Cherry Holt Care Home

Updated 2 September 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 carried out by 1 inspector, a bank inspector, a specialist nurse advisor, and an 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 Holt Care Home 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 Holt Care Home is a care home with 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 integrated care board who commission care with 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 all this information to plan our inspection.

During the inspection

We visited the service on 3 and 4 July 2023. We also made phone calls to relatives on 4 July 2023. We spoke with 9 staff members including the registered manager, compliance apprentice, senior care staff, care staff, registered nurses, activities staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 1 visiting healthcare professional. We spoke with 5 people who used the service and 14 people's relatives. Not everyone living at the service was able to or wanted to speak with us, therefore we spent time observing interactions between staff and people. We reviewed a range of records. This included 8 peoples care records and multiple medicine records. We looked at 5 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, policies and training records were reviewed.

Updated 2 September 2023

About the service

Cherry Holt Care Home is a purpose-built residential care home providing the regulated activities of personal and nursing care to up to 52 people. The service provides support to older and younger adults and adults with physical disabilities. At the time of our inspection there were 47 people using the service. Support is provided across two floors with a large lounge on the ground floor.

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

Risks were not consistently managed or monitored. Medicines were not always managed safely. Staff were recruited safely and there were enough staff deployed to meet people’s needs. The registered manager reported safeguarding concerns to the local authority in a timely manner. We were assured that the provider’s infection prevention and control policy was up to date.

Internal quality assurance processes were not always effective in monitoring the service which meant improvements were not always made. Staff, people, and their relatives were encouraged to share their views. The registered manager understood their responsibility to be open and honest with people and had acted when things went wrong. The provider worked in partnership with others.

People's needs were assessed however we found some assessments lacked detail to ensure staff had the correct information to support people safely. Referrals to some health and social care professionals were not always made in a timely manner. The premises and environment were under refurbishment therefore did not always meet the needs of people. The registered manager had highlighted gaps in training prior to our inspection. Specialist training had been sought and booked to ensure people received effective care and support. People were supported to eat and drink enough to maintain a balanced diet.

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.

People's communication needs were assessed and documented within care plans. However, we found inconsistencies with how these needs were managed. People were supported by staff who had a good understanding of each person’s individual needs. Staff supported people to follow their interests and hobbies. End of life wishes had been discussed and documented within care plans.

People and their relatives told us, staff respected people’s dignity and independence. People’s individual choices were fully respected. People told us, and care records demonstrated, people had been given a choice of who they would like to help support them. People were encouraged and supported to express their views.

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 outstanding (published 22 February 2020). Since our last inspection there has been a change in both the management and ownership of this service.

Why we inspected

The inspection was prompted in part due to concerns received about nursing care, infection control and the management of medicines. A decision was made for us to inspect and examine those risks.

The overall rating for the service has changed from outstanding to requires improvement 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 section of this full report. You can see what action we have asked the provider to take at the end of this full report.

During our inspection the provider took significant action to address the concerns we found to mitigate risks. Risk reduction measures implemented during our inspection were found to be effective in managing the risks we identified.

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

Enforcement

We have identified breaches in relation to medicines, management of risk and quality monitoring at this inspection. 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 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.