CQC report explained · a residential care home
What the CQC found at Cherry Tree Cottage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks linked to people's health, behaviour and the environment were assessed and monitored. Medicines were safely stored, administered and recorded.
- Effective?
- Good
- Staff had relevant training and support. People were helped with food, health appointments, communication, independence and decisions about their care.
- Caring?
- Good
- Staff knew people well and treated them with kindness, dignity and respect. People were involved in choices about their daily lives and care.
- Responsive?
- Good
- Care plans gave staff detailed guidance about people's needs and preferences. People were supported to maintain relationships, follow interests and take part in community activities.
- Well-led?
- Good
- Audits and checks had improved, and managers used action plans when they found shortfalls. The previous breach about governance had been resolved.
What inspectors found, August 2019
Cherry Tree Cottage was rated Good; inspectors found kind, safe and person-centred care, with some further work needed on staffing pressure and end-of-life wishes.
This was an unannounced planned inspection on 9 July 2019. One inspector spoke with four people, managers and staff. They reviewed care records, staff files, medicines, accidents, complaints, audits and the building. They also contacted two adult social care professionals after the visit.
The home supported six adults with learning disabilities and autistic spectrum disorder, and was registered for up to seven people. Inspectors found people felt safe and were treated kindly. Staff supported people with their health, medicines, food, activities, relationships and independence. The home was clean, and people regularly accessed the local community.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous inspection had rated the service Requires Improvement and found one breach. Inspectors found enough improvement had been made, so the home was no longer in breach.
Kind and respectful care
People described staff positively and inspectors saw relaxed, warm interactions. Staff involved people in decisions and respected their privacy and dignity.
“People were supported by staff who were kind and caring and who knew them well.” from the report
Choice and independence
People were supported to make everyday choices, develop skills and do more for themselves. This included helping with household tasks and using the community.
“Independence was fully promoted.” from the report
Improved oversight
Managers had improved monitoring of the home, medicines and care records. Environmental improvements had also been made since the last inspection.
“At this inspection we found enough improvement had been made and the provider was no longer in breach of Regulation 17.” from the report
Learning from incidents
needs fixingIncidents were recorded and discussed, but inspectors said the home could miss some opportunities to learn from behavioural incidents.
“However, further work was needed to ensure opportunities to learn from behavioural incidents were not missed” from the report
End-of-life wishes
needs fixingPeople had books to record their wishes, but inspectors said these discussions needed to happen so staff understood people's preferences.
“People's wishes regarding end of life care required further discussion to ensure staff understood their preferences.” from the report
Staffing pressure
minorThe home said there were enough staff, but staff reported that employing more people would reduce pressure from covering shortfalls.
“However, they did say the employment of additional staff would be supportive and relive the pressure from them in covering staff shortfalls.” from the report
- 01How many staff are currently employed, and has the pressure from covering staff shortfalls reduced?
- 02How do you make sure learning from behavioural incidents is recorded and acted on?
- 03Have all residents now discussed and recorded their end-of-life wishes?
- 04How are people's support plans reviewed with them, and how are changes made when their wishes change?
- 05How do you support people to keep accessing community activities, volunteering or work?
This was an unannounced planned inspection of the whole care home, covering all five CQC questions; the previous Requires Improvement ratings had improved to Good. This explanation was written from the published report of 9 August 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2018
Cherry Tree Cottage was rated Requires Improvement; inspectors found kind care but concerns about staffing, safety checks, medicines, activities and management oversight.
Inspectors visited the home without warning on 12 March 2018. They spoke with people living there, relatives, managers and a support worker. They reviewed care records, medicines, staff files, training records, complaints and management checks.
The home was caring. Staff were kind, respectful and knew people well. People were involved in decisions, encouraged to be independent and supported to access health services. Their needs, meals and health plans were generally assessed and recorded.
However, staffing levels had sometimes been too low, including at night. Safety checks, medicine systems and infection control supplies were not always reliable. People also had too few meaningful activities and limited opportunities to follow their interests.
The overall rating changed from Good in all areas at the May 2016 inspection to Requires Improvement overall. The provider took immediate action to increase night staffing and said other improvements, including replacing vehicles, would follow.
Kind and respectful staff
Staff knew people well, treated them with dignity and respected their choices and privacy.
“Staff were found to be caring and knowledgeable about the people they supported.” from the report
Support for independence
People were supported to make choices, prepare food and drinks, complete household tasks and use equipment that helped them remain independent.
“People's independence was promoted. People told us they were encouraged and supported to develop their independence.” from the report
Health and care planning
Care plans were personalised and generally kept up to date. People were supported to attend health appointments and specialist services.
“People had health action plans that recorded their health needs, appointments and support needs and these were found to be up to date and detailed.” from the report
Staffing levels
seriousStaffing was sometimes too low for people's needs, particularly at night. The provider increased night staffing immediately after inspectors raised the concern.
“The provider had failed to ensure staffing levels were adequate at all times to meet the dependency needs of people who used the service.” from the report
Environmental safety
seriousInspectors found several hazards in and around the home, including a slippery decking area, uneven ground, rubbish, an unsecured gate and unsafe manhole covers.
“The management team had identified some of these issues but not all and agreed to complete a risk assessment and tidy the garden area to make it safe for people to use.” from the report
Medicines systems
needs fixingMedicines were generally stored and given correctly, but there was no clear system for recording medicines when people were away. Some audits and checks were also out of date.
“There was no policy in place for when people were away from the service.” from the report
Limited activities
needs fixingPeople had too few meaningful activities and limited opportunities to follow hobbies, interests and aspirations. Low staffing and unreliable transport contributed to this.
“This confirmed people received limited and restricted opportunities.” from the report
Weak management oversight
seriousQuality audits, daily record checks, training monitoring and incident reviews were not effective. This was the subject of the report's regulation breach.
“These examples show there was a lack of leadership, accountability and oversight of the service.” from the report
- 01Are there now always enough staff on duty, including two staff members overnight, for the needs of all residents?
- 02Have all the garden, decking, gate, fence, manhole cover and other environmental risks been assessed and made safe?
- 03How are medicines recorded when a resident leaves the home, and when was the latest medicines audit completed?
- 04What regular activities and community opportunities are now available for each resident, including people who cannot go out independently?
- 05What quality checks are now in place to monitor staffing, medicines, daily records, incidents, training and environmental safety?
This was an unannounced comprehensive inspection covering the accommodation and care provided, with ratings given for all five key questions. This explanation was written from the published report of 18 April 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Cherry Tree Cottage
4 rated inspections over 5 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 9 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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