Cherry Lodge

Updated 27 January 2024

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

The inspection was carried out by 2 inspectors, 1 specialist advisor who was a nurse, and 2 Experts 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 Lodge 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.

Registered manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for two months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service. 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 9 relatives about their experience of the care provided. We spoke with 9 members of staff as well as the acting manager, deputy manager, senior care workers and care workers. We spoke to the nominated individual to ask them about how they monitored the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 8 people's care records, quality assurance records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We continued to seek clarification from the provider to validate evidence found, including information about the provider's monitoring and medicines documentation.

Updated 27 January 2024

About the service

Cherry Lodge is a residential care home providing regulated activities of personal care and accommodation to up to 46 people. The service provides support to older people, people living with dementia and people with mental health needs. At the time of our inspection there were 34 people using the service. Cherry Lodge accommodates people in one adapted building. The home is set out over three floors with a passenger lift available to access the first and second floors of the home.

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

The provider’s systems and processes required further improvements to ensure records contained all the required information to meet people’s needs. Some people’s risk assessments required more detailed instructions for staff to keep them safe.

Accident and incident records were completed and monitored by the registered management however further work was required to ensure patterns and trends were identified and strategies put in place to reduce the likelihood of reoccurrence.

People were not always supported to be involved in activities that met their own individual needs or preferences.

Some medicines records were not up to date and care plan reviews were not always completed within agreed timescales.

Governance systems and processes were not always effective at monitoring the quality and safety of the service.

The provider had safeguarding systems and processes in place to keep people safe. Staff knew about the risks to people and followed the assessments to ensure they met people's needs.

People felt safe and were supported by staff who knew how to protect them from avoidable harm.

People received their medicines safely and as prescribed and were supported by sufficient numbers of staff to ensure that risk of harm was minimised.

Staff had been recruited appropriately and had received relevant training, so they were able to support people with their individual care and support needs.

Staff sought people's consent before providing care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way and in their best interests: the policies and systems in the service supported this practice.

People's individual communication needs were considered to support them to be involved in their care.

Staff spoke positively about working for the provider. They felt well supported and that they could talk to the management team at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.

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 the service was inadequate (published on 24 February 2023). This service has been in Special Measures since 24 February 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cherry Lodge on our website at www.cqc.org.uk.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook an unannounced comprehensive inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

Enforcement and Recommendations

This inspection has identified a continued breach relating to people receiving care that is centred on them and the governance systems in place to maintain oversight of the service. We will continue to monitor the improvements within the service through existing conditions we have placed on the provider’s registration. This includes sending us monthly reports of actions the provider has taken to make improvements within the service.

We have made a recommendation about delivering meaningful activities to people.

Follow up

We will request 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.