Cherry Tree Lodge Nursing Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider was previously in breach of the legal regulation relating to person-centred care. Improvements were found at this assessment, and the provider was no longer in breach of this regulation, although further improvements were still required.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not always experience care that consistently promoted kindness, compassion and dignity.

Relatives consistently described staff as caring, kind and compassionate. One relative told us, "The staff are loving and attentive towards all the people who live there", another said, "The staff are all really lovely." During parts of the assessment, staff demonstrated a good understanding of people's needs and positive relationships were evident.

However, the quality of interactions was not always consistent. During some observations, support was delivered in a task-focused manner with limited engagement or meaningful conversation. This differed from the warmer and more person-centred interactions observed elsewhere during the assessment. People were not always supported in ways that promoted dignity and respect. For example, people were not always given time to enjoy their food or swallow before being offered the next mouthful. On another occasion, a person was supported to eat whilst the member of staff remained standing over them rather than sitting alongside them at eye level. This reduced assurance that people's dignity and comfort were consistently promoted.

Whilst many caring and compassionate interactions were observed, these were not consistently reflected across all of people's experiences.

Most staff knew people well and were able to describe their preferences and support needs. Relatives spoke positively about staff knowledge and their understanding of the people they supported.

However, this knowledge was not always reflected in practice. Support did not always reflect people's individual needs and preferences. During observations, people were not always supported in response to what they were communicating at the time. For example, one person fell asleep during the evening but was woken so they could follow the usual supper routine with everyone else.

During the evening observation, people had already been changed into their nightwear and were following the same routine. The same food options and drinks had been prepared and provided for people, despite care records identifying individual preferences. This reduced opportunities for people's individual choices and preferences to be reflected in the support they received.

People were not always supported to maximise their independence or have meaningful opportunities to make choices about how they spent their time.

Opportunities for meaningful activity and engagement were limited. Activities were largely being facilitated by care staff at the time of the assessment, although an activities coordinator had recently been recruited and was due to commence employment. One relative told us, "They need more activities and more opportunities to get out." Similar views were shared by other relatives and professionals, who felt people would benefit from more opportunities to take part in meaningful activities and experiences that reflected their interests. One professional described people spending extended periods in communal areas with limited stimulation or interaction, which was consistent with our observations during the assessment.

Activity records were often brief and did not consistently demonstrate how people were being supported to pursue their interests or take an active role in their day-to-day lives.

Care plans often identified what people could do for themselves and the support they required to maintain their independence. However, this was not always reflected in practice. During observations, staff frequently completed tasks for people rather than using everyday opportunities to encourage participation, develop skills or promote independence.

People's immediate needs were not always recognised and responded to appropriately.

Care plans contained information about how people communicated, including the meaning of specific sounds and other non-verbal forms of communication. Staff were generally able to describe how people expressed their needs and emotions.

However, observations and feedback did not always demonstrate that this understanding was consistently applied in practice. For people who relied on non-verbal communication, recognising the meaning behind their actions and responses was particularly important. Opportunities were sometimes missed to explore whether people were expressing a choice or attempting to show an unmet need. As a result, people did not always experience support that was responsive to what they were communicating in that moment.

Despite this, some staff demonstrated a good understanding of people's communication needs and there were examples of staff recognising and responding appropriately to changes in people's wellbeing.

Staff felt supported and valued within their roles. Staff spoke positively about the registered manager and described a supportive team culture where colleagues helped one another and support was available when needed. Staff told us they felt able to raise concerns and were generally listened to. One staff member said, "[The] manager listens and [is] always willing to help."

The provider had invested in a range of initiatives to promote staff wellbeing, development and inclusion. Staff had access to wellbeing support, an employee assistance programme and opportunities to access advice and support outside of formal supervision arrangements. Leaders promoted staff learning and development through regular learning initiatives and resources designed to support a diverse workforce.