Cherry Tree Manor

We found the following examples of good practice.

¿ The service was receiving visitors with clear infection control procedures in place. All visitors were directed to a separate entrance on arrival where they were welcomed by a member of staff and screening took place. All visitors were required to wear personal protective equipment (PPE).

¿ Face to face visits, where one nominated visitor and people could meet and hold hands, were taking place in designated rooms, or within people’s bedrooms if this was required. Visits were pre-arranged, with visitors being provided with a rapid test for COVID-19, guidance and personal protective equipment (PPE). Other visitors were also able to continue visiting, with garden visits or ‘window visits’ being facilitated if this was preferred. All visiting areas were cleaned between visits.

¿ The service was clean and hygienic. Cleaning schedules were in place, with tasks methodically completed throughout the day.

¿ The provider had developed procedures and guidance for people and staff in response to the COVID-19 pandemic. Risks to people and staff in relation to their health, safety and wellbeing had been assessed.

Cherry Tree Manor is registered to provide accommodation and personal care support for up to 58 older adults. At the time of the inspection, 52 people were living in the home and receiving the regulated activity of personal care.

People’s experience of using this service:

People told us they felt safe. One person said, “I feel very safe since moving here, it’s a really nice place to live.”

Incidents that occurred in the home were not always managed to keep people safe. Staff awareness of keeping people safe from harm varied and was not consistent.

Quality assurance audits were not always effective in identifying people’s experience of the service. Care records were not reflective of people likes dislikes, preferences and changing care needs.

Staff were not all clear about how to respond in an emergency such as a fire. Risk assessments were in place to manage risks however were not consistently clear or updated as people’s needs changed.

Training in key areas had elapsed for some staff, however people told us staff were competent and staff felt well supported.

People’s consent had not always been sought in line with the legal requirements

People, their relatives and staff told us that the quality of care received was sufficient and they were happy with the care provided.

People were supported by sufficient numbers of staff. Staff recruitment checks were in place.

People were cared for in a clean and hygienic environment by staff who followed infection control procedures.

People received their medicines and these were safely managed.

People were happy with the food provided and meal times were a sociable event. People’s weight and dietary needs were monitored where necessary

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People lived in a purpose-built home that met their needs. The environment was maintained and appropriate safety checks were regularly completed.

People’s dignity was maintained and peoples independence was promoted and respected.

People were able to take part in a wide range of activities and outings.

People and their family were involved in their own care planning as much as was possible.

People and relatives felt able to raise complaints and an effective complaints procedure was in place.

Staff felt well supported by the registered manager.

Rating at last inspection: Good (report published 16 July 2016)

Why we inspected: This was a planned comprehensive inspection based upon the previous Good rating. At this inspection we found that the service is now rated as Requires Improvement. More information is in the full report.

Follow up: We have referred our findings to the local authority. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

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

The service provides accommodation and personal care for up to 58 older people, some of whom were living with dementia. At the time of our inspection there were 54 people using the service.

There was a registered manager in post. 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 safeguarded from avoidable risk of harm and staff understood the process to follow and report any concerns regarding people’s safety. There were risk assessments in place which detailed how people could be supported safely and control measures were in place to minimise and to mitigate risks. Staff were trained to move people safely and meet their needs in order to keep them safe. People’s care plans were detailed, person-centred and included information regarding their backgrounds, preferences and activities they enjoyed. These had been reviewed regularly with involvement from people and their relatives where possible.

People’s healthcare needs had been identified and met. There were good links with community healthcare professionals where required. People had enough to eat and drink and their nutritional needs had been monitored so that their health and wellbeing was maintained. There was a creative and varied program of activities available to people including opportunities to visit local places of interest and outings.

People were treated with dignity and respect and their views were listened to and acted on.. The service were able to evidence the ways in which people gave consent to receiving care. Staff demonstrated an understanding of the Mental Capacity Act 2008.

Staff received a variety of specialised training for their roles. Staff completed a thorough induction programme when they first joined the service. The recruitment processes used to employ new members of staff were safe and ensured that staff employed had the skills, character and experience to meet people’s needs. There were enough staff to keep people safe and meet their needs. The service held regular team meetings and sent out staff surveys to provide staff with an opportunity to provide their feedback and contribute to the development of the service. Staff had been provided with opportunities to develop within their roles and had been supported through regular supervision and appraisal.

There was a robust quality monitoring system in place for identifying improvements that needed to be made across the service. The provider’s director carried out monthly monitoring visits to ensure that the quality of care and compliance was consistently of a high standard. The environment was clean and well maintained with robust systems in place for monitoring health and safety and controlling the potential spread of infection. Equipment was regularly checked and there were contingency plans in place in case of emergency.

We found that people's privacy and dignity had been respected and that they or people acting on their behalf been involved in the decisions about their care. We noted that the provider had done an assessment of the number of staff needed to support people who use the service.People had an assessment of their needs carried out and the care plans we reviewed demonstrated that their needs were being met appropriately. We found that there were processes in place to ensure people's nutritional needs were being met.

We found that there were insufficient staff to engage with people who use the service. We also found there were insufficient staff to respond in the event of an emergency

People told us that their privacy and dignity was respected when they received personal care. Another person said that they liked being in their room, however since the new building work started at the home in May 2012 they have had to keep their heavy curtains closed at times when they needed privacy as the work men could see into their room. We found evidence that this issue had been raised but not addressed.

People were satisfied that there were plenty of activities, although we observed minimal interaction between staff and the people. We saw that the people had been left alone without stimulation for long periods of time.

We observed the home to be visibly clean on the day of our visit. All the people appeared to have had their personal care needs met.

Staff told us how they enjoyed working at the home and felt supported by management.

We identified that people's care needs were not consistently recorded and that nutritional needs were not always being met. We saw that people were left unattended for long periods of time.