Cherry Tree

Updated 17 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, a medicines 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.

Service and service type

This service 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.

Registered manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The manager of the service had submitted their application to register and this was in progress at the time of the inspection.

Notice of inspection

The inspection was unannounced on both days of the inspection.

What we did before the inspection

We reviewed the information we already held about the service. This included the last inspection report and notifications. A notification is information about important events, which the provider is required to tell us about by law.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make

We used all of this information to plan our inspection.

During the inspection,

We spoke with the manager, the deputy manager, a senior support worker, 5 support staff and the director. We carried out observations of people’s care and support and spoke with 2 people for their feedback on the home. We spoke with 2 relatives by telephone for their feedback.

We reviewed documents and records that related to people’s care and the management of the service. We reviewed 6 people's care plans and 4 staff training and recruitment files. We looked at other documents such as those for complaints, incidents, safeguarding, medicine management, quality assurance and infection control audits. After the inspection we continued to seek clarification from the provider to validate evidence found.

Updated 17 March 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Cherry Tree is a residential care home providing accommodation and personal care for up to seven people with learning disabilities, autistic people and people with mental health and physical health needs. At the time of this inspection six people were living at the service. People living in the home had their own bedrooms and there were shared communal spaces, including lounges, a kitchen and a garden area, all on one floor.

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

We found improvements had been made in the service following our last inspection.

Right support

The provider had made improvements following our previous inspection, to make the home safer. Systems were in place to protect people from the risk of abuse. Risks to people’s health were assessed so staff could support them safely. People’s medicines were managed safely but staff did not always record the temperature of refrigerators, which stored some medicines. The provider told us they would follow this up. Staff were recruited appropriately to ensure they were suitable to work with people. Staffing numbers in the home were sufficient so people could be supported and their needs met. Systems were in place to prevent and control infections. Lessons were learned following accidents and incidents in the home. People had control of how their care and support was arranged. People were supported to go out and visit the local community.

Right care:

Processes to assess people’s needs to determine if the home was suitable for them were in place. People received care and support that was personalised for their needs. Staff were trained to carry out their roles and received support with their development. People attended health appointments with professionals to help maintain their health. They were supported to maintain a balanced diet and their nutritional and cultural needs were met. 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.

Right culture:

The values and attitudes of staff and managers in the home enabled people to be as independent as possible, feel empowered in their daily lives and achieve positive outcomes. Managers took action to ensure staff understood their professional responsibilities to support people in the right way. The management team learned lessons when things went wrong in the home. However, people’s dignity, privacy and human rights were not always respected. We discussed this with the manager as part of ongoing improvement actions. We have also made a further recommendation for the provider to follow best practice with using effective communication tools for people.

People were supported to follow their interests inside and outside of the home. For example, we saw people go out to a day centre and take part in their preferred activities. Systems were in place to manage and respond to complaints. Feedback was sought from people and relatives to help make continuous improvements to the home.

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 the service was Inadequate, (published on 24 May 2022) and there were multiple breaches of regulations. We issued warning notices to the provider for breaches of Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 18 (Staffing).

We issued requirement notices to the provider for breaches of Regulation 9 (Person-centred care), Regulation 10 (Dignity and respect), Regulation 11 (Need for consent), Regulation 14 (Meeting nutritional and hydration needs) and Regulation 15 (Premises and equipment).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

This service has been in Special Measures since 29 June 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures and no longer in breach of regulations.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cherry Tree on our website at www.cqc.org.uk

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.