This inspection of Cherry Tree House took place on 8 and 14 May 2018 and was unannounced. At the last inspection in February 2017 the service did not meet all of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. That was because the provider had not deployed sufficient staff to meet people’s needs, ensured people were occupied and entertained or notified the Care Quality Commission (CQC) of a serious accident. They were in breach of two regulations relating to staffing and sending notifications. At that inspection the service was rated ‘Requires Improvement’.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Is the service safe?, Is the service responsive? and Is the service well-led?, to at least good. They sent us an action plan stating when and how they would achieve the improvements needed.

At this inspection the provider’s deployment of staff was sufficient to meet people’s needs, activities were taking place and we had been told about all events that required a notification being sent to us. However, there was some improvement needed with regard to medicines management, to ensure the store room remained below the recommended temperature for storing medicines and those to be returned were safely accounted for. The registered manager assured us these would be addressed. The service was rated as Good.

Cherry Tree House is situated in the Ashby area of Scunthorpe close to local shops and amenities. The home is registered to provide accommodation and personal care for up to 34 people, some of whom may be living with dementia. Communal rooms: lounge, dining and bathroom, are located on two floors along with people’s bedrooms, so that the premises are sectioned into four wings. Staff, catering and laundry facilities are all on the ground floor. An enclosed garden provides a safe outdoor space where sheltered seating is available. At the time of this inspection there were 12 people permanently living at Cherry Tree House and three people staying there on respite.

Cherry Tree House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager who had been in post for the last 25 years. A registered manager is a person who has registered with the CQC 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 were protected from the risk of harm. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of safeguarding concerns. The premises were safely maintained. Accidents and incidents were appropriately managed and equipment was safely used. Recruitment policies, procedures and practices ensured staff were suitable to care for and support vulnerable people. People were protected from the risks of infection and disease by good infection control management. Lessons were learnt when things went wrong.

People made choices and decisions wherever possible in order to exercise control over their lives. They were supported by qualified and competent staff that were regularly supervised and received annual appraisals of their personal performance. Staff respected people's diversity and met their individual needs. People’s nutrition and hydration needs were met. The provider worked well with other health and social care professionals. People were supported with their health care.

The premises were suitable for providing care to people with dementia but needed improved signage to aid pe

Cherry Tree House is situated in the Ashby area of Scunthorpe close to local shops and amenities. The home is registered to provide accommodation and personal care for up to 34 people some of whom may be living with dementia. At the time of our inspection there were 23 people using the service.

We undertook this unannounced inspection on the 8 and 13 February 2017. The service was last inspected in November 2014, when it was found to be compliant with the regulations inspected and was rated as good.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found there were not enough staff available to meet people’s needs, which meant their health, safety and welfare was potentially placed at risk. This was a breach of the staffing regulation and meant the registered provider was not meeting the requirements of the law. You can see what action we told the provider to take at the back of the full version of the report.

Safeguarding training had been provided to enable care staff to recognise and report potential signs of abuse. Recruitment checks were carried out to ensure care staff were safe to work with people who used the service. Risks to people were monitored and assessed, although accidents had not always been appropriately reported which meant people’s health and wellbeing was potentially compromised at times. This was discussed with the registered manager who acknowledged this was an oversight on their behalf. People’s medicines were administered in a safe way, by care staff who had received training on this aspect of their role.

Care staff were provided with a range of training opportunities to help them develop their careers and carry out their roles. People received a choice of nourishing home cooked meals and were consulted about their care and support. Community based health care professionals confirmed the service had good working relationships with the service.

Care staff were familiar with people’s needs and we found they had developed strong relationships with people. Care staff involved people in decisions about their support, to ensure their wishes and feelings were respected.

Opportunities for people to meaningfully interact with staff in activities was sometimes limited, which meant their health and wellbeing was not always fully promoted. People were able to raise concerns and complaints and have these investigated and resolved wherever possible.

People who used the service, their relatives and staff had confidence in the registered manager. Management checks were carried out to enable the quality of the service to be assured, although accidents and incidents had not always been reported to the CQC as required. Action was not always taken address shortfalls when noted to enable improvements when required.

One of the people stated in their care plan “I can make my own decisions and choices. I communicate well with staff and family. “Another said “Sometimes I need to be told what time it is and need prompting at meal times to eat my food.” We found this all recorded in the care plan.They told us they received good care. One person said “If I need help I only have to ask”.

People were provided with a choice of suitable and nutritious food and drink. We visited the kitchen and looked at the weekly menu. The cook told us the menus were changed every four weeks. We saw there were choices of different foods and options for people who had special dietary needs.

We looked at the laundry facilities. There was a process for segregating clean and dirty laundry. This ensured the risk of cross contamination was minimised. We also found there were suitable arrangements in place for the handling and disposal of clinical waste. The manager told us that regular checks were carried out of the environment and we saw cleaning rotas were in place and checks regarding cleanliness of facilities were completed.

The manager told us that they were always willing to listen to complaints and deal with them in the appropriate manner. Staff we spoke to said they would not hesitate in contacting the manager if they had a problem. One member of staff said, "If I passed on a complaint to my manager I know it would be listened to and acted on effectively."

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. We looked around various parts of the service. We found it was clean and free from odours.

People who used the service told us they were “Very happy” with the service and had made a positive decision about moving into the home. We found that information about the home was available to help people know what to expect from the service.

We saw that staff demonstrated a caring and professional manner that was open and friendly. We observed that staff interacted with people in a positive and encouraging way and involved people in decisions about their support. One person said that staff were “Like Angels”.

People told us they were “Very comfortable” and that staff treated them well. People that used the service said they had “No concerns” about the home.

We found that appropriate recruitment checks were carried out, before staff had begun working in the home to ensure they were safe to work with people that used the service.

We saw evidence of regular meetings and surveys of people’s views to enable them to be consulted and contribute ideas and suggestions for the home. We saw that systems were in place to enable the health, welfare and safety of people that used the service to be monitored effectively by the provider.

At the unannounced inspection on 18 August 2011 we spoke to six people who told us that all their needs were currently being met. Some people liked to do things for themselves when they could such as dusting and making their own bed. They talked about how patient and caring staff are when ensuring their care needs are met.

This inspection took place over two days on 5 November and 6 November 2014 and was unannounced. At our last inspection in August 2013 the service was meeting the regulations inspected.

Cherry Tree House is situated in the Ashby area of Scunthorpe close to local shops and amenities. The home is registered to provide accommodation and personal care for up to 34 older people, some of whom may be living with dementia.

There was a registered manager in post at the service. 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.

Staff received training about the protection of vulnerable adults from harm or abuse and were familiar with roles and responsibilities for reporting safeguarding or whistleblowing concerns.

Recruitment checks were carried out on new staff before they were allowed to start work to ensure they were safe to work with people who used the service and did not pose an identified risk to their wellbeing and safety.

A variety of training was regularly provided to ensure staff were able to safely carry out their roles. Regular supervision and appraisals of staff skills were carried out to ensure their performance was monitored and they were able to develop their careers.

Information was available about the assessed needs of people who used the service to ensure staff supported and respected their wishes and feelings about these. Details about known risks to people were recorded and monitored, together with guidance for staff on how these were managed and people were supported to make sensible decisions and kept safe from harm.

Staff demonstrated a good understanding of the promotion of people’s personal dignity and privacy, whilst involving them in making active choices about their lives.

People who had difficulty with making informed decisions were supported by staff who had received training about the promotion of people’s human rights to ensure their freedom was not restricted. Systems were in place to make sure decisions made on people’s behalf were in their best interests.

Systems were in place to ensure people’s medication was handled safely.

People were able to make choices from a variety of wholesome and nutritious meals. Assessments about people’s nutritional needs and associated risks were monitored with the involved specialist health care professionals when required.

A complaints procedure was in place to enable people to raise concerns. People’s complaints were followed up and addressed and wherever possible resolved.

Regular management checks were carried out to assess the quality of the service and identify where any changes were needed.

There were limited opportunities available at the time of our inspection visits, for people to engage in meaningful activities, although the registered manager was in the process of recruiting a replacement member of staff to take responsibility for this and ensure people’s wellbeing was fully promoted. We recommend the service considers the National Institute for Health and Care Excellence (NICE) Quality Standard for supporting people to live well with dementia QS30.

Systems were in place to monitor the environment and to put right any potential hazards. The registered manager was waiting for authorisation from the registered provider for work to be completed which had been requested by the fire department in these respects.