Cherrytree Residential Home

Cherrytree Residential Home is a residential care home providing care and accommodation to older people, some of whom are living with dementia, people with a physical disability, people with mental health needs, and younger adults. The service can support up to 40 people. At the time of the inspection there were 23 people using the service.

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

People and relatives made many positive comments about the service and said they would recommend it to others. A relative told us, “Every time I come in there’s activities. Staff interact with all the residents.” Another relative said, “This is the best care home I’ve visited. The staff are wonderful.”

The service had a friendly, happy atmosphere. Staff and managers worked closely together to ensure people were safe and well-cared for. Staff were attentive and met people’s needs promptly. The service’s two activity co-ordinators provided a range of group and one-to-one activities based on what people wanted to do. Staff were safely recruited and trained.

All areas of the premises were clean and well-maintained. Some areas had been refurbished and re-decorated. People and relatives said they were pleased with how the premises looked. New cushion flooring had been fitted in most areas.

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.

Staff acted promptly if people needed medical support and worked with local GPs and district nurses to ensure people’s healthcare needs were met. Accidents and incidents were reported and recorded, and action taken to reduce further risk. Medicines were managed safely, and people had their medicines when they needed them.

The provider and managers had improved the service’s governance systems meaning they had a good overview of all aspects of the service. They listened to the views of people, visitors and staff and made improvements where necessary.

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 inadequate (published 01 November 2022). At the last inspection we found improvements were needed to people’s safety, infection control, staff competency, and governance.

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

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to confirm they now met legal requirements.

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.

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 inadequate to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cherrytree Residential Home 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.

Cherrytree Residential Home is a residential care home providing care and accommodation to younger people living with physical disabilities, mental health needs and older people over the age of 65 years, some of whom were living with dementia. The service can support up to 40 people in one building. At the time of the inspection there were 28 people living at the service.

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

People were not safe because unexplained injuries were sustained and were not always identified, investigated or reported. Risk was not always identified or managed.

People were at risk of catching infections because not all areas of the service were clean.

People mostly had their medicines at the right time and in a safe way, however, not all staff had their competency assessed regarding managing people’s medicines.

Oversight and leadership were ineffective. The provider and registered manager were not aware of all incidents which had occurred at the service. Some people’s relatives expressed some frustration about a lack of communication, missing personal items and restricted visiting arrangements.

Audits had not identified shortfalls such as food and fluid records not being completed for all people who were losing weight. Care plans and risk assessments were not fully reflective of people’s needs. Mechanisms for seeking feedback from people using the service were limited. This meant people’s views and feedback were not always used for driving improvement.

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.

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

The last rating for this service was good. (Published 19 January 2022).

Why we inspected

The inspection was prompted in part due to concerns received about safety and leadership. A decision was made for us to inspect and examine those risks.

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 inadequate based on the findings of this inspection.

Enforcement

We have identified breaches in relation to safety, protecting people from abuse and leadership.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Cherrytree Residential Home is a residential care home providing care and accommodation to younger people living with physical disabilities and mental health and older people over the age of 65 years, some of whom were living with dementia. The service can support up to 40 people in one building. At the time of the inspection there were 21 people living at the service.

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

People were supported to stay safe and maintain their health and well-being. Risks were identified and responded to. There was a system in place to report any incidents, including safeguarding concerns, which were analysed for any themes or trends. People were supported by enough staff who knew them well and had been safely recruited. Staff administered people's medicines in a safe way. The environment was clean and good infection control procedures were followed.

People and their relatives were involved in planning for their care. People and their relatives knew how to raise their concerns and complaints about the service. The registered manager checked and assessed the quality of the care and support provided to people. They worked to ensure people received high quality care, and achieved the best possible outcomes. The provider worked in partnership with other organisations to develop 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

The last rating for this service was good (published 12 March 2020).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and cleanliness. A decision was made for us to inspect and examine those risks. We carried out a focused inspection of this service on 15 December 2021. This report covers our findings in relation to the key questions safe and well led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained good. This is based on the findings at this inspection.You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cherrytree Residential Home on our website at www.cqc.org.uk.

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 until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Cherrytree is a residential care home providing personal care for to 40 people. The service supports older and younger people, people with a physical disability and mental health needs. At the time of our inspection 20 people were using the service. Accommodation is provided across two floors with communal lounges and areas.

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

People received safe care and were protected against avoidable harm, neglect and discrimination. Risks to people’s safety were identified and assessed. Strategies were put in place to reduce the risks. People received their medicines safely. There were sufficient numbers of staff who had been safely recruited to meet people’s needs. Incidents were reviewed and analysed to identify any trends or themes. The premises were clean, well maintained and people were protected from the risk of infection.

Staff were supported to provide good support through effective training and induction to the service. People's needs were assessed and staff worked with other health professionals to enable people to maintain their health and well-being. People were supported to eat and drink a balanced diet which took account of their needs and preferences. The provider was in the process of completing a redecoration and upgrade programme for the premises to ensure it met people's needs. People had benefited from increased light and space, a choice of comfortable communal areas and improved bathing facilities and soft furnishings. Further work was planned to improve signage that would enable people to find their way around independently where possible.

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.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support. People’s privacy and dignity was maintained at all times.

Care plans had been developed to support staff to provide personalised care. People were encouraged to take part in a range of meaningful activities and interests of their choice. Staff recognised the importance of protecting people from social isolation and supported people to maintain relationships that were important to them. There was a complaints procedure in place and systems in place to deal with complaints effectively. The service worked with other agencies to provide end of life care for people.

The provider had systems in place to check the quality and safety of the services provided. People, relative and staff views were sought and feedback used to drive improvements within the service. Staff worked with other health and social care professionals to achieve the best possible outcomes for people.

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

Rating at last inspection

The rating at the last comprehensive inspection was requires improvement (published 14 February 2019) and there were multiple breaches of regulations. We undertook a focussed inspection (published 17 April 2019) to check the provider had made the immediate improvements required. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.

Why we inspected:

We carried out an unannounced comprehensive inspection of this service on 20 December 2018 where we found four breaches of the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We served a warning notice for Regulation 12, Safe Care and treatment to the provider and told them they must be compliant by 4 February 2019. Our concerns were the cleanliness and infection control practices within the service. We were also concerned about a potential fire risk in a one area and lack of risk assessments identified for some people.

We rated the service as 'Requires Improvement'. The provider submitted information stating what they intended to do to address the shortfalls.

You can read the report from our latest comprehensive inspection by selecting 'all reports' link for Cherrytree Residential Home on our website at www.cqc.org.uk.

At this inspection we found the provider had made improvements to meet the requirements of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

• People were protected from the risk of infection because systems and processes complied with the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance. Action had been taken to address all the infection prevention and control concerns identified at the last inspection.

• The premises and equipment were now clean and staff had the equipment they required for effective cleaning, hand washing and hand hygiene.

• Equipment had been replaced and communal bathrooms were being refurbished to meet the needs of people.

• The environment was undergoing a programme of redecoration and ongoing maintenance to fittings and furniture to be completed by September 2019.

• Risks in the environment were identified and managed appropriately.

• The courtyard and side alley had been cleared of all the rubbish and were fully accessible for people to use.

• The fire safety risk had been reviewed and rectified to keep people and staff safe.

Follow up: We will continue to monitor this service and respond accordingly. We plan to inspect in line with our re-inspection schedule for those services rated Requires Improvement.

On the day of our inspection thirty-two people were using the service.

People were not protected from the risk of infection because systems and processes did not comply with the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance. Some areas of the premises and some equipment was not clean and staff did not have the equipment they required for effective hand washing and hand hygiene. Risks in the environment were not identified or managed appropriately.

The environment had not been adapted to meet the needs of people living with dementia and was in need or redecoration and ongoing maintenance. There was a schedule of planned redecoration and replacement of fittings and furniture to be completed by September 2019.

The quality of meals provided was inconsistent and did not always meet the needs and preferences of people who used the service. People had access to the healthcare services they required. People had their needs assessed before moving into the service and staff received the training and support they required. People were asked for their consent before care and support was provided. Staff were following the principles of the Mental Capacity Act (MCA).

People did not always receive personalized care. Care plans did not fully reflect people’s physical, emotional, mental health and social needs and were not up to date. People were not always supported to raise concerns. People were able to take part in activities they enjoyed.

Staff did not always have time to spend with people. Some people’s furniture or equipment in their rooms was broken, worn or dirty. There were unpleasant odours in some people’s rooms.

People told us they liked the staff and had developed positive relationships with them. Staff knew how to protect people’s privacy when providing personal care and information about people was stored securely.

The providers systems and processes for monitoring the quality of service provision had failed to identify risk and did not gather or act on the feedback and experience of people who used the service.

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

Staff felt supported by their managers and told us their managers listened to them and took action where action was required.

People had their medicines managed in a safe way and usually received their medicines at the times they were prescribed and needed.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.

Further information is in the detailed findings below.

Cherrytree Residential Home provides accommodation and care for up to 40 people who are aged over 65 and who may also have a physical disability or have a diagnosis of mental health. The home is located on two floors and has three communal lounges, a large garden and a dining room where people could spend time together. At the time of inspection there were 36 people using the service.

The service had a registered manager. 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.

People were protected from the risk of harm at the service because staff knew their responsibilities to keep people safe from avoidable harm and abuse. Staff knew how to report any concerns that they had about people’s welfare.

There were effective systems in place to manage risks and this helped staff to know how to support people safely. Where risks had been identified control measures were in place.

There were enough staff to meet people’s needs safely. The provider had safe recruitment practices. This assured them that staff had been checked for their suitability before they started their employment.

People’s equipment was regularly checked and there were plans to keep people safe during significant events such as a fire. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

People’s medicines were handled safely and were offered to them in accordance with their prescriptions. Staff had been trained to administer medicines and had been assessed for their competency to do this.

Staff received appropriate support through an induction and guidance. There was an on-going training programme to ensure staff had the skills and up to date knowledge to meet people’s needs.

People received sufficient to eat and drink. Their health needs were met. This is because staff supported them to access health care professionals promptly.

People were supported to make their own decisions. Staff and managers had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We found that assessments of mental capacity had been completed where there were concerns about people’s ability to make decisions for themselves. However, these were not completed to make a specific decision. The registered manager told us that these were being completed with support from Leicestershire County Council. Staff told us that they sought people’s consent before delivering their support.

People were involved in decisions about their support. They told us that staff treated them with respect. Staff knew people they cared for and treated people with kindness and compassion.

People received care and support that met their individual needs and preferences. Care plans provided information about people so staff knew what they liked and enjoyed. People took part in activities that they enjoyed.

People and their relatives knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives.

People and staff felt the service was well managed. Staff felt supported by the registered manager.

Systems were in place which assessed and monitored the quality of the service and identified areas for improvement. This included a plan for maintaining and improving the environment. People were asked for feedback on the quality of the service that they received. The service was led by a manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.

Cherrytree Residential Home is a care home registered to accommodate up to 40 people who are aged over 65 and who may be living with dementia or have a diagnosis of mental ill health. The home is located on two floors, with lift access to both floors. The home has a variety of communal rooms and areas where people can relax. At the time of the inspection 35 people were using the service.

The service had a registered manager. 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.’

People told us that they felt safe when staff supported them and that they enjoyed living at Cherrytree Residential Home.

Risk assessments were in place which described how to support people in a safe way. The service had safeguarding and whistleblowing procedures in place. Staff were aware of their responsibilities in these areas.

The provider carried out checks before staff started to work at the service.

People received their medicines safely and at the right time by staff who were trained and assessed as competent to administer these.

Staff were supported through training and supervision to be able to meet the needs of the people they were supporting. They undertook an induction programme when they started to work at the service.

Staff sought people’s consent before providing personal care. People’s capacity to make decisions had been considered in their care plans. Assessments of a person’s capacity to make a specific decision had not always been fully completed.

People were supported to maintain a balanced diet. People were supported to access healthcare services.

People told us that staff were caring. Staff we spoke with had a good understanding of how to promote people’s dignity. Staff understood people’s needs and preferences.

People were involved in decisions about their care. They told us that staff treated them with respect.

People were involved in the assessment of their needs. People and their relatives were sometimes involved in the review of their needs.

People were supported to take part in activities that they enjoyed.

People told us they knew how to make a complaint. The service had a complaints procedure in place.

The service was well organised and led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.

People were asked for their feedback on the service that they received. The provider carried out monitoring of the quality of the service.

The provider wrote to us and told us that they would make changes to the outcome area by 9 October 2013. We returned to the home and looked at the changes the provider had put in place.

We noted there had been improvements in medication administration and this was now stored and dispensed appropriately. We noted the staff were also using the medication administration charts (MAR) charts more effectively. Staff were now recording medicines coming into the home using their initials instead of a simple tick system. That meant the medication system was more secure.

We saw that the provider had introduced documentation to ensure people had the capacity to make informed decisions, and so protect their human rights.

We saw where the home had been decorated since our last visit. The manager told us that this was an on-going programme, with some bedrooms and corridors having been decorated. New bedroom door locks have been replaced throughout the home. That was due to some locks being an inappropriate type that could have allowed people to lock themselves in their room.

We found that people that people who do not have capacity, do not have the necessary legal checks in place to provide them with appropriate protection. We also found where improved monitoring is necessary on medication and the improvements to the security and decorating round the building. We also looked at staff recruitment and noted some of the security checks are not regularly renewed.

We spoke with a number of people living in the service and a number of visiting relatives. One of the people using the service stated 'it was ham and parsley sauce (for lunch) today, I enjoyed that'. Another stated 'the meals are nice, but sometimes the plates are cold'.

People also made the following comments about the home. '(persons name) has only been here a short while, he seems happy here; the staff have been very helpful'. Another stated 'When mum went into hospital, they contacted us right away'.

On our tour around the home we saw people in a relaxed state. There has been a number of floor coverings replaced and some areas decorated recently. There is regular maintenance of the equipment in the home where a number of external contractors are used to ensure this is safe for use by the staff.

Staff are employed in sufficient numbers and receive regular training to ensure people are cared for safely.