CQC report explained · a nursing home
What the CQC found at Cherry Tree House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safer medicines management, suitable risk assessments, enough staff and good infection control. They also found systems for reviewing accidents, incidents and safeguarding concerns.
- Effective?
- Good
- Staff supported people's health, nutrition and changing needs. Mental capacity and best-interest decisions were recorded properly, and staff supported people in the least restrictive way.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people well, involved them in decisions and supported them to develop skills and independence.
- Responsive?
- Good
- Care was personalised and based on people's preferences, communication needs and goals. People were supported to maintain relationships, take part in activities and raise complaints.
- Well-led?
- Good
- Inspectors found positive leadership, an open culture and new quality assurance systems. Staff understood their roles and felt listened to and supported.
What inspectors found, February 2023
Cherry Tree House is rated Good and is no longer in Special Measures; inspectors found major improvements and good care across all five areas.
This was an unannounced follow-up inspection on 13 December 2022. Three inspectors spoke with three people, three relatives and eight staff. They also checked care records, medicines records, recruitment files, training information and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were safe, their medicines were managed properly, and staff understood their needs. People were treated with kindness and supported to make choices and build independence.
The report says there had been significant improvements since the last inspection. The previous rating was Inadequate, with breaches of regulations, and the home had been in Special Measures since 31 July 2021. The provider was no longer in breach, had completed the required improvement work and the home was no longer in Special Measures.
Major improvement
The home had improved substantially since the previous inspection and had addressed the earlier regulatory failures.
“Significant improvements had been made in the service since our last inspection.” from the report
Safe medicines
People received medicines as prescribed, with staff assessed as competent. As-needed medicines were guided, recorded and reviewed.
“People received their medicines as prescribed with support from staff who were assessed as competent.” from the report
Kind and skilled staff
Staff were described as caring, experienced and able to spend time understanding each person. They supported people to make choices and work towards independence.
“People were supported by caring, skilled and experienced staff who had time to get to know them and how best to support them.” from the report
Strong leadership checks
The provider had introduced regular audits and action plans to monitor safety and quality. Inspectors found that identified improvements were acted on.
“The provider had introduced new effective quality assurance systems and processes to monitor the safety and quality of the service.” from the report
Recent history of serious failings
needs fixingThe previous inspection, published in June 2022, rated the home Inadequate and found regulatory breaches. These issues were reported as resolved at this inspection, but families may want to ask how the improvements will be kept in place.
“The last rating for this service was inadequate (published 8 June 2022) and there were breaches of regulation.” from the report
- 01How are medicines errors now identified, reviewed and prevented?
- 02How do you check that the new quality audits continue to find and fix problems?
- 03How will you support my relative if they become anxious or distressed, and how do you avoid restraint?
- 04Which staff members would regularly support my relative, and what training do they have for their specific needs?
- 05How will my relative and our family be involved in care reviews, complaints and decisions about treatment?
This was an unannounced follow-up inspection covering all five key questions and checking action required after the previous Inadequate inspection. This explanation was written from the published report of 1 February 2023 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, June 2022
Cherry Tree House rated Inadequate and remains in special measures; inspectors found unsafe medicines and restraint records, unlawful restrictions and weak management oversight.
This was an unannounced focused inspection on 27 and 28 January 2022. Two inspectors spoke with five people using the service, eight staff members and two relatives. They reviewed care records, medicine records, policies and management documents.
The home was still not safe. Medicines were not always available or recorded correctly. Records of physical restraint were incomplete, risks were not always properly managed and actions were not always taken after incidents.
The home had improved from Inadequate to Requires Improvement for Effective, but it remained Inadequate for Safe and Well-led. The overall rating stayed Inadequate because the inspection found continued breaches of legal requirements.
The home remains in special measures. The regulator will monitor it, request an action plan and usually re-inspect within six months. If there is not enough improvement, action may be taken to prevent the provider from operating the service.
Staffing and recruitment
Inspectors found enough staff and safe recruitment checks. Staff had suitable training and understood how to support people using their care plans.
“There were sufficient numbers of staff deployed to ensure people were supported safely.” from the report
Infection control
The home had systems for preventing and managing infection, including safe visiting arrangements and effective use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Personalised surroundings
People's bedrooms reflected their belongings and interests. Communal areas included activities that people used during the inspection.
“People's bedrooms were personalised with their belongings, such as, pictures and artwork.” from the report
Food choices
People were involved in planning meals and were encouraged to cook. Staff supported people with healthy eating and shopping.
“People were encouraged and supported to cook their own meals and people were involved with planning what they would like to eat.” from the report
Medicines and restraint
seriousMedicines were sometimes missing or not recorded as given. Restraint records did not always include how long the intervention lasted or whether staff had a debrief, creating a risk of inappropriate treatment.
“Medicines were not always in stock, records evidenced multiple occasions where medicine had not been available, this meant people had not always received their medicines as prescribed.” from the report
Risk management
seriousIdentified risks did not always have suitable strategies in place. The home also did not consistently act after incidents to reduce the chance of them happening again.
“Actions had not always been taken following incidents to reduce the risk of a reoccurrence.” from the report
Mental capacity and restrictions
seriousSome restrictions were not supported by the required capacity assessments or best-interest decisions. Conditions attached to a legal authorisation were not always followed.
“We found one person had restrictions in place which was not supported by a mental capacity assessment or best interest decision.” from the report
Management oversight
seriousQuality checks failed to identify or correct important problems. Records were sometimes inaccurate, and training checks for regular agency staff were not fully managed.
“Quality assurance systems and processes did not identify or address all of the issues found during this inspection.” from the report
Communication with relatives
needs fixingRelatives said they were not kept up to date and were not routinely asked for feedback or suggestions about improvements.
“Relatives told us they were not kept up to date or informed about their family member, and that they had to ask for feedback as this was not offered.” from the report
- 01What has changed to ensure every medicine is in stock and every administration is recorded correctly?
- 02How do you now record, review and monitor physical restraint, including its duration and staff debrief?
- 03How are mental capacity assessments and best-interest decisions completed and checked before restrictions are used?
- 04How do you ensure all conditions attached to a person's legal authorisation are followed by every member of staff?
- 05What checks now identify problems with care records, agency staff training and other quality concerns before they put people at risk?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating also used previous ratings for the questions not inspected. This explanation was written from the published report of 8 June 2022 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 House
3 rated inspections over 2 years: the service has improved, from Inadequate to Good.
- February 2023Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2022Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- July 2021InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2019
Registered with the Care Quality Commission on 10 June 2019.
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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