Trees is a residential care home for 22 people, some of whom may be living with dementia. People have their own rooms with shared bathing and social facilities. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us they felt safe and staff knew how to report any concerns. Risks were managed in a person-centred manner with measures in place to minimise the risk of harm. Staffing levels ensured people’s needs were met promptly as they worked well as a team and medication was safely managed. Staff had received relevant training and had access to regular support from the leadership team. The home was clean and fresh.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s nutritional and hydration needs were met with a varied menu and they were able to access health and social care support as needed.

Staff were caring, kind and considerate, providing reassurance and encouragement where needed. People’s privacy and dignity was respected and wherever possible people were included in discussions about their care needs.

Care records were detailed and reflected people’s needs, providing staff with necessary information and guidance. Complaints were handled well and compliments were shared with staff.

The registered manager and provider were committed to delivering high standards of care and the policies, procedures and systems supported and evidenced this. Where improvements were needed, these were actioned promptly and effectively. Best practice was followed and people were happy and settled in their home.

Further information is in the detailed findings below.

The inspection of Trees Residential Care Home took place on 8 September 2015 and was unannounced. The service had previously been inspected in August 2013 and was found to be fully compliant at that time.

Trees Residential Care Home provides residential care for 22 older people. There were 19 people living in the home on the day of our inspection, of whom two were on respite. Everyone has a single room. The home is situated in a residential area close to the centre of Pontefract and all local amenities and facilities. There is a car parking area to the front and lawn areas to the front and back of the building.

There was a registered manager in post although they were not there on the day of the inspection due to annual leave. We spoke with the deputy manager and the registered provider on the day and we spoke with the registered manager following the inspection. 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.

People we spoke with told us they felt safe and staff were able to identify what may constitute a safeguarding concern. Staff were able to explain various techniques they would use to try and avert such situations, if they arose between people living in the home and staff knew how to report more serious concerns. Staff we spoke with told us they had never had to raise any concerns about their colleagues.

We found risk assessments were based on individual need and regularly updated. Staff showed a good understanding of people’s specific requirements and knew what to do if there was an emergency.

Medicines were administered, recorded and stored in accordance with requirements and staff had received the necessary training to fulfil this role.

There were some areas of the environment which needed attention which we spoke with the registered provider about. These were immediately actioned or work chased up where it had not been completed.

We spoke with staff and saw records which showed they had received a comprehensive induction. They then had regular meetings with the registered manager to discuss their performance, understanding and any identified gaps in their knowledge. Staff were encouraged to contribute to these meetings and they told us they were a positive experience. This was reflected in the appraisals we found which acknowledged staff’s skills and experience.

People told us they enjoyed the food and we saw plenty of choice being offered to people throughout the day. We saw that people were encouraged to do as much for themselves as possible and staff offered assistance only where absolutely necessary. People’s nutritional intake was monitored and recorded as required.

We saw the service accessed additional health and social care resources, where needs arose, and people told us they received this quickly.

People we spoke with said staff were caring, considerate and kind and involved them in any decision-making about their how their care needs were to be met.

We saw the service was focused on meeting people’s needs, offering flexible support and based on people’s wishes. Care records were detailed and showed that the service was keen to ensure people had the opportunity to participate as much or as little as they wished in various activities within the home.

People and staff were keen to say how much they enjoyed being in the home and knew the registered manager and their deputy well. There was evidence of effective support for all staff reinforced by the robust quality assurance systems in place which were used effectively.

We spoke with three people who lived in the home, two relatives, three care staff, the manager and deputy manager.

We saw that staff treated people with respect, offered them choices and maintained their privacy and dignity. People’s comments included: “They are all very kind.” “It is ok here.” “The food is good.”

We found people were well cared for and the care documentation was person-centred. Staff showed a good understanding of people’s needs. We saw they were kind and considerate in their interactions with people.

We observed people enjoying walking around and sitting in the enclosed garden which had been upgraded. People were now able to walk through the home, out into the garden and around the house safely. “It’s lovely being in the fresh air” one person said.

We spoke with relatives who told us that they were happy with the care of their family members. We spoke with staff, who said they were happy working in the home, enjoyed working with the people in the home and the teamwork amongst the staff.

The home had a complaints procedure which we saw displayed in the entrance of the home. This provided information about the complaints process including timescales.

We carried out this inspection on 5 November 2012 to follow up on actions we asked the provider to act on at our last inspection on 13th June 2012. We found that these actions had all been met.

Because the majority of people who were living in the home had some form of dementia, we had difficulty in being able to communicate effectively with them. However we spoke to eight people who live in the home and one relative who was visiting. All the people spoken with were relaxed and happy about the care and support they received. One person said; “ I like it here the staff are ok” another said” I like the food”.

The relative was very positive about the level of care within the home and about the number of changes that have taken place over the last few months.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with relatives of two people who lived at the home .

Most of the people who live in the home have dementia and therefore were unable to tell us in detail about the quality of the service they recieved .

One person said 'staff are very good they always help'

Most of the people who live in the home have dementia we were not familiar with everyone’s way of communicating, so we were not able to gain everyone’s views. However, everyone spoken with were very positive about the staff and the support they receive. One person said, “They are lovely they always help”

The relatives who were visiting the home said that they were very happy their relatives were cared for at Oakfoss, “It’s small and homely” “staff can never do enough for people”

People were seen being supported in a way that retained their dignity.