Cherry Trees

Updated 11 September 2021

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 Care Act 2014.

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

The inspection was carried by two inspectors, one specialist advisor who was a nurse, and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Cherry Trees is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager. This means the registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave very short notice of the inspection because of the risks associated with COVID-19. This meant that we could discuss how to ensure everyone remained safe during the inspection.

What we did before inspection

We reviewed information we had received about the service. We sought feedback from the local authority who work with the service and provider, and local Healthwatch who are an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used any information the provider had sent us from their annual Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During our inspection we spoke with nine people who received a service and eight visiting relatives. We spoke with five care staff, a deputy manager, a nurse, a hostess, a housekeeping manager and one housekeeper. We also spoke with the registered manager and regional director.

We reviewed a range of records. This included examples of four people's care records and examples of medication records. We also looked at two staff recruitment files and records that related to the management and quality assurance of the service, especially around managing risk, medicines management, infection control, complaints, compliments and systems to ensure good clinical oversight.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 11 September 2021

About the service

Cherry Trees is registered to provide nursing, accommodation and personal care for up to 81 people, including people living with dementia. At the time of our inspection visit there were 67 people living at the home. Care is provided across two floors. Nursing care was provided on the ground floor in a unit called, ‘Young at Heart’. On the first floor, there was a separate unit for nine people with residential/dementia care needs called Cherry Blossom. This was not in use at the time of our visit; however, plans were being made for a potential opening in September 2021. The remainder of the first floor was called Memory Lane for people living with dementia. Communal lounge and dining areas were located on both floors. People’s bedrooms were ensuite and there were further communal bathroom facilities located on each floor.

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

Since our last inspection, people, relatives and staff told us improvements at the home had been made. People and relatives said the overall experiences of living at Cherry Trees, was better. Staff said improvements had been made, especially in the management of the service.

People and relatives were complimentary about the service they or their relative received. Relatives told us, management, communication and feeling more involved in their family members care had improved and the quality of care.

People were safe because staff were recruited safely. People said they were safe because staff made regular checks on them or if they had a change in health, support was provided. Staff and the provider knew how to keep people safe and protected from abusive practice. Systems to learn lessons when things went wrong helped to drive improvements and the registered manager notified us and the relevant body at the right times.

People said staff were kind, caring, gentle and always willing to do what was needed and expected of them. People were cared for by staff who attended training relevant to their roles. Assessments were completed before care was provided. This helped to ensure staff had the relevant skills and knowledge to meet a person’s needs. Some staff said recent admissions and a lack of information upon admission, though not their fault, did cause additional pressures on the staff team before they got to know the person.

Staff followed infection control procedures in line with national guidance for reducing the spread of COVID-19. Regular cleaning took place; however, we found some communal dining rooms would benefit from further cleaning and checks to ensure standards were maintained.

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.

People’s plans of care were detailed helping staff to provide safe care. Staff’s knowledge of how to support people was consistent with people’s care records and what people told us. Staff said there was limited or no reliance on agency staff, which meant the staff team worked well together because their knew people and their preferred routines.

Risks related to people’s care were recorded and reviewed. There were instructions for staff to follow to manage those identified risks. however, some risk assessments, such as those relating to specialist equipment, required more detail to be fully personalised. The registered manager assured us this would be addressed, conversations with staff showed they knew how to manage risk. In some examples, intervention by a GP or occupational therapist had been sought to help keep people safe.

Regular audits and quality checks were completed with oversight through internal compliance checks. People and staff were complimentary of the management team. Relatives we spoke with confirmed the quality of care was much better than when we last inspected in 2019. Relatives said the management team was approachable and responsive.

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 29 October 2019) and there was a breach of regulation 12 safe care and treatment and regulation 17 good governance. 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

The inspection was prompted in part to follow up on action we told the provider to take at the last inspection. The inspection was also prompted in part by reviewing statutory notifications we had recently received from the provider where we had information related to two separate incidents of choking. A decision was made for us to inspect and examine those risks.

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 work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.