Cherry Tree Care Centre

Cherry Tree Care Centre is a residential care home providing personal care to up to 40 people. The home provides support to people living with dementia. At the time of our inspection there were 34 people using the service.

People’s experience of using this service and what we found

Medicines were not managed safely. The home did not follow best practice guidance for the receipt, storage, and administration of medicines. Medicine record keeping was inaccurate and incomplete.

Risks to people had not always been recognised and mitigated. Care plans held inaccurate information and lacked detail to support staff to keep people safe. Incorrect calculations relating to people’s weight management were not identified. Some best interest decisions regarding the use of bedrails were not in place. The deputy manager addressed this matter immediately.

The provider did not have effective systems to monitor the safety and quality of the care provided. This meant the failings we found had not been identified by the registered manager and the provider.

Staff completed safeguarding training. Incidents and accidents and safeguarding concerns were recorded. The provider had recognised that changes could be made in this area to drive improvement. People lived in a safe environment. Health and safety checks were regularly conducted.

The provider had a robust recruitment process. Enough staff were deployed to meet people’s needs. The home had a warm friendly atmosphere. Staff knew people well. People told us they felt safe and staff treated them with respect.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice. The home worked with external healthcare professionals to support and maintain people’s health.

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

Rating at last inspection and update

The last rating for this service was good (published 9 December 2019).

Why we inspected

The inspection was prompted in part due to issues within medicines, infection control, and quality assurance monitoring at the provider’s other services.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Due to the shortfalls found during the inspection the provider was requested to produce an action plan detailing what action and by when, they would address the issues identified.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, risk monitoring and management, and the governance of the home.

Follow up

We have already requested an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• Systems were in place to prevent visitors from catching and spreading infections. Visitors were screened before they could enter the building.

• Staff promoted and practised safe social distancing throughout the home. Systems were in place to shield and isolate people should outbreaks occur.

• Sufficient supplies of personal protective equipment (PPE) were in place. Staff received regular training in infection prevention and control measures and the appropriate use of PPE.

• Clear systems were in place to admit people safely into the home.

• People and staff were regularly taking part in the Covid testing programme.

Further information is in the detailed findings below.

Cherry Tree Care Centre is a residential care home providing personal care to 40 people at the time of the inspection. The service can support up to 42 people across two floors, each of which has separate adapted facilities. One floor specialises in providing care to people living with dementia.

People’s experience of using this service and what we found

People and their relatives all gave very positive feedback on the home. One person told us, “I couldn’t be in a better place. Nothing could be improved. It is pleasant, cheerful and helpful. They are only too pleased to help with anything. The atmosphere seems really positive.”

Everyone we spoke with felt safe in the home. There were systems and processes in place to help protect people from the risk of abuse.

There were enough staff on duty to meet people’s needs. Staff understood the needs of the people they supported well. Safe recruitment procedures were followed.

Medicines were managed safely at the home, however records of the application of creams were not always completed correctly and the manager was looking for ways to address this. Risk assessments were in place, so staff had the information necessary to minimise risk.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The dining experience was relaxed and enjoyable and the quality of food was good. People were supported with eating and drinking, and any special dietary needs were met. People were supported to have access to a range of healthcare professionals to ensure they remained healthy.

There was a caring culture supported by a strong staff team who respected people and treated them with dignity. Staff encouraged independence and supported people to maintain their skills. The service had a relaxed, homely atmosphere and relatives were always welcome.

People's care was delivered around their wishes and preferences and care plans reflected this.

People had access to a variety of activities inside and outside of the home.

A range of audits and checks were carried out to monitor the quality and safety of the service. Action was taken if any issues or concerns were identified.

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

Rating at last inspection

The last rating for this service was requires improvement (published 28 November 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.