Cherry Trees

Cherry Trees is a care home providing personal care for up to 66 older people some of whom were living with dementia. At the time of the inspection there were 60 people living in the home. Cherry Trees is a purpose-built care home consisting of 4 separate units, each of which has separate adapted facilities.

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

People were safeguarded from the risk of abuse. Staff knew what actions to take if they suspected abuse. The management team took appropriate actions to keep people safe. Risks associated with people's care were identified and managed safely. Accidents and incidents were analysed and trends and patterns were identified. Actions were taken to mitigate future risks.

People received their medicines as prescribed and by staff who were trained and competent to administer medicines safely.

The home was clean and well maintained. Scheduled maintenance of the building and equipment took place in line with current guidance. The provider had a safe recruitment process in place which ensured suitable staff were employed. There were enough staff available to respond to people in a timely way.

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.

Person centred care was promoted throughout the home. We observed staff interacting with people in a caring and supportive way.

We saw evidence the provider had involved professionals in people's care and had promptly sought assistance from relevant professionals when required. People, relatives, and staff were supported to feedback about the home and had several opportunities and forums to facilitate this.

The management team completed a series of audits to ensure standards were maintained. Actions identified were promptly resolved.

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 good (published 8 November 2019).

Why we inspected

We received concerns in relation to leadership, the management of medicines, meeting people’s needs and risks associated with people’s care. 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 remained good, based on the findings of this 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.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

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

Follow up

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.

The home had a system in place to support relatives to visit their family members by using a pod which was accessed via the garden area. Window visits, telephone and video calls were also available to assist people to keep in contact with their relatives.

On arrival to the home, essential visitors were asked to complete and sign a screening form regarding COVID-19 symptoms and were asked to sanitiser their hands, put on a facemask and have their temperature checked prior to moving from the reception area. This was to ensure they were not showing any symptoms of illness.

Risk assessments were in place to consider and reduce any impact to people who may be disproportionately at risk of COVID-19. Social distancing was observed as far as it was practicable to do so. Seating throughout the home had been positioned to help maintain a safe distance between people. Staff wore appropriate Personal Protective Equipment (PPE), regularly washed their hands and applied hand sanitiser.

Tests for COVID-19 were carried out monthly for people living at the service. Staff were tested three times a week. If a test result was positive, the person was required to isolate in line with government guidance.

The home was clean and there were no malodours. Staff had access to cleaning products and high touch areas such as door handles and handrails, were cleaned regularly. Decontamination sprays were used regularly throughout the home to help minimise the spread of infection.

Staff had completed training in infection control, COVID-19 and donning and doffing PPE.

The provider had a COVID-19 committee which was led by the senior leadership team. This committee supplied the home with any updates and shared information regarding the pandemic.

Cherry Trees is a registered care home providing personal care to up to 66 older people some of whom were living with dementia. At the time of the inspection there were 62 people living in the home.

Cherry Trees is a purpose-built care home consisting of four separate units, each of which has separate adapted facilities.

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

People, and their relatives, consistently told us they received a high-quality service at Cherry Trees and that they would recommend it. One person who used the service said, "I can't speak highly enough of all of them [staff]." Staff at all levels demonstrated an exceptionally caring approach that made people feel safe, comforted and valued. People told us they were listened to, involved in all decisions and respected. One relative who provided us with feedback said, “The staff are so caring, welcoming and approachable." Another relative told us, "The staff have been exceptional in their approach to all aspects of [person’s] care and needs."

The service assessed people's needs holistically and with their full involvement and care plans were designed to meet those needs. Care plans were individual to each person and reviewed on a regular basis. Staff knew people's needs and preferences well resulting in a tailored service. The service provided exceptionally responsive, person-centred support to people which consistently achieved outstanding outcomes for people. Staff provided excellent consistency and continuity of care which had a positive impact on people's quality of life. Staff were particularly skilled at involving people and their family, together with health and social care professionals in their care and support plans, so that they felt consulted, empowered, listened to and valued.

Staff went the extra mile to find out people’s past and current interests to enable people to carry out person-centred activities which enriched the quality of their lives. People were supported to maintain relationships that mattered to them which protected them from the risk of social isolation and loneliness. The registered manager used concerns to improve the service. The service worked closely with healthcare professionals and provided outstanding end of life care, which ensured people experienced a comfortable, dignified and pain-free death.

Staff had been safely recruited and the people who used the service had been involved in this process. People told us there were enough staff to meet their needs. The risks to people, visitors and staff had been identified and mitigated. Procedures were in place to help protect people from the risk of abuse and infection.

People received their medicines safely and as prescribed and their health needs were met. People told us they enjoyed the food provided, that they had choice and plenty to eat and drink. When accidents occurred, these were assessed to prevent reoccurrence and help protect people from harm. People told us they had no need to complain but would feel comfortable in doing so should the need arise; a policy was in place to manage any such complaints. Where people had specific communication needs, these were met on an individual basis.

All the people we spoke with talked highly of the staff and management team that supported them. They told us they had confidence in them, that they were well trained and knew them well. Staff agreed that they were well supported and felt valued. This had resulted in a positive, encouraging and supportive culture which benefited all. People, staff and visitors supported one another, and mutual respect was evident. The management team demonstrated a commitment to the service and procedures were in place to monitor and improve the service.

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

Rating at last inspection

Good (report published 30 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Cherry Trees is situated in the Kimberworth Park area of Rotherham. The service provides accommodation for up to 66 people who require personal care. The home has four units, one of which was closed at the time of our inspection.

The service had a registered manager in post at the time of our inspection. 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.

The management team consisted of the registered manager who was supported by a deputy manager and a team of senior care workers. We spoke with staff who felt supported by the management team. There was evidence of good leadership at all levels. Staff knew their roles and responsibilities and when to pass something on to the senior care worker.

We spoke with staff about safeguarding people from abuse and they were very knowledgeable about this. They knew how to report any concerns and were confident that appropriate action would be taken.

We looked at systems in place to manage medicines and found that they were safe.

We looked at staff recruitment files and found the provider had a safe and effective system in place for employing new staff. Satisfactory pre-employment checks had to be received prior to the person starting work at the service.

Care plans we looked at identified any risks associated with people’s care. Plans of care were put in place to reduce the risk from occurring.

We spoke with staff who said they received appropriate training which gave them the skills and confidence to carry out their responsibilities. They found training valuable and worthwhile.

The service was meeting the requirements of the Mental Capacity Act 2005.

People were offered a choice of food at each meal and drinks and snacks were provided throughout the day in line with their preferences and dietary requirements.

We looked at care records and found that referrals were made where appropriate and that staff acted on the advice given.

People we spoke with all told us that staff promoted their independence by helping them to make decisions about their daily routine and what they wanted to do. People felt that staff chatted with them and felt they were listened to and that their opinions mattered.

During our inspection we observed staff interacting with people who used the service. We saw that staff had developed positive, caring relationships with people based on their individual preferences and choices. It was evident that staff knew people very well.

We looked at care records and found they were informative and reflected the care and support being given.

The service employed two activity co-ordinators who were available over seven days a week and provided social stimulation to people.

The service had a complaints procedure and people felt at ease to raise concerns. People we spoke with felt their concerns would be listened to and addressed satisfactory.

People told us the registered manager was supportive and there was a good leadership structure in place.

We saw regular audits took place to check the quality of service provision.

People were involved in the service and their views were sought.