Cherrycroft

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

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.

Staffing levels were insufficient in Cherrycroft to enable people to fully pursue their leisure interests and form meaningful relationships within their local community. The management team could not demonstrate how people’s 1 to1 hours were being used. Whilst some people could access the community, there was a lack of information on people's care files about how people’s' goals and aspirations where identified, planned for and met.

Risk plans were not always updated or reviewed in a timely way. Minor improvements were required with medicines management. Effective systems were not in place to ensure there was learning from events which occurred at the service.

The environment was not always safe or clean. Health and safety checks were not being consistently completed.

Right Care:

Whilst staff understood how to protect people from poor care and abuse. We could not be assured potential safeguarding incidents were recorded or reported to the local safeguarding team.

The service did not have enough appropriately skilled staff to meet people’s needs and keep them safe. The training matrix provided demonstrated there were large shortfalls in staff refresher training.

Care was not always person centred, care records did not reflect people's goals and outcomes. Staff supervision was not up to date.

Right Culture:

People did not always receive good quality care, support and treatment. Management of the service was not effective, safety records and monitoring records which were not up to date.

Staff knew and understood people well but were not supported to enable people to meet their aspirations to live a quality life of their choosing. Audits had not been used effectively to identify and drive improvements and some relatives told us they had lost faith in the management at the 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 13 January 2022)

Why we inspected

We received concerns in relation to staffing, medicines, risk, safeguarding, and governance. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. Due to the concerns found we widened the scope of the inspection to a comprehensive inspection which included all key questions.

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

Enforcement

We have identified breaches in relation to staffing, staff training, risk, safeguarding, dignity and privacy, consent and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

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.

Cherrycroft is a residential care home for up to ten people. The service supports people with learning disabilities, and mental health needs. At the time of our inspection ten people were using the service.

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

People at the service were safe, staff understood their safeguarding responsibilities and knew how to identify abuse. Relevant risk assessments had been completed. Medicines were well managed, and people received their medicines as prescribed. Infection prevention and control was being managed well including risks associated with COVID-19.

Staff had received appropriate training and support to enable them to carry out their role safely. Peoples health was well managed, and staff had positive links with professionals, which promoted their well-being.

People were treated with dignity and respect by staff. People were supported to communicate in a way that helped them as the service provided information in easy read format. A complaints procedure was in place.

Systems were in place to ensure there was oversight of the service which was effective. People and relatives felt the service was well-led.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The service was registered for the support of up to 10 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated as people had their individual spaces, including one person who was living more independently in a flat on the top floor. The service was set in a residential area with good access to the local community. The service followed the principles to reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human rights. Staff always adopted the least restrictive practices and clear plans were in place to use positive approaches as much as possible

Right culture:

• The management and staff team knew every person they cared for in-depth, including what was important to them and the best way to provide care to them.

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

The last rating for the service under the previous provider was good, published on 5 October 2018.

Why we inspected

This was a planned inspection since the service registered with us.

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.