Cherry Tree Lodge Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider was previously in breach of the legal regulation in relation to good governance at the service. Whilst improvements had been made since the previous assessment, governance systems had not improved sufficiently to ensure compliance with this regulation, and the provider remained in breach of this regulation.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders had taken steps to improve the service following the previous assessment and staff were able to describe positive changes, including increased staffing levels and the recruitment of an activity’s coordinator.

However, the culture experienced by people was not always consistent. Whilst warm and caring interactions were often observed and feedback about staff was positive, this was not reflected throughout people's day-to-day experiences. Observations identified times when support was task-focused and centred around routines rather than the person.

There was a disconnect between the values leaders described and some of the care people experienced. People's individuality, choices and communication were not always recognised in practice, which reduced assurance that a shared person-centred culture had been fully embedded across the service.

The registered manager was viewed positively by staff, who described them as approachable, supportive and committed to improving the service.

Leaders had taken action to address a number of previously identified concerns and demonstrated a willingness to improve the service. This had resulted in improvements to some areas of practice, including care planning and staffing arrangements.

However, leaders had not identified or addressed the extent of the differences in people's experiences across the service. Whilst positive and person-centred support was often observed, people also experienced periods of task-focused care where individual preferences and involvement were not consistently recognised. This indicated that leaders did not always have a clear understanding of people's experiences. As a result, improvements made by leaders had not yet translated into consistently positive experiences for people using the service.

Staff felt able to raise concerns and speak openly about issues affecting the service.

Staff described the registered manager as approachable and told us they felt comfortable discussing concerns and seeking support when needed. Staff were open when sharing their experiences of working at the service and spoke candidly about areas they felt could be improved, including communication, staffing pressures and the support available during some shifts.

Staff appeared confident sharing their views and experiences and there was no indication that people felt unable to speak up when issues arose. Staff were able to discuss both positive aspects of the service and areas where they felt improvements were needed, demonstrating an open culture where feedback could be shared.

Leaders recognised that staff may require different levels and types of support to succeed in their roles.

The provider had arrangements in place to support staff with individual learning and development needs. For example, additional support and resources were available for staff with dyslexia to help ensure they could access and complete training.

Leaders promoted an inclusive approach through learning resources and initiatives designed to improve awareness and understanding of diversity within the workforce. Staff had access to support and learning opportunities intended to remove barriers and help all employees participate fully in their roles.

This demonstrated consideration of individual staff needs and a commitment to creating an inclusive working environment.

Leaders had established governance systems to monitor the quality and safety of the service. Regular audits and checks were completed, and improvements had been made in response to previous concerns.

However, governance processes were not always effective in identifying issues before they impacted on people's experiences. Whilst audits were completed, they had not identified concerns relating to the quality of some interactions, the extent to which evening support had become routine-led or the differences in people's experiences at different times.

Oversight of medicines used to manage distress was not sufficiently robust. Whilst records showed low use, governance processes had not ensured that records consistently provided sufficient detail about the reasons for administration or the approaches tried before medicines were used. Leaders had recognised the need for improved recording and directed staff to complete incident records when these medicines were administered. However, this had not been consistently embedded in practice and recording remained inconsistent.

As a result, leaders did not always have effective oversight of the quality of support people experienced or assurance that improvements identified had been fully implemented in practice.

Partnerships were not always used to maximise opportunities for people to be part of their local communities.

People were supported to maintain relationships with those important to them and visitors were welcomed into the service. Staff worked with external professionals to support people's needs and advocate on their behalf when additional support or services were required.

However, relatives and professionals felt people would benefit from more opportunities to access their local community and take part in activities outside the service. Feedback suggested people spent significant periods of time within the home and had limited opportunities to develop community connections or participate in activities that reflected their interests. This reduced assurance that partnerships and community links were being fully utilised to improve people's experiences and quality of life.

Leaders had demonstrated a commitment to improving the service and had acted in response to previous concerns. Staff described positive developments and recognised the efforts leaders had made to drive improvement.

Care planning had improved since the previous assessment, with records containing more information about people's needs and support requirements.

However, progress had been variable, and improvements were not always embedded into people's daily experiences. Some areas identified for improvement had not progressed as expected and people did not consistently benefit from the changes leaders had introduced. For example, improvements made to care planning had not always translated into consistent person-centred support in practice.