Archived: Cherry Orchard

Updated 21 June 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.

The inspection took place on 2, 3 and 4 May 2018 and was unannounced. On the first day of the inspection the inspection team consisted of one inspector, a medicine inspector, specialist advisor in nursing and an expert-by-experience. A specialist advisor is a person who has professional experience in caring for people who use this type of service. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise is dementia care. The second and third day of the inspection was carried out by one inspector.

Before the inspection we looked at concerns raised and information we already held about this service. This included details of its registration and notifications of significant incidents they had sent us. Notifications are information about important events which the service is required to send us by law. We contacted the host local authority with responsibility for commissioning care from the service to seek their views.

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

We spoke with seven people using the service and ten relatives. We observed how people were supported and how staff interacted with people. 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 to us.

We spoke with four members of the management team; this included the manager, regional director, deputy manager and relief support manager. We spoke with 14 staff; this included three nurses, five care assistants, activity co-ordinator, receptionist, maintenance person, head chef, kitchen assistant, and housekeeper. We also spoke with a healthcare professional and a social care professional visiting in the service.

We looked at the care files for 17 people using the service including care plans, risk assessments and care and treatment records. We looked at medicines records of ten people. We reviewed the training records for all staff and looked at the recruitment and supervision records of four staff. We looked at the minutes of team meetings. We checked various policies and procedures including adult safeguarding procedures. We reviewed quality assurance and monitoring systems at the service.

Updated 21 June 2018

Cherry Orchard 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.

Cherry Orchard is registered to provide accommodation and nursing care for up to 40 people. The accommodation was arranged across three separate units on ground floor level, each with separate adapted facilities. All units specialise in providing care to people living with dementia. We inspected the service on 2, 3 and 4 May 2018. This was an unannounced inspection. There were 31 people using the service at the time of our inspection.

The service had a manager who was in the process of applying to become the registered manager for the service. 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 last inspection on 10, 11 and 17 February 2016 the service was rated Good overall with a rating of Requires Improvement in effective. We made a recommendation because staff did not always receive regular one to one supervision and some staff needed to improve their knowledge of the Mental Capacity Act (2005). At this inspection we found improvements had been made to meet the recommendation.

People told us they felt safe using the service and their relatives agreed. Staff received safeguarding training and knew how to report safeguarding concerns. Recruitment checks were in place to ensure new staff were suitable to work at the service.

Risk assessments were completed and management plans put in place to enable people to receive safe care and support. Staff had a good understanding of infection control procedures and used personal protective clothing such as aprons and gloves to prevent the spread of infection. There were systems in place to manage people’s medicines so they received them when needed.

There were effective and up to date systems in place to maintain the safety of the premises and equipment. Lessons were learnt when accidents and incidents occurred to minimise the risk of recurrence.

People’s needs were assessed before they began using the service and they had access to healthcare professionals as required to meet their needs. Personalised care plans were in place, reflected people’s needs and were updated regularly.

Staff had a clear understanding of the application of the Mental Capacity Act 2005 and appropriate applications for Deprivation of Liberty Safeguards had been made and authorised. People using the service had access to healthcare professionals as required to meet their needs. People were offered a choice of nutritious food and drink to maintain good health.

Staff knew people they were supporting including their preferences to ensure personalised care was delivered. People using the service and their relatives told us the service was caring and we observed staff supporting people in a caring and respectful manner. Staff respected people’s privacy and dignity and encouraged independence. People had the opportunity to participate in a programme of meaningful activities. People and their relatives knew how to make a complaint.

Regular meetings took place for staff, people using the service and their relatives. The service had systems in place to seek the views of people and their relatives regarding the quality of the service. Quality monitoring systems were in place to identify areas of improvement.

People and their relatives told us the manager and management team were supportive and approachable.