Background to this inspection
Updated
21 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
The inspection was completed by an inspector, pharmacist specialist, specialist advisor and 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 Garth 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 Garth is a care home without 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we already held and had received about the service since the time of the last inspection. We sought feedback from the local authority, safeguarding team and other professionals who work with the service. We checked information held by the fire service, environmental health officer, Companies House, the Food Standards Agency and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. 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 took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with five people and nine relatives. We observed people’s care and staff interaction with them. We spoke with the interim manager, quality manager, operations manager, care workers, activities coordinators and cleaners. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We asked staff on shifts to provide their views. We reviewed a range of records. This included multiple people’s care records, personnel files and medicines administration records. A variety of records relating to the management of the service, including policies and procedures were also reviewed. We took digital images of the premises and provided copies to the service. We wrote to the interim manager, quality manager and nominated individual after the site visit and requested some information. We received multiple additional documents and written explanations.
Updated
21 January 2023
About the service
Cherry Garth is a residential care home providing accommodation and personal care for up to 60 people. The service provides support to older people, people living with mental health conditions, people with dementia, physical disabilities and sensory impairments. At the time of our inspection there were 28 people using the service.
The building layout is three floors, where people can live across five separate ‘houses’. Each person has their own bedroom, and there are communal toilets, bathrooms, lounge and dining areas. There is a hairdresser and a coffee shop. At the rear of the building, there is a garden and entertainment areas. Various offices for staff are located throughout the building.
People’s experience of using this service and what we found
Since the last inspection, numerous changes were made to ensure the safety of care people received. The service is now compliant with regulations, however further improvement is required.
People’s risk assessments and care plans were replaced, updated and made more individualised. Sufficient staff were deployed to meet people’s needs. An ongoing recruitment programme is in place as there are a high number of staff vacancies. Incidents and accidents were logged, there was consistent recording and follow up. Infection prevention and control remained satisfactory, with some deep cleaning required. People were protected against abuse and neglect. Medicines safety has improved. We made a recommendation about medicines policy.
People’s care was more person-centred. The service had started to implement best practice guidance into everyday practice. People received nutritious, healthy meals and snacks. The service’s premises were suitable for people receiving personal care; improvement to ensure a ‘dementia friendly’ environment is still required.
There was an active social life programme at the service. People commented on the wide range of activities and events. Complaints were investigated, most outcomes were communicated effectively. The provider had not ensured that complaints raised directly at head office were logged into the service’s register.
There were improvements to systems and processes in place to ensure safe, compassionate, well-led care. The service’s improvement plan was being used to track progress. The service had liaised with people, relatives, staff and the local authority more often than previously. There was evidence of a programme of audits, completed at different intervals, however more time is required to embed the governance system fully. There is evidence of meetings with people, relatives and staff. The oversight by the management team was better and they were more proactive at following up actions required. Staff reported some improvement in workplace culture, however felt morale still required improvement. We made a recommendation about the duty of candour requirement.
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.
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 inadequate (published 1 March 2022).
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.
This service has been in Special Measures since 28 February 2022. 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.
Why we inspected
We carried out an unannounced focused inspection of this service on 19 January, 20 January and 24 January 2022. Breaches of legal requirements were found. We issued two warning notices and the provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.
For key question Caring, we used the rating awarded from the October 2019 inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cherry Garth on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.