CQC report explained · a residential care home
What the CQC found at Cherry Tree House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines, risk assessments, safeguarding and recruitment were managed safely. However, some people reported long waits for support, parts of the building needed refurbishment, and infection control had some weaknesses.
- Effective?
- Good
- People received suitable training, healthcare support and help with eating and drinking. Staff followed best practice and acted in people’s best interests.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- The manager was open to feedback and audits were in place. However, records did not always show important information about people’s needs, including food and fluid requirements.
What inspectors found, April 2023
Rated Requires Improvement; inspectors found improvements, but staffing waits, the building and records still needed attention.
This was an unannounced focused inspection on 9 and 10 March 2023. Inspectors spoke with people, relatives, staff and health professionals. They reviewed care, medicines, recruitment and management records, and observed people’s care.
The home had improved since the previous inspection. Medicines were managed safely, risks were assessed, staff were safely recruited and people received support with healthcare, food and decision-making. The Effective rating improved from Requires Improvement to Good.
However, the home remained Requires Improvement overall. Some people said they waited too long for support. Parts of the building needed refurbishment, clean laundry was stored on top of clinical waste, and records did not always match people’s needs. Safe and Well-led remained Requires Improvement.
Safe medicines
Medicines were ordered, stored and given safely. Staff had medicine training and their competence was checked.
“Medication Administration Records (MAR) matched the correct quantities of medicines and medicines were stored safely in line with manufacturer guidance.” from the report
Good staff support
Staff received induction, ongoing training and opportunities to discuss their work and development.
“Staff received an induction, ongoing training, and regular opportunities to discuss their work, training, and development needs.” from the report
Risk management
Risk assessments were reviewed regularly and gave staff clear instructions about how to reduce avoidable harm.
“Risk assessments were in place and reviewed regularly to minimise risks.” from the report
Working with health professionals
The home made timely referrals and worked with health and social care professionals to support people’s wellbeing.
“The provider worked closely with several community health and social care professionals to ensure people maintained their health and wellbeing.” from the report
Delays in support
needs fixingSeven people told inspectors they sometimes waited a long time for help. Inspectors recommended reviewing how staffing levels are decided.
“Seven people commented they sometimes had to wait a long time for support.” from the report
Building and cleaning
needs fixingSome areas needed refurbishment to allow more effective cleaning. Inspectors also saw clean laundry stored on top of clinical waste.
“We observed staff storing clean laundry on top of clinical waste.” from the report
Incomplete records
needs fixingFood and fluid records did not always show the support set out in people’s care files. Inspectors recommended a system to make records reflect people’s needs.
“Records did not always evidence important information about people using the service.” from the report
- 01How do you decide whether there are enough staff to prevent people waiting a long time for support?
- 02What refurbishment is planned, and when will the areas needing better cleaning be completed?
- 03How do you make sure food and fluid records match each person’s care plan?
- 04What has been done to make sure clean laundry is stored away from clinical waste?
- 05Which ratings were carried forward from the previous inspection because they were not covered this time?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 14 April 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, December 2022
Cherry Tree House was rated Requires Improvement; safety, care records and management still had serious gaps, but it left special measures after some improvements.
This was an unannounced focused inspection on 6 and 8 September 2022. Inspectors spoke with 14 people, three relatives, six staff members and five health and social care professionals. They also checked care records, medicines records, staff files, audits and policies.
Some things had improved since the previous inspection. Staffing levels were safer, people said they felt safe, and staff were described as kind and more relaxed. Infection control, fire safety and consent arrangements had also improved.
However, medicines were not always managed safely. Care plans and risk assessments did not always give staff enough guidance, and monitoring of food, fluids and repositioning was not reliable. The home remained in breach of Regulations 12 and 17.
The overall rating improved from Inadequate to Requires Improvement, and the home was no longer in special measures. This was still the fourth consecutive inspection rated Inadequate or Requires Improvement. CQC said it would seek an action plan and continue monitoring progress.
Improved staffing
Staffing levels had improved and people received unrushed support. Recruitment checks were completed and staff had more training and supervision.
“A safe number of staff were deployed, and people received unrushed support to meet their needs.” from the report
People felt safe
People gave positive feedback about feeling safe and about the support from staff. Safeguarding training and policies were in place.
“People felt safe at the service and with the care and support staff provided.” from the report
Positive atmosphere
Inspectors found a friendly community where people enjoyed spending time with others and staff.
“There was a strong sense of community within the home and people enjoyed and benefited from the warm and friendly atmosphere.” from the report
Better partnership working
Health and social care professionals gave positive feedback about staff responding to advice and working with them to meet people's needs.
“They are very good at accepting advice.” from the report
Care plans did not give enough guidance
seriousSome care plans and risk assessments did not explain clearly enough how staff should support people, including with stoma care and behaviours that may challenge. This left people at increased risk of harm.
“People remained at increased risk of harm, because their care plans and risk assessments did not always contain enough information or guidance for staff on how to safely support them.” from the report
Medicines were not fully safe
seriousGuidance for variable or as-required medicines was sometimes missing. Inspectors could not be certain that refrigerated medicines were stored at a safe temperature, and stock checks were not robust enough.
“Where people were prescribed 'as required' or variable dose medicines, clear guidance was not always recorded to help make sure staff administered an appropriate dose of people's medicines when needed.” from the report
Monitoring and management were not reliable
seriousFood and fluid intake and repositioning were not monitored effectively. Audits had improved but had not consistently identified and addressed problems, and management action was described as reactive.
“The concerns identified during this inspection showed this system was not fully effective.” from the report
- 01What has been changed to make sure variable-dose and as-required medicines are given with clear instructions?
- 02How do you now check that refrigerated medicines are kept at a safe temperature and that unused medicines are returned?
- 03How are care plans and risk assessments being updated to give staff clear guidance about each person's needs?
- 04How do you monitor food and fluid intake and repositioning, and what happens if records show a concern?
- 05Has the manager completed an application to become the registered manager, and what progress has been made with the CQC action plan?
This was an unannounced focused inspection of Safe, Effective and Well-led only; ratings for Caring and Responsive were carried over from the last comprehensive inspection. This explanation was written from the published report of 22 December 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
8 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- April 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2022Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- May 2022Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- December 2021Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- December 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- June 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 18 August 2011.
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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32 live-in carers within about an hour of North Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,300 a week. 29 can care for a couple. 11 years' experience on average.
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.