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Inspection carried out on 25 October 2017

During a routine inspection

This inspection took place on 25 and 26 October 2017. It was an unannounced visit to the service.

The Cherries is a residential care home for seven people with learning disabilities. At the time of the inspection six people lived at the home. The care home is located within a residential town in Buckinghamshire. The main home is a two story building with communal and kitchen areas upstairs and bedrooms and bathrooms located on the lower ground floor.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

We received positive feedback from people and their relatives. We also observed positive interactions between people and staff. People told us they had developed a good working relationship with the staff. Comments included “I am really happy here,” “It’s good” and “They [staff] couldn’t do anything more for them.” A relative told us “I wouldn’t want my son to be anywhere else.”

People were protected from bullying and avoidable harm. Staff had a good understanding of how to recognise abuse and what to do in the event of a concern being raised. The service had clear processes in place to manage allegations of abuse and staff had received training.

Risks posed to people had been assessed and systems were in place to mitigate and reduce the risk of harm to people.

We observed people were supported by staff who were able to respond to their care needs when required.

People who required support with their prescribed medicines received this by staff who had received training. We found there were safe medicine management practices in place.

People were supported by staff who were supported to maintain their skills and develop new skills in line with best practice. Staff felt supported by the management team.

People’s human rights were supported. People were supported to understand and make decisions about their care needs.

People were encouraged to maintain a healthy, balanced diet. People were supported to maintain their health and attend any external healthcare appointments.

People told us they were supported to maintain and improve their level of independence. One person told us “I like being independent, I like going out and meeting people in the local area.” A relative told us “He is so wonderful now, when he first moved into the home he did not have a lot of speech. I now am able to speak to him on the phone.”

We observed people were treated with dignity and respect. People were relaxed in the company of staff and were seen to be smiling and laughing with staff.

People received a personalised service as staff worked with them to understand their hopes and wishes. Care plans were written to support people achieve their aspirations. Reviews of care plans and support provided were undertaken in a way people could understand.

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

There was a clear culture among the staff to support people achieve their potential and live the life they choose without barriers.

The service ensured it monitored the provision of care to drive improvements.

The registered manager was aware of their role and responsibilities. They had a good understanding of what needed to be reported to The Care Quality Commission (CQC) and how to meet the fundamental standards.

Further information is in the detailed findings below.

Inspection carried out on 16 & 18 June 2105

During a routine inspection

This inspection took place on 16 and 18 June 2015 and was unannounced. The Cherries is a residential home providing care and support to six men with learning disabilities.

The home had a registered manager in place. 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 home was experiencing uncertainty about its future. This was because the local authority who owns the building had informed the provider approximately two years ago of their plans to relocate the service. The impact of this had led to low staff morale and a number of staff left due to perceived job insecurity. At the time of the inspection we found the provider had recently taken the decision to continue to invest in the service. This was because although they were still uncertain of the future of the home, they recognised that the needs of people living in the home were paramount, and people continued to require support and care on a daily basis.

During our inspection we found some areas required improvement, such as the garden decking area and the number of staff employed within the service. These areas had also been identified by the registered manager and area manager and work had started to be undertaken to resolve these issues.

People appeared happy living in the home. They were familiar with their surroundings and they were relaxed and comfortable. Interactions between staff and people were sensitive, humorous respectful and friendly. People’s choices were respected and they were supported to be as independent as possible.

Each person had a care plan in place which recorded how care was to be provided to the person. Risk assessments highlighted identified areas that may pose a problem to the individual or staff. These were regularly updated to ensure people’s welfare was maintained. We did however find that mental capacity assessments had not been completed. This meant staff could not be confident of people’s consent to the care being provided. We have made a recommendation about the training of staff in relation to mental capacity assessments. Records showed, where decisions had been made on behalf of people these were done in consultation and people’s best interest.

Staffing levels had been assessed in line with people’s needs. However the registered manager and area manager had taken action to review the number of staff available to ensure staff and people were safe during the day and at night.

Staff were knowledgeable about the people they cared for, and took appropriate action to assist people to maintain their health and wellbeing. Staff were supported in their roles. They received training, supervision and encouragement from the registered manager and deputy manager.

People told us they liked the food, and we saw this was available to people throughout the inspection. People were supported to eat and drink where necessary, and they were involved in making choices about what food was provided.

Regular audits were carried out by the registered manager and the area manager. Findings were fed back to the provider and themes and trends were looked for to prevent reoccurrences and to improve the future quality of the service.

Inspection carried out on 29 August 2013

During a routine inspection

We met three people who lived in the home, they appeared happy and relaxed. We spoke with four relatives who spoke positively about the care provided at The Cherries. One person told us �The staff are wonderful, and this means that six people are having a lovely life.� Another relative told us the manager had improved the quality of care provided, they stated �It is the best it has ever been, it�s a home from home, they are all very happy there.�

We looked at documentation, spoke with a staff member and relatives about how people consented to their care. We saw families were involved in advocating for their relatives. We also saw how specialist advocates supported people who did not have relatives to speak for them.

We looked at how food was prepared and how people were supported with their nutrition. We saw people were encouraged to have a healthy balanced diet, and food was presented in an appetising way. We noticed some parts of the kitchen area were in need of cleaning and redecoration. This posed a minor risk of cross contamination, as staff could not reach the high ceilings to clean.

The manager, staff and family members told us there were sufficient staff employed to meet the needs of people. Our observations and checks on the staff rota verified this. We observed how extra staff were brought into the home when needed to ensure people�s needs were met.

Inspection carried out on 9 July 2012

During a routine inspection

People said that �they were happy with the care they received�. They said that �they were able to make decisions about their care�. For example, they were able to choose what time to get up and go to bed. They were able to choose what they wished to eat. People told us that �regular residents meetings were held and they were able to discuss anything at those meetings�.

People said that they had a link worker who spent time with them on a regular basis to discuss their care and support needs. People told us that their link worker regularly discussed their health action plan with them.

People said that �they liked living in the home and staff spoke to them in a calm and respectful manner.� People told us that �staff listened to them.� They said if they had a concern they knew who to tell.

Reports under our old system of regulation (including those from before CQC was created)