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Cherry Trees Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 October 2019

About the service

Cherry Trees is a purpose-built building registered to provide nursing, accommodation and personal care for up to 81 people, including people living with dementia. At the time of our inspection visit there were 67 people living at the home. Care is provided across two floors. Nursing care was provided on the ground floor in a unit called, ‘Young at Heart’. On the first floor, there was a separate unit for nine people with residential/dementia care needs called Cherry Blossom. The remainder of the first floor was called Memory Lane for people living with dementia. Communal lounge and dining areas were located on both floors. People’s bedrooms were ensuite and there were further communal bathroom facilities located on each floor.

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

Since the last inspection visit, we had received concerning information that indicated people did not always receive personalised care, specifically around staffing levels, falls management and risks related to people at risk of malnutrition and dehydration. The registered manager had left the service in July 2019 and the provider made sure, the service continued to be managed on a daily basis. During July 2019, the provider introduced and shared us with a management plan to drive improvements so we could be assured, people received good care.

During our visits, people and relatives told us they had concerns about staffing, in particular high agency staff usage which meant some staff did not always know people’s individual routines and preferences. Permanent staff said agency staff helped support planned staffing levels, however, they felt time was spent showing those staff what to do which did impact on the timeliness people received support. Several care and nursing staff had recently left so the staff team was supported by high numbers of agency staff. Plans were in place to recruit staff to those permanent roles.

Risks associated with some people’s care were not managed safely. For people with identified risks of malnutrition and or hydration, they were not consistently supported and records were not good enough to show, what levels of support people had received. Some people experienced weight loss but there was limited information to support what measures were being taken to respond to this because records of what people had consumed, were incomplete. People, relatives, staff comments and dining room record books told us some meals and choices were not always available to everyone or some food items were missing or not to the standard people expected.

Environmental risks in some cases continued to happen even though daily walkarounds gave assurances the risks were identified and managed. Safe food hygiene practice was not always followed by staff.

Mental capacity assessments, staff’s knowledge and how some people’s freedoms could be restricted, was applied inconsistently. There was variable information to show if the person had given consent, specifically when a relative’s decision was followed with no best interest’s decision recorded. Staff’s knowledge of deprivation of liberty safeguards was not always consistent and in line with best practice, so some people’s freedom of movement within the home, was restricted.

Medicines were administered safely however when some medicines where given covertly (disguised in food or drink), there was no information from a prescribing GP or pharmacist to show safe ways for this to be given. We saw plans to provide some epilepsy medicines on an as and when basis, were not consistent with care plan information and in one example, out of date pain relief continued to be given. The manager assured us actions would be taken to improve this.

People were complimentary of some staff, and relatives recognised staff did the best they could to support their family member’s needs. However, they shared some concerns with us that were similar to those at previous inspections. Relativ

Inspection areas

Safe

Requires improvement

Updated 29 October 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 29 October 2019

The service was not always effective.

Details are in our effecrtive findings below.

Caring

Requires improvement

Updated 29 October 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 29 October 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 29 October 2019

The service was not always well led.

Details are in our well led findings below.