Cherry Lodge

Updated 17 April 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

Two inspectors and 2 Experts by Experience carried out this inspection. 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 and/or personal care as a single package under one contractual agreement dependent on their registration with us. Cherry 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 were 2 registered managers in post, 1 of whom was the provider.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service and 1 relative. We observed the interactions between staff and people using the service. We reviewed the care records of 5 people who used the service and multiple medicines records. We reviewed 3 recruitment records. We spoke with 8 members of staff including the provider who was also a registered manager, registered manager, 2 senior staff, 2 care staff, the cook and 1 housekeeping staff.

Following the inspection, we reviewed records relating to the governance of the service, including incidents and accidents, training records, and audits. We also received feedback from a further 5 relatives, and 3 staff, which included care and senior care staff.

Updated 17 April 2024

About the service

Cherry Lodge is a residential care home providing accommodation and personal care to up to 27 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 24 people using the service.

The service is spread across a ground, first and second floor, and a passenger lift was in place to access each of the floors. There were communal areas that people could access, including a lounge and dining areas.

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

Actions to identify, investigate and report allegations of abuse were not sufficient. Incidents which indicated abuse had occurred had not been reported to the local authority safeguarding team. Reportable incidents had not always been referred appropriately to ensure external scrutiny of the home.

Risks to people were not robustly assessed and mitigated. Staff did not always have the information they needed to provide safe care because risks associated with people's care had not always been fully assessed. This included risks relating to falls, diabetes, behaviours of distress, and choking.

Improvements were needed to infection control practices in some areas of the service. Staff were observed to wear appropriate personal protective equipment (PPE) but disposal of this was not always in line with best practice to reduce the risk of infection.

Records did not reflect staffing numbers were adequate at all times, including in the event of an emergency. Staff received training relevant to their roles, but we were not assured that were applying the learning in the delivery of care. There was no system in place to check this.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The system in place for recording people's nutritional intake did not support the staff to clearly monitor what people had eaten daily, including any snacks to encourage weight gain. Some referrals to specialist teams such as falls prevention and dementia support had not been promptly actioned.

The provider had not considered best practice for creating dementia friendly environments and we have made a recommendation about this.

Governance systems were not robust. The service was not using governance processes effectively to learn lessons or improve the service. The inspection identified six breaches of regulation as systems and processes were either not in place, or not robust enough, to ensure people's care needs were identified and people received safe care and treatment.

Medicines were managed safely, and staff were recruited with suitable checks in place.

We observed caring interactions between staff and people. Staff told us they were very fond of and cared about the people at the home. Staff knew people well and had established positive relationships with them. Feedback from 9 people using the service confirmed that they felt positive about staff and comfortable with them.

The registered manager and provider were responsive to the inspection findings and feedback and took some action after the inspection for the more urgent concerns identified. However, there were many on-going improvements which will need to be made to ensure people receive a safe and effective service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 6 March 2018).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service was alleged to have been a victim of abuse. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident.

However, the information shared with CQC about the incident indicated potential concerns about the management of the risk of abuse. This inspection examined those risks.

The overall rating for the service has changed from Good to Inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safeguarding procedures, management of risk, staffing, consent, governance and reporting procedures.

We imposed conditions on the provider's registration, which means we receive monthly data and action plans from the provider to assess if improvements are being made in a timely manner.

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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.