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Inspection carried out on 20 August 2020

During an inspection looking at part of the service

Cherrywood House provides accommodation and personal care for up to 12 people who have a learning disability, autism and communication difficulties. Ten people were living at the service at the time of our inspection. One of these people lived in a self contained flat in the service. The other people had individual bedrooms and shared communal areas.

We found the following examples of good practice.

• People were supported to keep in touch with families and visits were planned and well organised to reduce risk and avoid the potential spread of infection. Visitors received information before coming to the service so they know what to expect. This included signing a health declaration and wearing the personal protective equipment (PPE) which was provided. People had a document in their care records entitled 'My Visiting Plan' which reviews individual risks and provides guidance to ensure people and visitors are protected as far as possible.

• A social story had been created about ‘Cory the Corona’ to share information about coronavirus in an accessible way. Creating a character helped people’s understanding and shared information meaningfully. This supported them to follow infection control measures and social distancing requirements.

• Staff had carried out individual assessments about Covid testing for people who did not have the capacity to give informed consent. Risk and context was considered, as well as distress to the person and the wishes of the family. This ensured testing was carried out in the person’s best interest.

• Staff were supported by regular supervision and contact with the registered manager and senior staff. Risk assessments had been carried out for those who were in high risk groups. When staff were on sick leave, the manager kept in contact with them and data is regularly sent to the provider to ensure all absence is monitored. On returning to work, a risk assessment was carried out with staff to ensure they were safe and able to resume their role.

• Staff had received additional infection prevention and control (IPC) training, and the local IPC lead was planning to attend additional training. Plans were also in place for staff to receive training in RESTORE2. This training supports staff to recognise physical deterioration in a person, act appropriately and carry out physical observations to ensure the person receives timely support and safe care which meets their individual needs.

• Contingency plans were in place to manage ongoing or future outbreaks or other events effectively. The provider collected data and regular reports from the service. This information was analysed and used to inform future incident management and support learning.

Further information is in the detailed findings below.

Inspection carried out on 18 September 2017

During a routine inspection

We inspected this service on the 18 September 2017. This was an unannounced inspection. At our last inspection in May 2016 we found that people were not always supported by adequate staffing levels which negatively affected their daily activities and access to the community. In addition, the service had failed to notify the Care Quality Commission of specific incidents they were legally required to do.

The provider wrote to us in July 2016 and told us how compliance with these regulations would be achieved. During this inspection we found improvements had been made.

Cherrywood House provides accommodation and personal care for up to 14 people who have a learning disability, autism or mental health needs. It does not provide nursing care. At the time of this inspection there were 10 people living at the service. Two of these people lived within individual flats that had their own bathrooms, toilets, kitchens, lounges and bedrooms. There were eight people who lived in the main house at the time of inspection.

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 2008 and associated Regulations about how the service is run. The registered manager was not the registered manager in post at our previous inspection and had commenced employment in Cherrywood House in November 2016.

People were now supported by sufficient numbers of staff. People and staff told us there was sufficient staff on duty that ensured people’s care and social needs were met. We made observations to support this. People received their medicines as required and there were processes to safely manage ‘as required’ medicines. Recruitment procedures were safe. Staff understood how to identify and respond to suspected or actual abuse and knew how to report matters internally and externally. People’s risks were identified, assessed and managed through guidance. There were systems to ensure regular maintenance and servicing of the environment and equipment was undertaken.

People received effective care from staff when they needed it. Staff received training and understood the principles of the Mental Capacity Act 2005 and empowered people through choices. The registered manager was aware of their responsibilities in regards to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the capacity to consent to care or treatment or need protecting from harm. People had access to healthcare professionals as required. People received support to eat and drink sufficient amounts and we saw that where needed staff followed professional guidance for weight management. New staff received an induction in line with nationally recognised standards and ongoing training and supervision was provided.

Staff were caring and people and their relatives spoke positively about staff. No concerns about the staff were raised. We made observations that supported people’s comments, with staff supporting people in a person centred way in accordance with the preferences. Staff we spoke with understood the people they supported well and this was reinforced through our observations and how we observed staff interacting with people. People’s privacy and dignity was respected, and when possible people were encouraged to be independent.

The service was responsive to people’s needs. People were encouraged to undertake activities and access the wider community. There was sufficient staff to support people to do this. The registered manager had ensured that where people were less social, events were arranged in the service. People’s care records contained current information that was person centred. People had allocated keyworkers who ensured their needs were me

Inspection carried out on 9 May 2016

During a routine inspection

We inspected this service on the 9 and 11 May 2016. This was an unannounced inspection. At our last inspection in February 2015 no concerns were identified.

Cherrywood House provides accommodation and personal care for up to 14 people who have a learning disability, autism and or mental health needs. It does not provide nursing care.

At the time of this inspection there were 14 people living at the home. Cherrywood House has two individual flats that had their own bathrooms, toilets, kitchens, lounges and bedrooms. There was 12 people who live in the main house. There is also a kitchen, dining area, a lounge, music room, an art room, an office, communal bathrooms and toilets. There is a front garden and private park area opposite the home and a patio and outdoor seating area gated from the drive way.

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 2008 and associated Regulations about how the service is run. The registered manager was present during the second day of the inspection.

People were not always supported by adequate staffing levels which affected their daily activities and access to the community. Staff supported people in a kind and caring manner. Staff demonstrated they knew people well, felt supported and felt able to raise any concerns with the management. People were supported by staff who had appropriate checks in place prior to commencing their employment.

People felt the home was safe. Care plans had detailed risk assessments and guidelines in place for staff to follow. People received their medicines safely and when required by staff who had received training. People were involved in their care planning and had support and assistance to access appropriate health professionals when their needs changed. People who were unable to consent to their care and treatment had completed assessments that involved significant others.

People were supported by staff who received regular supervision and training to ensure they were competent and skilled to meet their individual care needs. The registered manager was passionate about keeping people safe and ensured training was up to date following any incident. People were able to receive visitors whenever they wished. Relatives felt able to visit as often as they liked and people often visited their parents at weekends.

People’s views on the service were sought so improvements could be made. People felt happy to raise a complaint with the registered manager or the deputy manager. There was a quality assurance system that monitored the service and identified areas for improvement. Staff were recognised and rewarded for going the extra mile and their continuous service. They told us they felt happy and supported.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 11 February 2015

During a routine inspection

The inspection took place on the 11 February 2015 with two inspectors and was unannounced. Cherrywood House is a care home providing accommodation for up to 13 people who have a learning disability or autism. Eleven people live in the main house. Two people have their own self -contained accommodation attached to the main house. During our inspection there were 12 people living at the home. The property is a large detached house situated in a residential area of the town.

There was a registered manager in post at the service. 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 appeared relaxed during our visit, one person told us “I am safe living here I don’t worry about anything”. Staff knew the people they were supporting well. We saw staff encouraging people to engage in activities within the home. Relative’s told us people were treated well by staff.

Systems were in place to protect people from harm and abuse and staff knew how to follow them. Records we reviewed showed staff reported incidents to the registered manager. People’s medicines were administered safely. The service had appropriate systems in place to ensure medicines were stored correctly and securely.

Staff supervision wasn’t always held in line with the frequency identified in the organisation’s policy. Staff told us they received an induction when they started working at the service, we were unable to find any details of this in staff records. This meant we were unable to check if staff had received adequate training and induction when they started working in the home.

We saw that people’s needs were set out in individual plans. We found care plans and risk assessments were not consistently reviewed and updated with input from the person. We saw the registered manager was in the process of reviewing and updating care plans.

Relative’s told us they were confident they could raise concerns or complaints and they would be listened to.

The provider and registered manager assessed and monitored the quality of care. Audits covered a number of different areas such as care plans, infection control and medicines. The service encouraged feedback from people and their relatives and there were plans in place to improve the process of receiving feedback from people.

Inspection carried out on 16 December 2013

During an inspection looking at part of the service

We spoke with five people who lived in the home, three members of staff and observed the care and support provided to people.

At our last inspection on 6 and 9 September 2013 we had concerns about cleanliness and hygiene in the home�s wet room. We carried out this inspection to check that appropriate improvements had been made.

At this inspection we found all areas of the home were clean and fresh. The wet room had been deep cleaned and a new extractor fan had been installed. The room was clean and stain free. There was no sign of damp on the walls or ceiling. There were effective systems in the home to reduce the risk and spread of infection.

When we last visited the home people had restricted access to certain areas due to renovation work following an electrical equipment fire. This impacted on people�s independence and choice. We checked on this standard as part of our follow-up inspection.

We observed all areas damaged by the fire had now been redecorated and refurnished to a good standard. People were free to access all communal areas as they wished.

People told us staff respected their privacy, dignity and independence. One person said �They are kind and polite�. Another person said �I can have a laugh with the carers. No one treats me badly�. We heard staff speaking to people in a friendly and respectful manner. We observed staff knocked on people�s doors and waited to be invited in.

Inspection carried out on 6, 9 September 2013

During a routine inspection

We carried out our inspection at Cherrywood House over two days. We also spoke with six people who lived in the home and six members of staff. We also reviewed three people�s care plans. On the first day an expert by experience joined us to observe the care and support provided to people. The expert raised some concerns from what they observed which we followed up the manager on the second day of the inspection and appropriate action was agreed.

People had their care and support planned and assessed regularly by staff and other professionals to ensure it met their needs. We saw that people were relaxed and comfortable with other people living in the home. People spoken with told us they were happy living at Cherrywood House.

People had varying levels of communication and support needs. The majority of staff had a good understanding of people�s needs and knew how to support people in an emergency.

We had been informed that Cherrywood House had a fire in the main part of the house in July 2013. This had caused significant damage. Parts of the house were therefore not in use at the time of our inspection whilst renovation work was carried out.

We found there was a risk that people may acquire an infection due to a poor standard of hygiene and cleanliness in one of the home�s wet rooms.

People told us they knew what to do if they were not happy with their care. They also told us they were always asked for their consent before staff supported them with any care or treatment.

There were suitable arrangements in place to safely administer medicines to people.

Staff felt well supported by management and could discuss any aspects of their role either through team meetings or supervisions.

Inspection carried out on 23 January 2013

During a routine inspection

We spent time observing care practices, talking to people and staff and looking at records.

People we spoke with told us they were �very happy to live here� and �I like my room�. They said the staff were �friendly and always willing to help�.

People in the service told us they felt safe and could to talk to staff if they had any concerns. Staff received regular safeguarding training and were knowledgeable about keeping people safe.

People who used this service received a good quality of care and support. People were encouraged to express their views and were involved in their care. We observed that staff were caring and took time to speak with people, listened to them and responded to their needs.

Care plans reflected each person�s needs and wishes and families were encouraged to be involved where possible.

Inspection carried out on 18 October 2011

During a routine inspection

We spoke with three people who live at Cherrywood House who gave us positive comments on their experience of living at the home. They told us about the choices that they have and what they enjoy doing such as �I can choose to go to the art room� and �I can choose my food�. Others told us �Its nice here, I like going to the carnival and the zoo�. We saw that people using the service had a copy of the service user agreement in their records which they had signed where able.

One person told us that had been on holiday with their family and told us �I speak to my mum every day�.

We asked people who use the service if they felt safe living at Cherrywood House and they told us that they did. One person told us �If I was worried I would speak to my mum�.

We found that people we spoke with knew who their key worker was and had built up a good relationship with them. Telling us �I have been out to dinner and we go shopping to buy clothes� and �my key worker writes down my goals�. During our visit people were seen to be coming and going with their key workers. One person told us they had been working on their allotment with their key worker and another had been to the shops and was excited to show the manager what they had bought.

Two people that use the service showed us their bedrooms and told us that they had chosen the colours and bedding. The rooms were personalised and reflected their hobbies and art work they had made. Staff told us that people have a choice as to whether they would like a key to their room.

The manager told us how staff provided care and support for one person with particular needs. We reviewed their care plan but it did not contain sufficient information regarding the procedures that staff should use when dealing with this aspect of care.

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