Archived: Cherry Acre Residential Home

Updated 8 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This focused inspection took place on 27 July 2016. It was un-announced. The inspection team consisted of one inspector and an inspection manager.

We took account of information sent to us by the local authority relating to concerns about infection control, cleanliness, dilapidation of the premises, electrical and fire safety, lifting equipment testing and the risk posed by the provider not being able to meet legislation and regulations that were designed to protect people’s health, safety and welfare.

We carried out a full internal and external visual check of the premises. We spoke with the registered manager and the provider. We observed the care people were receiving. We sampled relevant sections of audits, policies, risk assessments, care plans and maintenance certificates where these had been raised as part of the concerns.

Updated 8 December 2016

The inspection was carried out on 20 April 2015 and was announced at short notice.

At our previous inspection on 4, 12, 13 and 16 December 2014, we identified six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and two breaches of the Health and Social Care Act 2008 (Registration) Regulations 2009. The breaches were in relation to care and welfare, safeguarding people from abuse, staff training, staffing numbers and their deployment. There were also breaches in relation to quality assurance in the service, having no registered manager in post and the non-reporting of incidents as required by law to CQC. We are taking action and have required the provider to make improvements.

Cherry Acre Residential Service provides accommodation and personal care for up to 17 older people. At our previous inspection in December 2014 there were 16 people living in the service, some of whom had behaviours that may harm themselves or others, were cared for in bed or needed end of life care. At this inspection we found that there were only six people living in the service, four of whom were independent and required minimal assistance with their care needs. The accommodation is arranged over two floors. A stair lift is available to take people between floors. Staff provided assistance to people like washing and dressing and helped them maintain their health and wellbeing.

At this inspection we found that the provider had taken action to address the breaches from the previous inspection and improved the quality of service they were providing to people. However, there remain some areas where the provider could further improve including ensuring they fully meet the conditions of their registration, safe storage of medicines and environmental health and safety. They also needed to ensure the staffing levels remained within acceptable limits to provide and meet people’s needs and could be sustained in the future. We have reported on these and the provider will have to provide an action plan detailing how they will make these improvements.

At the time of our inspection there had not been a registered manager employed at the service since 24 January 2011. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 premises were not adequately maintained to minimise risk to people. An area of carpet was a potential trip hazard.

The annual CQC registration fees due to be paid in July 2014 had not been paid by the provider.

We have also recommended that the provider seeks advice about their responsibilities to staff under employment law.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The manager had taken steps to comply with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. People were not being restricted and their rights were being protected.

People we spoke with told us they felt secure and safe in the service. Staff had received updated training about protecting people from abuse and showed a good understanding of what their responsibilities were in identifying and preventing abuse.

Procedures for reporting any concerns were in place and these had been used by the manager. Other training had taken place to provide staff with practical knowledge of first aid and manual handling.

Staff were responding more consistently to incidents in the service to maintain people’s safety. People’s health and wellbeing was supported by prompt referrals and access to appropriate medical care.

The manager and care staff were working with new individualised care plans and assessments of people’s needs had been reviewed. Staff planned people’s care to maintain their safety, health and wellbeing. Risks were assessed by staff to protect people and guidance was provided to staff about managing individual risks. People were involved in assessing and planning the care and support they received.

The risk to people’s safety had reduced. The numbers of people in the service had reduced from 16 to six since our last inspection. People with behaviours that may challenge or with higher care needs had moved to other services that could meet their needs. The staffing levels had not increased but had been reviewed in light of the reduced levels of care needed. Therefore, staff were available to people in the right numbers and with the right skills to meet people’s needs.

Incidents and accidents were recorded and checked by the manager to see what steps could be taken to prevent these happening again. Staff understood what changes they needed to make after incidents had occurred to keep people safe and equipment was provided to assist staff to manage risk.

Managers ensured that they had planned for foreseeable emergencies, so that should they happen again people’s care needs would continue to be met. Recruitment policies and procedures were in place that had been followed.

People were encouraged to eat and drink enough to maintain their health and wellbeing. Other areas of their health were checked to help prevent people becoming unwell.

Staff followed a medicines policy issued by the provider and their competence was checked against this by the manager.

The manager involved people in planning their care by assessing their needs when they first moved in and then by asking people if they were happy with the care they received.

People told us that managers were approachable and listened to their views. Staff knew people well and people had been asked about who they were and about their life experiences. Staff knew what they were doing and were trained to meet people’s needs. This helped staff deliver care to people as individuals.

The manager carried out audits and reported on the quality of aspects of how the service was run. However, these had not identified the areas we identified during the inspection.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.