About the service:

High Trees is a residential care home which consists of two separate houses leading off a shared driveway. High Trees is registered to accommodate, between both houses, up to 16 people living with learning disabilities or autistic spectrum disorder. At the time of our inspection there were 12 people living there.

The care service had not been developed or designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This was because High Trees provided accommodation for up to 16 people, some of whom were expected to use shared facilities including bathrooms and communal areas.

People’s experience of using this service:

People received safe care and support as the staff team had been trained to recognise signs of abuse or risk and understood what to do to safely support people.

People received safe support with their medicines by staff who had received training and who had been assessed as competent. The provider had systems in place to respond to any medicine errors. The provider completed regular checks to ensure that people were receiving the right medicine at the right time.

Staff members followed effective infection prevention and control procedures. When risks to people’s health and welfare were identified, the provider acted to minimise the likelihood of occurrence.

The provider supported staff in providing effective care for people through person-centred care planning, training, supervision. People were promptly referred to additional healthcare services when required.

People were supported to maintain a healthy diet and had choice regarding the food and drinks they consumed. The environment where people lived was well maintained and suited their individual needs and preferences. People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems supported this practice.

People received help and support from a kind and compassionate staff team with whom they had developed positive relationships. People were supported by staff members who were aware of their individual protected characteristics like age and gender and disability. People were supported to develop their independence and actively took part in decisions about where they lived.

People participated in a range of activities that met their individual choices and preferences and that they found interesting and stimulating. People were provided with information in a way they could understand. Policies and guidelines important to people were provided in an easy to read format with pictures. The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them.

The provider understood the requirements of their registration with the Care Quality Commission and was meeting the legal requirements. The provider had effective systems to monitor the quality of the service they provided and to drive improvements where needed. The provider had good links with the local community which people benefited from.

More information in Detailed Findings below.

Rating at last inspection:

At the last inspection High Trees was rated ‘Good’ (Published 24 November 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection, ‘Good.’

Follow up:

We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

High Trees residential home consists of two separate houses and provides accommodation and personal care for a total of 16 people with learning disabilities and autistic spectrum disorders. The two houses, High trees and Nova, provide accommodation for up to eight people each. There were 10 people living at the service at the time of our inspection.

People were protected from the risk of harm and abuse by staff who knew how to recognise and respond appropriately to any concerns that they had. Staff knew how to support people safely. Risks associated with people's care and support had been appropriately assessed and included ways to enable people to take risks, which respected their wish to try new things. Staff were knowledgeable about the Mental Capacity Act 2005 and enabled people to make decisions for themselves as far as possible.

There were sufficient staff employed to meet the needs of each individual living at the service. Staff did not start work until checks had been made to make sure they were suitable to support people and keep them safe. People were supported by a staff team who had the knowledge and motivation to be able to enhance their lives. People's independence was actively promoted. People and their families were included in any decision making and their views respected about what they wanted to do each day. Relatives were fully involved in the lives of their family members and good levels of communication were maintained. People were supported to access external healthcare support when required.

People had their nutritional needs assessed and were supported to be involved in meal preparation. Mealtimes were friendly and sociable occasions with much interaction between people and staff. People were supported to take their medicines as prescribed. Medicines were ordered, stored and dispensed according to national guidelines.

People enjoyed kind and caring support from the staff team. Staff treated people with high levels of respect and acceptance of their uniqueness. Care and support was provided with dignity and people’s privacy was maintained. People and their families were fully involved in the development of individual care and support plans. A large range of activities, both joint and individual to the person was available. Much support was provided by staff to enable people to take part. People were actively supported to talk about their views on the service provided, and make a complaint if required.

The head of home was approachable. There was a positive and inclusive culture in the service where the staff and head of home worked together as a team to ensure people's needs and wishes were met. The registered manager and director of High Trees, who also were the providers of the home, visited the home every week and were available to support the head of home and their team. The providers had checks in place to monitor the quality of the service and encouraged staff to drive improvements in the service.

We talked with some of the people who lived in the home and they said they were well looked after. They said the staff always asked them how they would like things to be done, were always mindful of their privacy and treated them with respect. They told us staff talked with them about how they would like their support to be provided.

We saw some people were not fully able to express their views or tell us what they thought of the service. We watched how they responded to the staff. People appeared relaxed and comfortable with the carers.

People told us they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training the home had arranged for them to attend so they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said the staff were friendly and always acted professionally. One person said, “They fuss over me”.

The provider had developed a system whereby they can monitor how well the home is meeting the needs of the people who live there.

This service was run as three separate living areas. Four people lived in two of the areas and eight in the other.

People who lived in this service had varying abilities to communicate. Some of the people who lived in this service were unable to talk with us. Because of this we looked at records, talked with staff and observed the way that the care was provided.

Some people told us that they were well looked after. They said that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect.

Many people were able to make it clear to us that they liked living at High Trees. Some said such things as, “I like it here” and, “It’s good”.

People told us that they felt able to raise any issues with the managers or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. They told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.

We saw that staff were always available when people needed help. People told us that staff were friendly and always acted professionally. One person said that they were, “Very nice” and another said, “The staff are good”.

The home’s management held regular meetings with the people who use the service to find out what people thought about how their care was delivered.

You can see our judgements on the front page of this report.