We carried out a review of the data available to us about Cherry Lodge Rest Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cherry Lodge Rest Home, you can give feedback on this service.
Cherry Lodge Rest Home is a residential care home providing personal care and accommodation for up to 19 people aged 65 and over. On the day of the inspection, the service was supporting 15 people, some of whom were living with dementia.
People’s experience of using this service and what we found
People told us they felt safe and staff were kind and caring towards them. People told us they felt supported with their healthcare needs and we reviewed care records which confirmed this. People told us there were sufficient staff to meet their needs.
People received their medicines on time and staff had undertaken competency checks to ensure they had the skills required to administer medicines.
We were assured staff were following safe infection prevention and control procedures to keep people safe.
Staff had received regular supervisions and told us they felt supported by management. There was a clear governance structure in place and staff knew their roles and responsibilities.
There were systems in place to monitor the quality of care provided. People and their relatives told us they knew how to raise concerns and felt confident management would listen and address these.
People, their relatives and staff told us they were regularly asked to provide feedback and felt they could approach management if they had any ideas on areas of improvement for the service
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 30 October 2020).
Why we inspected
This focused inspection was prompted by our data insight which assesses potential risks at services, concerns in relation to aspects of care provision and based on the rating at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Cherry Lodge is a residential care home providing personal care to 19 people aged 65 and over at the time of the inspection. The service was supporting their maximum registered amount of 19 people who are accommodated in one adapted building.
People’s experience of using this service and what we found
People told us that they felt safe at Cherry Lodge and were supported well by caring staff. Staff showed good knowledge of how to identify a safeguarding concern and how to report it.
People’s risks were managed well by staff and assessments were thorough, regularly reviewed and care plans offered correct guidance for staff. Regular audits were completed to ensure the quality of the home continued to be of a high standard. In the previous inspection it had been found that there was not an up to date legionella risk assessment. This was now in place.
Since our last inspection a new analysis model had been introduced to learn from accidents and incidents. This new system identified trends and patterns for staff to take action to prevent reoccurrence.
People were supported to take their medicines safely. Staff were up to date with training and regular competency checks were completed by management.
Staff were knowledgeable about people’s needs and individual risks. Staff supported people to access health professionals and follow up additional appointments and individual referrals in a timely way.
The care people received was person-centred. Staff knew individual likes and dislikes and encouraged people to take part in activities they enjoyed.
People and staff were involved in the running of the home and worked as a team. People and staff told us they felt listened to by the provider and management team.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was Requires Improvement (published 14 June 2019) and there were two breaches of regulation. These were in regards to the correct recording and reporting of safeguarding and accidents and incidents, as well as audits not highlighting health and safety risks. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 12 March 2019. At that inspection we rated the service a Requires Improvement rating and two breaches of legal requirements were found.
The service completed an action plan following our inspection. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as requires improvement.
At this inspection we reviewed the key questions of Safe and Well-led only and this report covers our findings in relation to these key questions.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurances that the service can respond to coronavirus and other infection outbreaks effectively.
The ratings from the previous comprehensive inspection for key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has improved from Requires Improvement to Good.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cherry Lodge Rest Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme when we will carry out a fully comprehensive inspection looking at all key questions. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
People were not safeguarded from abuse as an incident of potential abuse was not reported to the local authority and CQC as required by the registered manager.
Incidents and accidents were not always reviewed so actions could be taken to reduce the risk of them happening again.
The systems in place to assess and monitor the quality of the service were not effective as they had not identified the issues we pick up during this inspection.
Risk management plans were available but actions were not always taken promptly to maintain people’s health and well-being.
Legionella risk was not assessed to ensure that the water systems at the service were safe. After our inspection, evidence was sent to us to show that legionella risk assessment had now been completed.
Staff were trained on safeguarding adults from abuse and knew to report their concerns to management in line with the provider’s procedures.
There were sufficient staff deployed to meet people’s needs and recruitment checks were conducted before new staff were employed.
Health and safety checks were conducted including fire safety. The environment was well maintained.
Staff were trained in infection control and followed procedures to reduce risks of infection.
People’s medicines were managed in line with safe medicine administration and management guidelines.
People’s needs were assessed in line with best practice guidance. People and their relatives were involved in establishing their needs and planning their care.
The service provided people with nutritious food and drinks to meet their nutritional needs.
Staff received training, support and supervision to provide effective care to the people, and to carry out their duties effectively.
People had to access to healthcare services they needed to maintain good health. The provider had arrangements and systems in place to ensure people received well-coordinated care and support when they used other services.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People gave consent to the care and support they received.
The service complied with the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Relatives and healthcare professionals were involved in making decisions for people in their best interests where this was appropriate.
Staff were kind and compassionate to people. People were given emotional support and reassurance when they were distressed and unhappy.
People were given a choice about how their care should be delivered. They confirmed they were involved in planning their care.
Staff treated people with respect and dignity, and gave them the privacy they needed. Staff support people to develop and maintain their independence with activities of daily living.
People’s end-of-life wishes were documented in their care plans. The registered manager told us they would work closely with other services to provide end of life care to people when needed.
People were supported and encouraged to participate in activities they enjoyed.
The service supported people’s needs with regards to their disabilities, culture and religion. Staff had received equality and diversity training.
People and their relatives told us they were involved in developing the service. People’s views were sought and used to develop the service.
People and their relatives knew how to raise concerns about the service and the registered manager addressed any complaints they received appropriately.
The provider worked in partnership with other organisations and services to develop and improve the service.
The registered manager and provider understood their roles to deliver an effective and high-quality service to people.
There was clear and visible management at the service and staff told us that they were supported in their roles. Staff demonstrated they understood their roles and responsibilities.
Rating at last inspection: The service was rated Requires Improvement at their last inspection of November 2017. At this inspection the service was rated Requires Improvement overall for the second time.
Why we inspected: We carried out this inspection to check that improvements had been made following our last inspection where we found three breaches of regulations.
Our last inspection was in September 2016 where the service was rated ‘Good’ with no breaches of the legal requirements.
Cherry Lodge Rest Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Cherry Lodge Rest Home accommodates 19 people in one adapted building. At the time of our inspection there were 17 older people living at the home, some of whom were living with dementia.
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.
During this inspection we identified three breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities 2014). These related to consent, risk planning, medicines management, record keeping and audits. You can see what action we told the provider to take at the back of the full version of the report. This is the second time that the service has been rated as Requires Improvement.
There was not always a clear plan in place for staff to manage known risks to people. There was a lack of plans in place for specific healthcare needs and the risks associated with them. We also identified shortfalls in the recording of accidents and incidents that meant that the provider could not conduct an effective analysis of them. Safe medicine management practices were not always followed. We identified gaps in the recording of medicines and concerns with how medicines were stored and managed.
People’s legal rights were not protected because staff did not follow the Mental Capacity Act (2005). Restrictions were placed upon people before the legal process set out in the Act had been followed.
There were gaps in record keeping that meant care plans did not always reflect people’s current needs. The provider conducted their own audits but these were not robust enough to identify concerns that we found during our inspection.
Staff understood their roles in safeguarding people from abuse. Staff had been trained in how to carry out their roles and had regular one to one supervision meetings. There were effective infection control practices in place and staff had received training in this area. Staff felt supported by management and had regular meetings. There were enough staff to meet people’s needs safely and the provider had carried out checks on staff to ensure that they were suitable for their roles.
There was a wide range of activities available that reflected people’s interests. People were supported by staff that they got along well with. Staff were respectful of people’s privacy and dignity when supporting them and encouraged people to be independent. Systems were in place to provide people with choices and to involve them in their care. Staff provided care to people in a way that was person-centred and reflected their needs. People were prepared food that matched their preferences and their dietary requirements.
The home was in the process of being redecorated and refurbished. Plans were underway to make the home environment easy to navigate for people living with dementia. Checks were carried out on the health and safety of the home and plans were in place to keep people safe in the event of an emergency.
Staff communicated well with each other to meet people’s needs effectively. The provider consulted people and relatives on the quality of the care delivered in order to identify any improvements to be made. People and their relatives were aware of how to raise a complaint if they were not happy with the care that they received. We found examples of staff working in line with best practice to meet people’s needs.
The inspection took place on 12 September 2016 and was unannounced.
The service had a registered manager in post. 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. The registered manager was also the provider of Cherry Lodge.
At the last inspection on 23 July 2015 we asked the provider to make improvements to staffing levels, the way staff were supported, how consent was sought, nutrition and how people received personalised support. We found at this inspection that the provider had taken appropriate action in each of these areas. We made one recommendation as a result of this inspection. As such we asked the provider to consider ways of capturing people’s concerns in order to identify and possible trends and themes.
Cherry Lodge is a small service that provides residential care for people no longer able to live in their own homes. Many of the people accommodated previously lived in the local area and the service prides itself as being part of the community. As such, people benefitted from the ability to maintain previous networks and friendships.
People’s needs were met by a core of staff who worked effectively together as a team. Staffing levels were sufficient to meet people’s needs and provide them with appropriate levels of support. There were systems in place to ensure the appropriate recruitment and continuous monitoring of staff. This helped to ensure that only suitable staff worked at the service.
Staff received on-going training and support from the management team in order to deliver their roles effectively. People were protected by staff who understood their role in safeguarding them from the risk of harm or abuse.
People had good relationships with staff who took steps to ensure care was provided in a way that protected their privacy and dignity. People were encouraged and supported to both maintain and develop their independence and spend their time doing things that were meaningful to them.
People were supported to maintain good health and the service linked with other external professionals to ensure their healthcare needs were met. There were systems in place to ensure that people received their medicines safely and at the right times. People had choice over their meals and were supported to maintain a healthy and balanced diet.
People were involved in making decisions about their care and had choice and control over their daily routines. People and their representatives were able to share their feelings and staff ensured that when people raised issues that they were listened to and people’s opinions were valued.
The management team worked effectively together to ensure the smooth running of the service. Regular monitoring and auditing of the service provided mechanisms for on-going development and improvement.
Cherry Lodge Rest Home provides accommodation for up to 19 people, most of whom are elderly and frail and some, as described by the manager, who are living with mild to moderate dementia. Some of the rooms in the home are shared. At the time of our inspection 15 people were living in the home.
The inspection took place on 23 July 2015 and was unannounced.
There was a registered manager in post at the time of our inspection. The registered manager was also the provider. 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. There was a new manager to the home and also a deputy manager. All three were present during our inspection.
Staff followed correct and appropriate procedures in relation to medicines to ensure people received their medicines safely, however there was no guidance to staff for people who may request PRN (‘as required’) medicines.
Although people were not having to wait for assistance by staff we observed staff constantly working at tasks with little or no time to socially interact with people. The registered manager had not considered the deployment of staff and the kitchen staff were unsupported.
Care was provided to people by staff who, although competent in their role, were not provided with the support to attend training. Some staff were behind on their training.
Staff did not understand their responsibilities in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Best interest decisions were not made in line with legislation.
People were not provided with a varied or diet or involved in developing the menu’s.
Although we observed some good examples of kind care from staff, we found people’s privacy was not always upheld by staff.
Activities were not individualised and did not occur regularly. People were not supported to access the community. The environment in the home was not suitable for people living with dementia.
Care plans were not person-centred and not always accurate. It was difficult to identify if people received care responsive to their needs. For example, in relation to specific conditions.
Staff received supervisions and appraisals, but did not feel supported by the registered manager. Staff told us they were demoralised and unhappy.
Staff supported people to access health care professionals, such as the GP or district nurse, however we were told there were times people with nursing needs were admitted into the home.
Complaint procedures were available to people. People and relatives would speak to the manager if they wished to complain.
Staff knew the procedures to follow should they have any concerns about abuse taking place in the home. Risk assessments were carried out for people to maintain their individual safety, however we found the premises was not necessarily a safe place for people to live.
The provider had ensured safe recruitment practices to help them employ staff who were suitable to work in the home.
Relatives were made to feel welcome when they visited.
Quality assurance checks were carried out by staff to help ensure the home was a safe place for people to live. However, the registered manager did not always adhere to the requirements of their registration.
During the inspection we found some 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 the report.
As part of our inspection we spoke with four staff, one health care professional and four relatives. We were able to speak with seven people who lived in the home. At the time of our inspection 17 people received personal care.
One inspector carried out this inspection. The inspector considered the inspection findings to answer questions we always ask:
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
Is the service safe?
We saw that people lived in a safe environment. The service was clean and hygienic and people were able to move around the home and garden freely without any risk of harm.
We found that the provider obtained all the necessary information on staff to ensure that they were suitable to work with vulnerable people.
Is the service effective?
Our observations told us that staff had a good understanding of people's needs. Two relatives we spoke with told us they had seen a difference in their family member since they moved in to Cherry Lodge. One relative said, 'They had them back walking within two weeks of moving in.' Another relative told us, 'They look clean, tidy and so much better since they've been here.'
Is the service caring?
We saw that staff showed patience and gave encouragement when supporting people. One relative we spoke with said, 'I don't think I could get better for their needs.'
People's preferences, interests, and diverse needs were met. We saw how two people liked to spend some time in the garden, whilst another preferred to do some colouring.
Is the service responsive?
We saw that two district nurses visited the service during our inspection. The manager told us that one had visited as a result of their telephone call that morning.
Is the service well-led?
There were regular meetings for the people who lived in the home. Staff who we spoke with told us the manager was very supportive and they (the manager) had an open door policy.
We were shown that the service asked people who used the service, their relatives and visiting professionals to complete a satisfaction questionnaire. The results of these questionnaires were used to improve the service.
The evidence that we looked at demonstrated to us that people who used the service could be confident that staff would be able to recognise and respond to safeguarding matters in the correct way. We spoke to staff who were aware of the safeguarding procedures in place. Staff were also aware of other related policies, such as their responsibility for reporting abuse, whistle blowing and deprivation of liberty safeguards.
The provider regularly undertook audits of all care plans and these were updated accordingly. In addition the provider completes regular audits for example medication, catering, infection control, health and safety and risk assessments that ensured the health and welfare of people who used the service and to promote a safe working environment.
Suitable arrangements have been made to ensure the dignity and privacy of people using the service is promoted they are always provided with choices in respect of their meals. People living at the home told us that the staff always "chat with us about what we want to eat" and "if there is nothing I fancy they always come up with another choice".
One person said the staff always "come round and ask what we what for our meals about an hour before our meals".
Suitable arrangements have been made to ensure people who use the service are protected from abuse or the risk of abuse, policy and procedure now provide staff with up to date guidance and staff are aware of their role in safeguarding people who use the service.
We saw that all required documents have been obtained to ensure people using the service are protected from persons who are fit to work in a care service.
The social and leisure needs are fully met. One person who lives at the service told us that they attended some of the activates but if they did not want to "someone would spend some time sitting or chatting" with them and "that they did not like to join in with all the activities but they were always asked if they wanted to come down and join in".
One person using the service said they liked living in the service more than at their previous home. Another person using the service told us they were satisfied at the service but not exactly happy there.
Two people who use the service told us that as no menu was provided they did not know what meal would be available until it was served. Two other people who use the service told us they amused themselves and provided their own entertainment because there was 'not much going on'.