Cherry Tree Lodge Private Residential Care Home

Updated 15 February 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

This inspection was carried out by 2 inspectors

Cherry Tree Lodge 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 Tree Lodge 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 had received about the service. We sought feedback from the local authority and professionals who work in the service. 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 used information gathered as part of monitoring activity that took place on the 18 November 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We observed how staff provided support for people, to help us better understand their experiences of the care they receive. We spoke with 3 people living in the home and 4 relatives. We also spoke with 9 staff including, the registered manager, deputy manager, cook and care staff.

We had a tour of the building with the registered manager. We reviewed a range of care records, including, 4 people’s care records, 2 staff recruitment files, records relating to medicines, building maintenance, cleaning and equipment checks and accidents and incidents. We reviewed evidence that was sent to us remotely as well as seeking clarification from the registered manager to validate evidence found. We looked at audit and governance data, training and supervision records as well as policies and procedures.

Updated 15 February 2023

About the service

Cherry Tree Lodge Private Residential Care Home (referred to throughout this report as Cherry Tree Lodge) is a care home providing accommodation and personal care up to a maximum of 23 people in 1 adapted building. At the time of our inspection there were 20 people living at the service. Cherry Tree Lodge is also registered to provide personal care and support to people living in their own houses and flats in the community. However, at the time of the inspection Cherry Tree Lodge was not proving this service.

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

Various risks including fire and accident and incidents were not always monitored. People were safeguarded from abuse, the systems and processes for this service supported this. Medicines were managed safely. However, training in this area needed to be improved. The environment was clean and tidy, but some infection prevention practices needed improving. People were supported to have regular visitors. Recruitment processes were safe and there was enough staff to safely support people.

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; However, the policies and systems in the service did not always support this practice.

People were not always deprived of their liberty in a lawful and safe way. The necessary assessments were not always carried out in line with the mental capacity act. There was a system in place for staff when they commenced their role. However, not all staff had the relevant training such as medication and fire safety training. People’s care plans did not always contain accurate information and were found to be conflicting. We made a recommendation about this. People and their relatives spoke highly of the assessment process and felt involved. The environment was accessible and suitable for people’s needs.

People and their relatives spoke positively about the staff and the care they received. One person said, “The staff are lovely and caring.” We observed encouraging interactions between staff and people during the inspection and we found people were treated with dignity and respect.

People’s records and care plans were person centred. End of life discussions were taking place when appropriate and this was documented. People’s communication needs were identified, and information was made available to people in an accessible format. A complaints policy and procedure was in place. However, people told us they had no reason to complain and no complaints had been logged. The registered manager was in the process of recruiting an activities coordinator and we observed staff engaging with people during the inspection.

Audits were in place. However, they did not always identify risk and there was little evidence of learning lessons when something goes wrong. There was no evidence of people and their relatives taking part in feedback or satisfaction surveys. Following on from the inspection the registered manager has now implemented this to ensure people’s voices are heard. Staff worked in partnership with various agencies to support people and staff meetings were taking place. Staff and visiting healthcare professionals spoke highly of the registered manager.

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 outstanding (published 4 February 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

You can see what action we have asked the provider to take at the end of this full report.

The registered manager and provider have been responsive to the feedback provided during the inspection and has implemented changes to improve the quality and safety of the service.

Enforcement

We have identified breaches in relation to risk management, staff training, mental capacity and good governance. We have also made a recommendation in relation to modified diets.

Please see the action we have told the provider to take at the end of this report.

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 to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.