Archived: Cherry Tree

Updated 12 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 September 2018 and was unannounced.

The inspection was carried out by one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed the information we held about the provider, including previous inspection report, notifications and information about any complaints and safeguarding concerns received. Notifications are events which providers are required to inform us about. We also reviewed information that we had received from the local authority and Healthwatch. We did not receive the Provider Information Return (PIR) due to technical issues. The PIR is a form in which the provider tells us what improvements they plan to make and what they do well.

During the inspection, we spoke with two people who used the service. We also spoke with three relatives on the telephone to obtain their views of the quality of the service. We reviewed three people's care files, people's medicine administration record (MAR) sheets, health and safety records and quality assurance checks. We spoke with three care staff and the regional director. We were not able to access staff files during the inspection as the acting manager, who held the keys to the filing cabinet, was away. After the inspection the provider reviewed staff files and sent us information on their staff recruitment, supervision and annual appraisal processes.

Updated 12 October 2018

Cherry Tree 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 support to a maximum of seven people. At the time of the inspection there were five people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection in March 2017 the service was rated Good. At this inspection we found the service remained Good.

The service did not have a registered manager in post, however, it was managed by an acting manager who had applied to register with the CQC. 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.

Medicines were not managed safely. We found people's medicines were not always kept securely in locked medicine boxes. This put people's health and safety at risk.

Staff had been trained in the Mental Capacity Act 2005 (MCA) and people's care plans showed mental capacity assessments had been completed and applications for Deprivation of Liberty Safeguards (DoLS) were made to local authorities. We found some staff were not confident in their understanding of MCA.

Although the premises was free from malodours, we noted that there were areas that needed cleaning, repair or replacing. We made a recommendation in this area.

There was a robust staff recruitment system in place to ensure staff were checked and safe to support people.

Staff were provided with induction, training and supervision opportunities. However, their satisfaction with their support from management was mixed with some saying they felt supported and others stating they did not feel well supported.

The service had enough staff to provide care and support for people. However, we noted that the service relied on agency and bank staff to cover shifts due to absence and turnover of staff. The provider was recruiting new staff the reduce the impact of this on the continuity and consistency of care.

Staff had appropriate personal protective equipment and knowledge to ensure the risks of infections were minimised whilst supporting people.

Risks to people were identified, recorded and reviewed. Staff were aware of the steps to take to ensure risks to people were managed.

Various health and safety aspect of the service such as of fire alarms, fire doors, electrical equipment and cleaning were in place to ensure people's safety. One of the fire doors in the annexe was out of order but there was an alternative fire exit whilst this was being rectified.

Each person had a care plan which described their needs, preferences and how they wanted to be supported. People and relatives told us they were involved in the review of their care plans.

People had a choice of meals. Staff supported and encouraged people to choose, prepare and have their meals at the times of their choice. Staff also worked with healthcare professionals to ensure people had access to healthcare.

The service had a complaints procedure presented in a format suitable for people to understand. No complaints had been received since our last inspection. People's communication preferences were identified and staff knew how to communicate with them.

People's preferences of activities were identified and they had opportunities to go to different places of interest.

The provider sought feedback from relatives to ensure that their views were used to improve the service. Regular audits of aspects of the service such as health and safety and the records were undertaken to make sure appropriate action was taken to address any shortfalls.