Cherry Tree Care Centre

Updated 6 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors carried out this inspection.

Service and service type

Cherry Tree Care Centre is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Cherry Tree Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. During the inspection we were supported by the deputy manager.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 6 December 2022 and ended on 19 December 2022. We visited the service on 6 and 9 December 2022.

What we did before the inspection

We reviewed information we had received about the home since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 relatives and 8 people about their experience of the care provided. We spoke with 13 members of staff including the deputy manager, the administrator, 3 senior care staff, a cook, 6 care staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at the care records of 5 people and other records relating to the management of the home.

After the inspection

We continued to seek clarification from the nominated individual and deputy manager to validate evidence found.

Updated 6 January 2023

About the service

Cherry Tree Care Centre is a residential care home providing personal care to up to 40 people. The home provides support to people living with dementia. At the time of our inspection there were 34 people using the service.

People’s experience of using this service and what we found

Medicines were not managed safely. The home did not follow best practice guidance for the receipt, storage, and administration of medicines. Medicine record keeping was inaccurate and incomplete.

Risks to people had not always been recognised and mitigated. Care plans held inaccurate information and lacked detail to support staff to keep people safe. Incorrect calculations relating to people’s weight management were not identified. Some best interest decisions regarding the use of bedrails were not in place. The deputy manager addressed this matter immediately.

The provider did not have effective systems to monitor the safety and quality of the care provided. This meant the failings we found had not been identified by the registered manager and the provider.

Staff completed safeguarding training. Incidents and accidents and safeguarding concerns were recorded. The provider had recognised that changes could be made in this area to drive improvement. People lived in a safe environment. Health and safety checks were regularly conducted.

The provider had a robust recruitment process. Enough staff were deployed to meet people’s needs. The home had a warm friendly atmosphere. Staff knew people well. People told us they felt safe and staff treated them with respect.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice. The home worked with external healthcare professionals to support and maintain people’s health.

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 good (published 9 December 2019).

Why we inspected

The inspection was prompted in part due to issues within medicines, infection control, and quality assurance monitoring at the provider’s other services.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Due to the shortfalls found during the inspection the provider was requested to produce an action plan detailing what action and by when, they would address the issues identified.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, risk monitoring and management, and the governance of the home.

Follow up

We have already requested an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.