Cherry Garden

Updated 10 March 2018

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.

Our inspection took place on 7 February 2018 and 8 February 2018 and was unannounced.

Our inspection was completed by an adult social care inspector, a specialist advisor and an expert-by- experience. The inspector and specialist advisor were registered nurses. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert-by-experience had knowledge of older adults living in residential care settings.

We reviewed information we already held about the service. This included notifications we had received. A notification is information about important events which the service is required to send us by law. We also checked feedback we received from members of the public, local authorities and clinical commissioning groups (CCGs). We checked records held by Companies House, the Information Commissioner’s Office (ICO), the Food Standards Agency (FSA) and the local fire inspectorate.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with five people who used the service and two relatives who visited during our inspection.

We spoke with the nominated individual, the registered manager, the deputy manager, an administrator, the chef, a cleaner, a laundry worker and maintenance person. We also spoke with two registered nurses and five care workers.

We looked at seven people’s care records, three personnel files, all medicines administration records and other records about the management of the service.

Updated 10 March 2018

Our inspection took place on 7 February 2018 and 8 February 2018 and was unannounced.

Cherry Garden is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection.

Cherry Garden can accommodate 36 people across two floors, each of which has separate adapted facilities. The service cares for adults, including people living with early stages of dementia. The premises are a converted building with extensions. People live in their own bedrooms and have access to communal facilities such as a dining room, lounge and activities areas. Cherry Garden has a large garden at the side and rear of the building and is situated in a rural area. At the time of our inspection, there were 24 people living at the service.

The provider is required to have a registered manager as part of their conditions of registration. 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. At the time of our inspection, there was a registered manager in post.

At our last inspection on 18 January, 19 January 2017 and 20 January 2017, we found the provider had repeated breaches of Regulation 9, 11 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating was “requires improvement.” Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions effective, responsive and well-led to at least “good.” At this inspection, we found that the service had improved the process for obtaining people’s consent, that changes had occurred to ensure people received person-centred care, and better governance processes were in place to monitor the quality of care.

Improvements were made to staffing deployment, medicines management, infection prevention and control. This ensured people’s safety was maintained. This included protection from the risks of abuse, neglect, discrimination, injuries and accidents. The risks from the building and premises were mitigated, and people’s risk assessments ensured their care was safe. There were sufficient staff deployed to meet people’s needs. People were protected from the risk of infections. The service was clean and well-maintained. The management of people’s medicines was robust.

The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted 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 practise. Better systems were in place for obtaining and recording people’s consent.

Staff training and supervision ensured employees had the necessary knowledge and skills to effectively perform their role. People’s care preferences, likes and dislikes were assessed, recorded and respected. We found there was appropriate access to community healthcare professionals to ensure people’s wellbeing. People had adequate nutrition and hydration. We made a recommendation about the redecoration and refurbishment of the premises.

Staff were described as caring and kind. There was complimentary feedback from most people who used the service and their families. People told us they were able to participate in care planning, if they wanted, but some people chose not to. People’s privacy and dignity was respected when care was provided to them.

The service had achieved person-centred care. There was increased information in care documentation about people’s specific likes, dislikes and preferences for support. We observed staff knew people well and were able to care for them effectively. Care plans were thorough and contained information of how to support people in the best possible way. We saw there was an appropriate complaints system in place. There were regular meetings and surveys to ensure respective points of view could be conveyed to the service.

Governance of the service had improved. Changes in management had supported the improvement of the quality of care. The service had increased monitoring of care and other operational aspects, measuring areas that worked well or required improvement, and using action plans when needed. Staff worked well together and there was an improved workplace culture. The service continued to work well with community partners like the local authority and commissioners.