Staff knew people's routines, preferences, communication methods and past experiences.
“Care plans showed person-centred language and gave good detail about exactly how staff should care for people.” from the report
Kind relationships
Inspectors saw warm and respectful relationships between people and staff. Staff spent time talking with people and understood how to reassure them.
“We saw staff interacting with people in a caring and professional way.” from the report
Safety and medicines
The home had enough staff and suitable checks for safeguarding, risks, infection control and medicines. Medicine records had no gaps.
“Medicines were well managed and stored in line with national guidance.” from the report
Health and nutrition
Staff noticed changes in people's health and made timely referrals. Nutritional needs and swallowing risks were assessed and managed.
“Staff referred people to appropriate health professionals in a timely way.” from the report
Few trips out
needs fixingPeople had access to a large garden but no organised outdoor trip had taken place that year. The manager said this would be a priority.
“There had been few outdoor trips this year, the provider mini bus was shared between all homes.” from the report
Supervision slightly behind
minorStaff supervision sessions were slightly behind schedule because the manager had been organising recruitment. The report says sessions had been booked.
“These were slightly behind schedule as the registered manager had been organising recruitment but they were now booked.” from the report
- 01What has changed to make sure residents can go on regular trips outside the home?
- 02How many organised outings are planned, and how are residents' choices about destinations used?
- 03Are staff supervision sessions now up to date, and how often are they held?
- 04How is the home managing its reported recruitment difficulty while keeping staffing levels safe?
- 05How will you involve my relative and our family in care planning and best-interest decisions if needed?
This was an unannounced inspection covering all five CQC questions; the Effective rating improved from Requires Improvement at the 2016 inspection and the other ratings remained Good. This explanation was written from the published report of 9 January 2019 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, September 2016
Rated Good overall; inspectors found safe, kind and responsive care, but the home needed to improve how it protected people's legal rights.
This was an unannounced inspection on 23 and 24 August 2016. One inspector reviewed records, observed care and spoke with people living there, relatives, staff and health and social care professionals.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were rated Good. Effective was rated Requires Improvement because staff did not fully understand the Mental Capacity Act, and some capacity assessments were not specific to individual decisions.
Inspectors found enough staff, safe medicines systems, suitable care plans and good support with food, drink and healthcare. People were generally treated kindly, supported to make choices and able to take part in activities.
The Requires Improvement rating means some important improvements were needed. The provider and manager said they would arrange face-to-face training, review guidance and improve audits.
Safe staffing and medicines
There were enough staff to meet people's needs. Medicines were administered by trained staff, securely stored and checked through regular audits.
“There were sufficient numbers of staff to keep people safe and meet each person's individual needs.” from the report
Good understanding of people's needs
Staff knew people's communication methods, health needs and preferences. Information was shared at handovers three times a day.
“Staff were able to describe people's support needs in detail, for example their preferred method of communication” from the report
Food and healthcare
People had enough to eat and drink, with special diets catered for. The manager acted promptly to involve health professionals when people's needs changed.
“People had sufficient to eat and drink and received a balanced diet.” from the report
Kind and respectful care overall
Staff supported privacy, dignity, independence and choice. People and relatives spoke positively about the care and relationships in the home.
“People told us they were supported by kind and caring staff.” from the report
Activities and community
People could join activities linked to their interests, including quizzes, music, outings and social events. People also helped contribute to activities and the newsletter.
“People were able to take part in daily activities according to their interests.” from the report
Confident management
People, relatives and staff felt able to speak with managers. The home sought feedback and used meetings to discuss suggestions and improvements.
“People, relatives and staff expressed confidence in the management.” from the report
Mental Capacity Act practice
seriousPeople's legal rights were not always protected. Staff were unclear about best-interest decisions, and some assessments did not relate to a particular decision.
“People's human rights were not always protected under the Mental Capacity Act 2005 (MCA).” from the report
Out-of-date deprivation of liberty guidance
needs fixingThe guidance for staff about when to refer someone for a deprivation of liberty assessment was inaccurate and did not reflect current legal guidance at the time.
“The guidance for staff about when a referral was necessary was out of date and inaccurate” from the report
Respectful language
needs fixingMost staff were respectful, but inspectors heard some staff use inappropriate terms when speaking to people. The manager said this would be addressed urgently.
“During the inspection we heard some staff addressing people inappropriately.” from the report
Care plan involvement
minorPeople and relatives were not always sure they had helped draw up care plans, even though they had been involved in decisions about care.
“People and their relatives were unclear whether they had been involved in the drawing up of their care plan” from the report
Quality checks missed the legal rights issue
needs fixingThe home's audits did not identify the problems with capacity assessments. The manager said the audit system would be improved.
“However, we found the audits were not always effective, because they did not recognise people's human rights were not always protected” from the report
- 01How do you now make sure mental capacity assessments relate to a specific decision at a particular time?
- 02How are staff trained and checked on best-interest decisions under the Mental Capacity Act?
- 03What has changed in the guidance about when a deprivation of liberty referral is needed?
- 04How do managers monitor the way staff speak to people and deal with any inappropriate language?
- 05How are residents and relatives involved in reading, discussing and agreeing care plans?
This was an unannounced inspection of the overall service, covering all five CQC questions and reviewing records, care practice, views and the management systems. This explanation was written from the published report of 24 September 2016 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 Dove Tree House
2 rated inspections over 2 years: the service has held its Good rating throughout.
- January 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- August 2012
Registered with the Care Quality Commission on 20 August 2012.
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.
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