About the service:

Cherry Trees Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 25 people. There were 23 people living at the home at the time of the inspection.

People’s experience of using this service:

People were happy with the care they received from the staff at Cherry Trees Care Home.

People and family members told us that safe care was provided.

Staff were well trained and received appropriate support and supervision.

People received their medicines as prescribed and infection control risks were managed effectively.

Individual and environmental risks were managed appropriately, and people were protected from avoidable harm.

People's rights to make their own decisions were respected. Staff supported people to make choices in line with legislation.

People were supported to access health and social care professionals if needed.

People's dietary needs were met and people were provided with enough to eat and drink.

Staff were kind, patient and responsive to people's needs. People were treated with dignity and staff respected their privacy.

People knew how to complain and were confident that if they raised concerns, the management would act promptly to address these.

People and staff were fully engaged in the running of the service.

The management team were open and transparent. They understood their regulatory responsibilities.

A quality assurance system was in place to continually assess, monitor and improve the service.

The service met the characteristics of Good in all areas. More information is in the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

The service was last inspected in April 2018 where we undertook a full comprehensive inspection (report published June 2018). It was awarded a rating of Requires Improvement.

Why we inspected:

This was a planned inspection based on the previous inspection rating.

Follow up:

There is no required follow up to this inspection. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

Cherry Trees Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 25 people. There were 23 people living at the home at the time of the inspection.

The home was based over two floors, connected by a passenger lift and stairwells. Not all bedrooms had en-suite facilities but there were toilets available on each floor. There was one communal space available for people to socialise.

The inspection was conducted on 27 April and 2 May 2018 and was unannounced.

At the time of the inspection there was not a registered manager in post at the service, there was a manager who had taken over the overall running of the service and was planning to apply to become registered to manage the home. 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 and associated Regulations about how the service is run.

At our last inspection, in April 2017, we gave the service an overall rating of ‘Requires improvement’ and identified a breach of regulation12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to mitigate risks to the health and safety of people using the service effectively. The provider wrote to us, detailing the action they would take to address the concerns.

At this inspection we recorded two breaches of Regulations in relation to Safe Care and Treatment and Good Governance . You can see what action we told the provider to take at the back of the full version of this report.

Systems and processes used to monitor the quality and safety of the service had not been fully effective in preventing the shortfalls found at this inspection.

Risks to people had been assessed; however information within people’s risk assessments and care records was not always followed by staff and guidance from professionals to keep people safe was not always followed.

Action had not been taken to ensure the laundry area was free from clutter or that the flooring was appropriate to mitigate the risk of infection and cross contamination.

Where accidents, incidents, and near misses had occurred there was a process in place which recorded the incident. However, the information provided of the incident/accident or near miss was not always detailed and ideas of how to mitigate risks or prevent reoccurrence had not always been considered, followed up or implemented. Medicines were not kept secure at all times or administered safely.

Consent to care was not always obtained in line with the Mental Capacity Act 2005.

People were protected from the risk of abuse and staff knew how to identify, prevent and report abuse. Staff understood how to keep people safe in an emergency.

There were enough staff to meet people’s needs in a timely way. Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.

People’s needs were met by staff who were competent, trained and supported appropriately in their role. Staff followed the principles of the Mental Capacity Act 2005 (MCA) and sought verbal consent from people before providing care.

People were supported to have enough to eat and drink and had access to health professionals and other specialists if they needed them. Staff worked in partnership with healthcare professionals to support people at the end of their lives to have a comfortable, dignified and pain-free death.

Staff showed care, compassion and respect to the people and people spoke positively about the attitude and approach of staff. There was a relaxed and calm atmosphere within the h

This comprehensive inspection took place on 9 March 2017 and was unannounced. Cherry Tree Care Home provides accommodation with personal care for up to 25 people, including for people living with a cognitive impairment. At the time of the inspection 24 people were living at the service with one person expected to move in later that day.

The home was based over two floors, connected by a passenger lift and stairwells. Not all bedrooms had en-suite facilities but there were toilets available on each floor. There was one communal space available for people to socialise.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Not all risks to people were minimised through the use of effective risk assessments which identified potential risks and provided information for staff to help them avoid or reduce the risks of harm.

Not all risks posed by the environment had been assessed or mitigated. For example, doors to corridors and people’s rooms were wedged or hooked open and some bedroom doors did not fully close. This would put people at risk in the event of a fire.

People were supported to receive their medicines safely. However, medicine was not always stored at a safe temperature.

People were protected from the risk of abuse and staff knew how to identify, prevent and report abuse. Individual risks to people were managed appropriately and staff understood how to keep people safe in an emergency.

Appropriate pre-employment checks were completed before new staff commenced working in the home and there were enough staff to meet people’s needs.

A training programme was in place although not all staff had completed all essential training in a timely manner.

Although people were satisfied with the way they were treated we found there was a task driven approach to care and staff did not always respect people’s right to choose when they got up in the morning.

Staff followed legislation designed to protect people’s rights.

People were encouraged to remain independent and their privacy and dignity was respected. People received a varied diet and were supported appropriately to eat. People received mental and physical stimulation in the form of organised activities.

There was a complaints policy in place and people knew how to raise concerns. Where issues had been raised the provider had acted to the satisfaction of the person raising the concern.

We identified breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We spoke with five of the 25 people living at Cherry Tree and met two other people living there. People said they were comfortable and happy and staff took care of them well. One person told us “I have no grumbles at all”. Another said “[the care] is first class. I’m looked after very well”.

We also spoke with three visitors to the home. One told us “I would recommend the home to anyone”. A visiting health professional told us “I have no concerns with the care provided here”.

We spoke with five care staff, the manager and provider. Staff were well informed of people’s needs and records showed people received care as documented in their care plan. We observed staff to be supportive and caring with people.

All parts of the home we viewed were clean and infection prevention and control measures were in place. Cleaning staff knew their duties and records showed these were carried out.

We viewed two staff records. These contained all relevant information and checks carried out before employment commenced. Processes were in place to ensure people using the service, their relatives and health professionals could give feedback about the service. Records showed action had been taken to improve the service.

This inspection was following up on concerns identified during an inspection carried out on 26 September 2012. We viewed records of food and fluids that had been provided to people. We also viewed records of people's food and drink preferences. We spoke with three people using the service, the registered manager and three other staff. We found that people were being offered a range of nutritious meals and that these had been adapted to meet people's various nutritional requirements. Records we viewed were up to date and a system was in place for reviewing and monitoring them.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by a practising professional.

We spoke with 13 people who were living at the home, three relatives, a visiting healthcare professional and eight staff as part of our visit. We observed how people spent their time, the support they received from staff and whether they had positive outcomes.

People told us that they were treated with respect and that the staff were kind. They said that they received help and support when they needed them. They told us that they had a choice to take breakfast in their bedrooms. Other people spoken with said that they liked to go downstairs to the main dining room for lunch. One person told us that they preferred to have their meals in their room as they needed to rest their legs and “this was not a problem”. They told us that they were offered choices with their daily activities such as when they got up and went to bed. Five people said that the staff were very good at maintaining their privacy when receiving personal care. Comments included “yes they always close the door”. Another person said “they treat you well and especially the young girls”. One person said that they received “excellent care”. When we asked a person if the staff respected their privacy and dignity a person commented “more than”

We observed that the staff spoke to people in a calm manner and offered people choices with drinks at coffee time and a choice of biscuits. People were supported to mobilise and staff were seen to monitor their movements to ensure that they were safe. Relatives told us that they had visited the home prior to their relative moving into the home. They felt that they were given adequate information to make an informed choice.

This inspection took place on 18 and 21 August 2015 and was unannounced.

Cherry Tree Care Home provides accommodation for people requiring personal care. Care is provided over three floors and the home can accommodate up to 25 people. At the time of our inspection 22 people were living at Cherry Tree. The home had a large lounge/dining room, and outside space which was accessible to people.

The home 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.

Care provided at Cherry Tree Care Home was safe. Risks to people’s health and wellbeing were assessed and managed. People receive their medicines appropriately and these were stored safely.

There were enough staff to care for people’s needs and spend time talking with people. People had good relationships with staff and complimented them on the standard of care they received. Staff knew people’s preferences well and respected these. They ensured they gained people’s consent before providing care and took care to respect people’s privacy and dignity.

People felt safe in the home. Staff were knowledgeable about safeguarding people from abuse and were confident to report any concerns they may have. People had access to healthcare when this was required and were supported to attend appointments if needed. People had no complaints but were confident a complaint would be taken seriously as minor concerns had been acted on promptly.

Food served in the home was attractively presented and nutritionally well-balanced. People had a choice and said they could eat their meals when and where they wanted to. When people required support to eat and drink this was provided with respect and discretion and at the appropriate level to help people retain their independence

The registered manager led the service well. They supported staff informally as well as through supervision meetings and guidance. Staff were well trained for their role and had opportunities to gain further qualifications. A friendly and calm atmosphere prevailed in the home and it was clear that people had developed positive relationships with staff.

A variety of meaningful and enjoyable activities were available to people. The service monitored the quality of the care provided and made improvements as a result of feedback from staff and people living in the home. All the feedback from visitors, relatives, and health professionals was positive.