St Anne's Community Services - Cherry Tree Dispersed

The Cherry Tree Dispersed Scheme provides 24-hour care for adults with learning disabilities, in two houses in a quiet residential area of Wetherby, just outside of Leeds. The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection there were eight adults with learning disabilities using the service.

The care service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion so that people with learning disabilities and autism can live as ordinary a life as any citizen.

At our last inspection in May 2016, we rated the service ‘good’. At this inspection, the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager. A registered manager is a person who has registered with the 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 registered manager also managed two other of the provider’s services and split their time between managing these services.

People told us they felt safe. Sufficient staff were employed; however, we have recommended that the provider keeps this under review. Staff were safely recruited. Risks to people's health were assessed and understood. Staff were trained to recognise and respond to safeguarding concerns. Some problems relating to the cleanliness of the premises were identified at the inspection; the registered manager addressed these promptly. Medicines were managed safely.

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 had regular training, supervisions and appraisals to support them to provide effective care. People had choice around what they ate and were supported to maintain good health.

We observed kind and caring interactions between people and staff. There was a positive and inclusive culture at the service. The provider promoted a culture of dignified and respectful care People were supported to increase or maintain their independence and were involved in planning their care.

Care plans were person centred, detailed and updated as and when people's care needs changed. People were supported to lead active and fulfilling lives. Systems were in place to manage complaints. Information was provided in a range of accessible ways and staff provided effective support to help people communicate.

Quality assurance processes were in place to monitor the quality of care delivered. The registered manager and staff worked in partnership with external health and social care professionals to ensure people's health and social care needs were met. We received positive feedback about the management team. They were described as supportive, effective and committed to providing good quality care and support for people.

Further information is in the detailed findings below.

The Cherry Tree Dispersed Scheme provides care for up to ten adults with learning disabilities, in two houses, called Cherry Tree and Orchard View. The homes are located in a quiet residential area of Wetherby, just outside of Leeds.

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 and associated Regulations about how the service is run.

People told us and indicated by gestures and body language that they felt safe in their home. People were comfortable with staff and there was a positive atmosphere in the service.

There were systems in place to ensure that people received their medication as prescribed. However we made some recommendations as to how the service could improve in this area.

In the main, people were cared for by sufficient staff who knew them and their needs. Recruitment was on-going to try and improve the numbers of permanent staff available to ensure consistency of staff. Recruitment procedures were robust to ensure that staff were suitable and fit to be employed.

Staff were aware of the processes in place to report incidents of abuse; and had been provided with training on how to keep people safe from abuse and harm. Processes were in place to manage identifiable risks and to promote people’s independence.

Staff received an induction and training and were provided with these skills and knowledge in a timely fashion to fulfil their role. Staff were given effective supervision.

People were supported to eat and drink well and to maintain a varied balanced diet of their choice. People had access to healthcare facilities and support that met their needs.

People had developed good relationships with the staff team who treated them with kindness and compassion. Systems were in place to ensure that their views were listened to; and their privacy and dignity was upheld and respected.

People's needs had been assessed and support plans outlined their preferences and how they should be supported. Staff showed a good knowledge of these preferences.

People were able to enjoy activities of their choice. Arrangements were in place for people to maintain links with the local community, friends and family.

The service had quality assurance systems in place which were used to drive continuous improvements.

Below is the summary of what we found but if you want to see the evidence supporting our summary please read our full report. The summary is based on speaking with people who used the service, the staff supporting them, our observations and from looking at records.

Is the service safe?

Care plans and risk assessments were detailed and person centred and provided staff with clear guidance on how to meet people's health and social needs properly.

Staff were kind and supportive to people; they treated people as individuals. Staff gave good examples of how people were treated with dignity and respect and encouraged to be independent.

We saw there were good systems in place to review accident and incident records to ensure risks of re-occurrence were minimised.

Is the service effective?

People who used the service said they were provided with a good choice of food and they always got their favourite dishes on the menu.

Staff described how they met and monitored people's health needs. Care records showed that people had regular contact with health and other professionals. People also had a Health Action Plan with details of the actions needed to maintain good health. This included details of family history illnesses.

People were cared for by staff who were supported to deliver care safely and to an appropriate standard. Staff said they were well trained to carry out their role. They said they received regular updates to keep them up to date with current practice, for example, moving and handling.

Is the service caring?

We spoke with seven people who used the service. They told us they enjoyed living at the service and considered it home. They said staff treated them well.

We also spoke with two visiting relatives. They spoke highly of the care their family member received. One said, 'They are so kind and caring, they could not be any better, they are everything we have wished for.'

We saw that care practices were good. We saw people were happy, relaxed and comfortable with staff in their interaction with them. There was a positive atmosphere and good eye contact. It was clear that staff were well aware of the needs and wishes of the people who used the service. Staff understood people's individual ways of communicating their needs.

Is the service responsive?

We saw that people who used the service were responded to promptly when they asked for any support or assistance. It was clear that staff knew the needs of people who used the service very well.

People were supported to be involved in activity of their choice within the home and the community. People we spoke with told us of a wide range of activity that they were involved with. One person said, 'I am never bored, always something to do.'

There had been no complaints made to the service for many years. However, staff were able to say what they would do to assist anyone who wished to make a complaint.

Is the service well led?

Staff said they felt the service was well managed and the Registered Manager was very approachable, highly motivated and enthusiastic. They said they had confidence that any issues brought to their attention were always dealt with properly and thoroughly. Staff said they understood their role and what was expected of them.

There was an effective system in place to regularly assess and monitor the quality of the service that people received. We looked at reports and records which showed the provider had assessed and monitored the quality of service provision.

The service was clean, tidy and free from bad odours.

We saw that appropriate checks were undertaken before staff began work to make sure that they had the relevant experience and skills for the role.

The service had good systems in place for managing complaints although they had never received any formal complaints from people who used the service or their family.