Cherry Tree Nursing Home

Updated 25 April 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

• The inspection was carried out by a bank inspector, an adult social care inspector and an expert by experience (ExE). An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. For example, dementia care.

Service and service type:

• Cherry Tree Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

• Cherry Tree Nursing Home is set in attractive well laid gardens. The building has been extended and a lift is available to facilities on the first floor.

• The service had a manager registered with the Care Quality Commission. This means that 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 did not give the service notice of our inspection on the first day. They were aware of our intention to return to the service to continue the inspection on the second day.

What we did:

• Before the inspection we reviewed the information we held about the service which included notifications they had sent us. Notifications are sent to the Care Quality Commission (CQC) to inform us of events relating to the service which they must inform us of by law. We looked at previous inspection reports and reviewed the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

• During the inspection we spoke with eight members of staff including the registered manager; the activity organiser, the chef, two nurses and three care assistants. We also spoke with a consultant advisor and a health professional who were present in the home. We observed staff interacting with people and supporting them. We spoke with 14 people and five family members.

• We looked at records related to the management of the service including five people’s support plans and associated records. We reviewed the medicines administration records for people and inspected three staff files including recruitment records. We reviewed minutes of meetings and a selection of quality assurance audits and health and safety records.

Updated 25 April 2019

About the service:

• Cherry Tree Nursing Home is a residential care home that was providing personal and nursing care to 45 older people at the time of the inspection. The service is registered to accommodate up to 52 people.

People’s experience of using this service:

• During our previous inspection in February 2018 we identified areas that required improvements. These included records that were not up to date and accurate, and a lack of management oversight and quality assurance. During this inspection we found improvements had been made in all areas. The service has been awarded a rating of good in all domains.

• We found systems were in place to ensure the safety of people living in the service. Records were up to date, and risk assessments had been completed to minimise risks to people.

• Checks had been completed on essential safety apparatus such as fire protection equipment and hoists. Services such as gas and electricity had been maintained.

• People’s nutritional and dietary needs were assessed, documented and care was provided in line with their needs. External professional provided professional advice when needed.

• Staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Where appropriate, advocates were employed to support people with making choices about their lives.

• Information about people was being recorded in a respectful and dignified way. Records were up to date and clear in their content whilst providing appropriate direction for staff in how to care for people. People’s health care needs were monitored.

• People were treated equally by the staff. Training was provided to staff the area of equality and diversity.

• Staff told us they felt supported by senior staff. The staff in the service were caring. They told us they worked well as a team. They respected each other and supported each other. They received support from the provider and the registered manager. They also received support through regular training, supervision and team meetings.

• Staff were trained and knew how to protect people from the risk of abuse. Where concerns had been raised these had been dealt with appropriately.

• A recruitment system was in place that minimised the risk of unsafe candidates being employed.

• Medicines were stored, administered and disposed of by trained staff. However, we observed staff signing to indicate they had administered medicines before doing so. This is not safe practice. We have made a recommendation about medicine training for staff.

• Effective quality assurance tools were in place to drive forward improvements, these had been used and their impact was apparent.

• People spoke positively about their experience of living in the service. Comments included “You do feel safe here, I do, seriously. I love this room and I feel safe here. I feel cared for and looked after, they (staff) are there for you and they don’t go missing”.

• Where possible people could feedback to the provider and share ideas for improvement. This could be done daily via the senior staff or through meetings or filling in questionnaires.

• Activities were available to people. A new activity coordinator had been employed to develop this area of the service.

• Complaints were dealt with effectively and efficiently.

Rating at last inspection:

• The previous inspection was carried out on the 12 February 2018. (Published on 5 April 2018). The service was rated Requires Improvement at that time.

Why we inspected:

• Following our last inspection in February 2018 the provider sent us an action plan. This stated how they would improve the areas we identified that required improvement. We carried out this inspection to check whether the actions had been completed and if the service was compliant with the regulations.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care.

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