Cherry Wood Grange Care Home

Updated 19 November 2020

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.

Inspection team

One inspector and a nursing specialist advisor visited the service on 27 October 2020. We limited the amount of time spent at the service to minimise risk.

We spoke with four people, and seven staff. An Expert by Experience rang and spoke with five family members. 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 Wood Grange 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.

A few weeks prior to our inspection, the new manager received their registration certificate with the Care Quality Commission and so is referred to in this report as the registered manager. They 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 rang the registered manager to announce our inspection. This helped us to discuss with them how best to minimise the risk of infection at the service.

What we did before the inspection

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 took this into account when we inspected the service and made judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

We used all of this information to plan our inspection.

During the inspection

We focused on speaking with people who lived at the service and observing how they were cared for. Where people at the service were not able to talk with us, or chose not to, we used observation to gather evidence of people's experiences of the service. We also spoke with four people.

We spoke with the new registered manager, the business manager, a senior staff member, and seven care staff.

We viewed a limited number of key records as we were minimising our time at the service.

After the inspection

We received additional information from the registered manager, as requested and spoke with them on the phone.

Updated 19 November 2020

About the service

Cherry Wood Grange is a residential care home providing personal and nursing care to people aged 65 and over. At the time of the inspection there were 54 people living at the service. Care is provided over three floors. The top floor accommodates people with nursing needs, the middle floor specialises in providing care for people with dementia and the ground floor accommodates people with personal care needs.

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

When we last inspected this service in February 2020, we found that some of the systems in place to monitor the quality and safety of the service were not effective and risks to people were not always safely managed.

People had not always been involved in reviewing their care, and care records were not always personalised. A few months after the inspection, a new registered manager was appointed.

The number of safeguarding alerts had reduced since the arrival of the new registered manager. They were working well with external professionals to investigate and resolve outstanding concerns.

The feedback we received during our inspection combined a positive view of the new registered manager and the changes that had been made. One person said, “There is enough staff. There was one staff member who was a bit abrupt, I told the manager and I have not seen her since. I love it here, I am never leaving.” A staff member said, “It’s a lot happier here now. Sometimes staff haven’t always got on at times, but that has been resolved. The management has sorted this out now.”

The new registered manager had put in place systems to monitor the quality and safety of the service, we found these to be effective. The registered manager had introduced measures to learn from incidents and to look at how they could improve the service.

Since the last inspection, people's care records had been updated and reflected people’s needs and preferences. People and relatives were involved in reviewing care.

The way people’s medicine was managed had improved. Audits were in place and carried out routinely. People received their medicines as prescribed and were supported by staff who had received the appropriate training.

The registered manager had started to address the concerns we had raised at our last inspection. They had a practical, person-centred approach which was making a difference to the care people received. Although the registered manager had made positive changes and staff and relatives spoke highly of them, we would need to see a stable management team in the future to ensure improvements are sustained. At the time of the inspection, the provider was recruiting for a clinical lead for the home and told us a person had been recruited and would be starting shortly. A senior nurse was providing an oversight of the clinical care in the interim. The registered manager had a good understanding of the health needs of the people at the service.

Feedback was particularly positive about how well the registered manager was communicating with people, families and staff. One relative said, “Communication is excellent if they have any concerns or need to report anything to us. The care on the dementia floor is brilliant.” Another relative said, “The staff are very good at trying to motivate people. I have seen staff go and sit with people who are sitting on their own to check if they want any company.” Another relative said, “I am impressed with the strategies the staff use. The staff never seem to rush.”

We found the risk from the spread of infection was well managed. People’s care was well-planned, and staff minimised risks to people’s safety. The administration of medicines had improved.

There were enough staff to keep people safe. The registered manager was working well with the staff team to improve staff turnover and morale.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The registered manager promoted a person-centred approach to managing restrictions resulting from the covid-19 pandemic. They communicated well with people and families to explain the restrictions.

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 31 March 2020). After the last inspection, the provider completed an action plan 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

Our data indicated that the provider did not have effective systems in place to keep people safe. We also had concerns about the turnover of registered managers within the provider’s service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. Therefore, we did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

We considered how well the provider had responded to the concerns and breach found at the last inspection.

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

Follow up

We will continue to monitor the information we receive about the service, and we will carry out an inspection if we receive any concerning information indicating that people are not safe.