Cherry Lodge

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People, where they could, and family members and friends told us they had been involved in the assessment and reassessment of people’s needs. Assessments considered people’s communication needs, their health, care and wellbeing to make sure they received care and support to meet their individual needs. People who lived at the service whose first language was not English, were sometimes supported by staff who could converse with them in their preferred language. Staff understood people’s needs and when asked how they supported people, it was clear staff knew people very well.

Care plans had been reviewed and the registered manager and deputy manager had completed regular audits. There were some minor discrepancies contained within the care plans, daily notes and risk assessments, these were discussed with and addressed by the management team at the time of the assessment.

Where there had been any changes to people’s needs, the changes had been documented and communicated to, for example, external health care teams such as the community nurses if a person had sore skin developing. We saw prompt referrals had been made to the GP, dietician and SaLT where people’s needs had changed around their nutritional support. For example, a drop in their weight, or found to be struggling with eating and swallowing their food. Where people were at risk of weight loss, there were food and fluid charts in place.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, we found in a number of policies, such as, medication, infection control and safeguarding, there were references to sections of legislation and working practices not applicable in England. People’s care and treatment should be delivered in line with legislation, and current evidence-based good practice and standards. The registered manager explained how they went through a policy a month with staff during staff meetings, but had failed to identify that the policies being referred to contained legislation from other countries.

Staff told us they had undertaken training in caring for people with dementia, learning disability and autism, but not all specific medical and health conditions, such as sepsis, had been included in their training programme. The provider took immediate action to address this.

Some people had regular input from visiting health care professionals and communication between the care staff and the visiting professionals was good. Staff raised any issues or concerns they had about a person’s health and wellbeing, with the registered manager, family member or directly with a nursing practitioner. Staff had regular meetings and updates from the management team to understand about best practice, in the form of supervision and/or spot checks.

Not everyone required support with their nutrition and hydration, but those who did were happy with the support they received. Our observations found people were given opportunities throughout the day for drinks and snacks.

Everyone we spoke with told us the provider and their staff delivered good care and support to them.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services such as into hospital. One relative told us, “I have nothing but thanks to give the manager and staff, I feel comfortable speaking to them, and we know all the staff and they know [person] very well. [Person] has settled in quickly and doesn’t say they want to go home; they say now this is their home.”

Staff were positive about their working relationships with external professionals, the provider, family members and the people they supported. One staff member said, “We all work well together, we work as a team to look after the residents.”

People and relatives told us communication with the provider and their staff had improved under the current management team and they all felt comfortable in raising any concerns or issues as they arose.

Feedback from healthcare professionals confirmed the staff promptly made them aware of any deterioration in people’s health conditions. One professional told us, “Under the current manager's leadership, staff now demonstrate greater confidence in triaging concerns and understanding clinical accountability."

The provider supported people to manage their health and wellbeing as much as practicably possible to maximise their independence, choice and control. Staff supported people to live healthier lives such as encouraging people to stay active through exercise. People were encouraged to make healthier choices with their eating and drinking. For example, 1 person and their family members had agreed catering staff could store sweets and cakes the family had brought in for the person, to make sure their diabetes was monitored correctly.

Reviewing care plans we found people were supported to access routine health appointments, for example, access to optician, dentistry and podiatry services.

Staff told us how they worked with people, their family and friends and other health and social care professionals to support people’s health. We saw appropriate and timely referrals were made, for example to the occupational therapy team, community nurses and the GP.

One person told us about the positive impact the provider and their staff had on their health by successfully working with them to reduce the risk around their smoking.

The provider routinely monitored the care and treatment to improve outcomes for people. For example, 1 person was at risk of financial abuse. We found the provider, in full discussion with the person, had put measures in place to support the person with their finances. The person told us, “They (staff] help me manage my finances. I insist on being independent, but I’m just not good at managing money. They (staff] have put things in place to help me which I have agreed to, and I needed support with that.”

The registered manager and their staff explained how they supported people, as much as practicably possible, with their daily lives to maintain their health and wellbeing. Staff told us they spoke with health professionals if they had any concerns or to make sure they knew how to support people with any prescribed treatments.

People and relatives told us the staff that supported them understood their care and support needs and their input had helped to maintain their independence and achieved positive outcomes.

The registered manager met with people and their relatives to discuss their care and support to make sure care plans were relevant and being followed. People and relatives confirmed this and spoke highly about the quality of the care. One relative said, “There has been a massive improvement since (registered manager) came here. The organisation is better, there’s more for people to do, relatives can become more involved if they want to.”

Care plans showed the correct use of monitoring tools, such as Waterlow scores used for assessing the risk of pressure ulcers in people. The staff also used the Malnutrition Universal Screening Tool (MUST) scores to assess a person's risk of malnutrition and weight loss. Care plans also contained goals for people to try and achieve, such as encouraging exercise, reducing levels of cholesterol and encouraging a healthy diet.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People and their relatives felt their views and wishes had been considered when care and support was being planned. People told us staff always sought their consent before supporting them with their care needs. Relatives told us they felt involved with the support for their loved ones and that their views were considered.

Care plans considered people’s capacity and their ability to consent to their care and make decisions about the support needed. The provider had tried to ascertain whether relatives and friends had power of attorney to support people when making decisions about their health and welfare and finance. Where decisions had been made for people who did not have the mental capacity to understand the decision they were being asked to make, we found the Mental Capacity Act (2005) (MCA) had been followed and decisions had been made in people’s best interest involving the relevant agencies and people where appropriate.

Staff told us they had completed training around the MCA and consent and demonstrated in their answers they understood about people’s capacity to make decisions about their care and support.