Archived: Cherry Tree House

Updated 17 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 18 and 19 April 2016 and was unannounced. It was carried out by an adult social care inspector.

Prior to the inspection the provider completed and returned to us a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed previous inspection reports and other information we held about the service including notifications. Notifications are changes or events that occur at the service which the provider has a legal duty to inform us about.

We spoke with 4 people who lived in the home, 2 relatives, 1 visitor and 4 staff including the manager, care staff and housekeeper. We spoke with one health professional and received information following the inspection from another. We reviewed four people’s care plans and associated documentation related to medicines. We examined four staff recruitment files and records related to the running of the service including audits and safety checks.

Updated 17 August 2016

This unannounced inspection took place on the 18 and 19 April 2016. The home was previously inspected in August and September 2014 when it was found to be complying with the requirements of the law.

Cherry Tree House is a residential care home providing care for up to 20 older people. Until April 2016 the home had a registered manager in place. At the time of the inspection a new manager had been appointed and had applied to be registered with the Care Quality Commission. The previous registered manager had changed roles in the home, and was therefore still employed but in a different capacity.

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 new manager had been in post for five weeks at the time of the inspection. They were in the process of receiving a handover and induction from the previous manager and being supported by the provider.

We looked at care plans and risk assessments and found them to be up to date and reviewed regularly. We found records for a person receiving respite care were not as comprehensive as those for people who lived permanently in the home. This was rectified by the manager.

Checks carried out prior to the employment of staff were not always robust. We found newly employed staff were shadowing more experienced staff before their references and Disclosure and Barring Service (DBS) checks had been received. Gaps in employment histories and reasons for leaving previous employment had not been investigated or documented.

We found medicines were being stored and administered in a safe way. Audits were completed to ensure practice was safe.

We observed sufficient numbers of staff to meet people’s needs. However, comments and feedback forms mentioned the need for more staff. The manager told us this was in relation to periods of time when staff were busy due to increased demand. They were looking into how they could support staff during these busy periods.

Staff knew how to identify and report concerns of abuse. The manager was clear about the process for reporting concerns and how to protect people.

People and their relatives told us staff were skilled in how to care for people and encourage independence.

Information related to staff training was incomplete. For example the training matrix showed only one staff member had completed training the provider deemed as mandatory. The training policy was out of date. When speaking to staff we found they did not understand the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS) and how these applied to their role. This was important in order to protect people’s rights. This was an area the manager planned to make immediate improvements in. Staff received regular supervision and felt able to approach the manager and their colleagues for support and guidance.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The manager had taken appropriate action to apply for a Deprivation of Liberty Safeguards (DoLS) for one person.

Staff demonstrated limited understanding of the Act and DoLS. We have made a recommendation about MCA and DoLS training for staff and associated records.

People received good support with eating and drinking by staff who knew their needs well.

Food was well presented, nutritional and tasty. The chef clearly had a good relationship with the people in the home, who told us the chef met their needs and preferences.

Overwhelmingly people and their relatives told us how caring and kind the staff were to them. We observed this during our visit. There was a gentle and fun approach displayed by carers. We got the impression staff knew people well and were able to communicate with them in a way that showed respect to people.

Where possible people or their relatives were involved in the planning of the care they received. Consent was obtained from people and their opinions and preferences were recorded. People spoke positively about the home and the sense that it was “a home from home.”

Activities were available to people to ensure they did not experience social isolation.

People and staff spoke positively about the new manager and the managerial staff in the home. We were told they were supportive and managed the service well. From our discussions with the manager we noted they had already identified areas that could be improved and had developed a good rapport with some of the staff.

Checks were in place to ensure the safety of equipment. Audits had been completed to assess the standard of care being provided. Feedback was obtained from people and staff to drive forward improvements to the service.