The Cherry Tree

We found the following examples of good practice:

The provider was following best practice guidance to prevent visitors to the home spreading COVID-19 infection. The provider kept in touch with family members and people's friends through emails, phone and text messages.

The provider had arrangements for visitors to meet with people virtually through video conferencing and physically in the home. All visitors were asked to complete a COVID-19 screening form on arrival, and had their temperature checked. Visitors had to undertake a lateral flow test on arrival or show proof of negative lateral flow test taken on the day of the visit and visiting professionals had to show proof of negative lateral flow test taken on the day of the visit; in addition, all visiting professionals had to show proof of their COVID-19 vaccination.

In order to control the spread of infection the provider promoted social distancing in the lounge and dining areas. The provider informed us that staff used Personal Protective Equipment (PPE) including gloves, mask and apron when providing personal care and when social distancing was not possible.

All COVID-19 positive service users were isolated according to Public Health England Guidelines. The provider informed us if a resident tested positive, they were isolated and were allocated a dedicated carer to cater their needs.

The provider had an admissions process in place. The provider informed us that as soon as the service users arrive, they perform a lateral flow test and a PCR test was undertaken on the day of admission into the service. The provider informed us that all new service users were usually isolated for 14 days where possible.

The home had two PPE stations for staff to don and doff (put on and take off) Personal Protective Equipment (PPE). The provider informed us that temporary PPE stations were set up outside the rooms of residents who were isolated due to COVID-19.

Our observations during the inspection confirmed staff were adhering to PPE and social distancing guidance.

The provider informed us that all staff had received the infection prevention and control and personal protective equipment training.

The provider informed us that all staff undertook COVID-19 lateral flow tests three times a week and PCR tests once a week. The provider confirmed us that all staff working at the service had received the first two doses of COVID-19 vaccine and most of the staff had received their booster dose. The provider informed us that all residents had received their booster dose. The provider maintained a vaccination and testing register for staff and service users.

The provider had ensured staff who were more vulnerable to COVID-19 had been assessed and plans were in place to minimise the risk to their health and wellbeing. The provider informed us that they had an open-door policy and had regular meetings with staff. The provider informed us they supported the wellbeing of staff by encouraging them to take regular annual leave. The provider informed that staff had access to wellbeing support and information. The care home manager indicated they had a really good management support system in place, and they had twice weekly COVID-19 support calls with all the managers in the company.

Further information is in the detailed findings below.

The service supports up to four adults with learning disabilities and/or autism. There were three people living at The Cherry Tree at the time of our inspection all of whom had complex needs.

The service continued to have a registered manager in post. The registered manager was aware of their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service.

At the last inspection of the service in 2016, the service was rated "Good". At this inspection we found the service remained "Good". The service continued to be well organised and managed.

The Cherry Tree has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People living at The Cherry Tree were living as ordinary a life as any adult. They had busy, active social lives which reflected their age and interests. Staff assisted people to keep in contact with their family and friends which helped to ensure they did not become socially isolated.

The provider had followed the Mental Capacity Act 2005 in assessing people's capacity to consent to their care. The provider made appropriate applications to deprive people of their liberty. Staff obtained people's consent before providing care or support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People and their relatives were fully involved in planning their care. Care plans included information about people’s abilities, likes, interests and background. People received care which met their individual needs from a consistent staff team who knew them well. The provider had effective systems in place to support people in relation to their behaviour which may challenge others. The care people received reflected their emotional as well as physical and mental health care needs.

People were protected from abuse and foreseeable harm. Risk assessments considered people's individual needs, strengths and areas where support was required. Support plans were in place which helped people manage the risks identified as safely as possible. Staff encouraged and empowered people to develop independent living skills.

Staff were kind and caring. They treated people with dignity and respect. Staff understood people's individual communication needs well and adapted the way they communicated accordingly. There was a sufficient number of staff to support people safely, meet their needs and support them to go out into the community. The provider ensured staff had the necessary training, skills and experience to support people safely and effectively.

Staff encouraged people to have a balanced diet and a sufficient amount to eat and drink. Staff supported people to maintain good emotional, physical and mental health and liaised well with outside social and health care professionals. People received their medicines as prescribed.

Recruitment processes were robust and appropriate checks were conducted before staff began to work with people. Staff received essential training but also training specific to the needs of people they were supporting.

People were given opportunities to feedback on the care they received. The registered manager listened to and used feedback to improve the quality of care people received. Staff were involved in the development of the service.

The registered manager kept abreast of developments in adult social care and supporting people with learning disabilities. She understood what was required to provide good quality care and was effectively supported by the provider to do so. There were appropriate systems in place to assess and monitor the quality of care people received.

The Cherry Tree provides accommodation for up to three people who require care and support on a daily basis. The home specialises in looking after adults with a learning disability. At the time of our visit, there were three people using the service. The people have moved to The Cherry Tree from another care home that the provider has now deregistered.

The home had a registered manager at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People were safe at the home. The provider took appropriate steps to protect people from abuse, neglect or harm. Training records showed staff had received training in safeguarding adults at risk of harm. Staff understood what constituted abuse and the action they would take to protect people if they had a concern.

Risks were managed so that people were protected and supported in a non-restrictive way. We saw that risk assessments and support plans were appropriate to meet people’s needs. Where risks were identified, risk management plans were in place. We saw that regular checks of maintenance and service records were conducted. This helped to keep people and the environment safe.

We observed there were sufficient numbers of qualified staff to support people and to meet their individual needs. We saw that the provider’s recruitment process helped to ensure that staff were suitable to work with people using the service.

People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Medicines were stored securely and staff received annual medicines training to ensure that medicines administration was managed safely.

Staff had the skills, experiences and a good understanding of how to meet people’s needs. Staff spoke about the training they had received and how it had helped them to understand the needs of people they cared for.

The service had taken appropriate action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed. DoLS authorisations were in place to protect people where they did not have capacity to make decisions and where it was deemed necessary to restrict their freedom in some way, to protect themselves or others. We saw that each person had been assessed through a mental capacity assessment and the provider had applied to the local authority to verify their findings. Each person had a time specific DoLS authorisation and this was clearly displayed in the person care plan.

Detailed records of the support people received were kept. People had access to healthcare professionals when they needed them. People were supported to eat and drink sufficient amounts to meet their needs.

People were supported by caring staff and we observed people were relaxed with staff who knew and supported them. We saw that people had the privacy they needed and they were treated with dignity and respect at all times.

The provider had arrangements in place to respond appropriately to people’s concerns and complaints.

We saw clear evidence of a person-centred, innovative and creative approach that was taken towards a person’s individual needs. Records showed and we saw that people’s complex needs and behaviours were managed through staff having a thorough knowledge and understanding of that person.

Staff were flexible about the activities people were involved in according to their preferences. . Records showed activities were risk assessed to ensure the person and others were safe. This helped to ensure the person enjoyed a good experience of the activity of their choosing.

From our discussions with the registered manager it was clear they had an understanding of their management role and responsibilities and the provider’s legal obligations with regard to CQC.

The provider had policies and procedures in place and these were readily available for staff to refer to when necessary. There were systems in place to assess and monitor the quality of the service. Weekly, monthly and annual health and safety and quality assurance audits were conducted by the home. The provider's quality assurance systems were effective in identifying areas where improvements were required so they could take the necessary action to address any concerns.