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?
- Requires improvement
- Inspectors found gaps in risk-monitoring records and were not always clear that one person received the modified diet advised by a speech and language therapist. Recruitment checks were mostly completed, but some work histories were incomplete.
- Effective?
- Good
- People were supported to eat and drink enough, access healthcare and receive care based on their assessed needs. Staff had training, supervision and ongoing support.
- Caring?
- Good
- Staff were observed providing kind, patient and respectful care. People were supported to make choices and maintain their dignity and independence.
- Responsive?
- Good
- Care plans were person-centred and reflected people's preferences and communication needs. Activities were being developed, and complaints were responded to appropriately.
- Well-led?
- Good
- The new senior management team had made significant improvements. Audits, checks and action plans were being used to monitor and improve care, although they had not always identified minor recording gaps.
What inspectors found, February 2024
Rated Good overall; inspectors found kind, personalised care, but the home was still Requires Improvement for safety.
This was an unannounced follow-up inspection on 17 and 23 January 2024. Inspectors spoke with people, relatives, staff and a visiting health professional. They also reviewed care records, staff files and management records.
The home had made significant improvements since the last inspection. Care plans were detailed and personalised. Staff were kind and respectful, medicines were managed safely, the home was clean, and complaints were dealt with appropriately.
Safety was still rated Requires Improvement. Inspectors found gaps in monitoring records, including records about the consistency of food and drinks. They also found one person was not always clearly receiving the modified diet advised by a speech and language therapist. Recruitment records were not always complete.
The overall rating was Good, with Effective, Caring, Responsive and Well-led all rated Good. The home was no longer in breach of the regulations identified at the previous inspection, but two recommendations were made about monitoring records and recruitment.
Personalised care
Care plans were detailed, current and tailored to people's needs, preferences and communication needs.
“Care and plans were comprehensive, personalised and contemporaneous that detailed people's current care needs” from the report
Kind and respectful staff
Inspectors saw calm, patient and attentive interactions. People and relatives generally said staff were kind and caring.
“People received compassionate care from kind and caring staff.” from the report
Improved leadership
The new senior management team had made significant improvements since the previous inspection. Regular audits and checks were in place.
“The new senior management team had made significant improvements throughout the home since the last inspection” from the report
Medicines and infection control
Trained staff supported people to receive medicines safely. The home was clean, and staff used protective equipment safely.
“People were supported to receive their medicines and creams safely by trained staff.” from the report
More activities
An activity team and programme had recently been introduced. Inspectors saw people enjoying group and individual activities.
“We observed activities within the home from both an outside entertainer and in-house activities.” from the report
Risk records were incomplete
seriousSome monitoring charts had gaps. It was not always clear whether food and drinks had the required safe consistency, and one person's modified diet was not always clearly followed.
“Charts to monitor individual risks were in place, although we did find some gaps in recordings.” from the report
Recruitment records
needs fixingMost recruitment checks were completed, but some staff records did not include a full work history. The provider corrected the gaps during the inspection.
“We found not all staff had fully completed work history records.” from the report
Mixed views about staffing
needs fixingStaffing levels were suitable during the inspection, but some people and relatives said staff could be busy and call bells could take time to answer.
“When I use the bell, they can be busy and it takes a bit of time for them to come.” from the report
Mixed views about food
minorPeople and relatives gave mixed feedback about meals, particularly the pureed diet. The home had made improvements to monitoring nutrition and drinks.
“In particular, people fed back their dissatisfaction with the pureed diet provision.” from the report
Different experience on one unit
needs fixingThe second-floor unit was busier, and inspectors did not always see staff spending the same amount of time with people there.
“However, we found the second floor unit to be busier and did not always see staff having the same time to spend with people.” from the report
- 01What extra checks are now used to make sure food and drink consistencies and other monitoring charts are recorded correctly?
- 02How do you make sure people receive modified diets exactly as advised by speech and language therapists?
- 03How many staff are usually on duty on each floor, especially the second floor, and how quickly are call bells answered?
- 04What changes have been made to the pureed food choices since the inspection?
- 05How do you check that recruitment files contain complete work histories and all required employment checks?
This was an unannounced follow-up inspection checking action from the previous inspection, and inspectors considered all five key questions. This explanation was written from the published report of 13 February 2024 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, July 2022
Rated Requires Improvement overall, with Inadequate leadership and concerns about personalised care, dignity, nutrition and staffing.
Inspectors visited without notice on 10, 18 and 19 May 2022. They spoke with people living in the home, relatives and staff. They observed care, meals, medicines and infection control, and checked care records and management records.
The home was not consistently providing person-centred care. People sometimes waited for help, were not always treated with dignity, and did not always receive the support they needed to eat and drink. Call bells were sometimes out of reach. Staff were often busy and agency staff were used frequently.
The home had systems for recruitment, safeguarding, medicines, risk checks and infection control, but its checks did not reliably find or prevent problems. The management team acted quickly during the inspection, but the report says the provider had not shown that improvements could be made and sustained.
The overall rating was Requires Improvement. Safe, Effective, Caring and Responsive were also Requires Improvement. Well-led was Inadequate, meaning there were widespread and significant problems with leadership and oversight.
Medicines usually given correctly
Inspectors saw medicines being given at the right times, including medicines prescribed when needed for pain. Controlled medicines were handled safely.
“We saw that medicines were given at the right times and people were offered medicines prescribed 'when required' for pain relief.” from the report
Infection control arrangements
Inspectors were assured about the home's arrangements for PPE, testing, admissions, hygiene and managing infection outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Some good end-of-life care
End-of-life care plans were in place. Staff used anticipatory medicines to manage symptoms and provide comfort.
“Staff were proactive in using anticipatory medicines to manage symptoms being experienced and provide reassurance and comfort to people.” from the report
People waited for help
needs fixingStaff were often very busy, and people sometimes waited for support, especially at busy times. The home used a high number of agency staff.
“We observed staff were very busy. People often had to wait for support if they required additional support from staff, particularly at busy times.” from the report
Nutrition was not reliably supported
seriousPeople at risk of weight loss did not always receive the prompting, supervision, fortified food or snacks recorded in their care plans. This placed people at risk of harm.
“Oversight was not robust enough to ensure people at risk of weight loss were supported to eat enough to maintain a balanced diet.” from the report
Dignity and independence
seriousPeople were sometimes left waiting, ignored or told to sit down. Some call bells were not within reach, and choices about bedtimes and privacy were not always respected.
“We observed that many of these must have been placed in this way, rather than fallen out of reach, although care plans indicated it was important that staff ensured call bells were at hand for these people.” from the report
Weak oversight and lasting improvement
seriousThe home's checks did not identify several problems found by inspectors. The report says the provider had not shown it could embed and sustain improvements.
“Systems were not effective in ensuring the identification of shortfalls within the home, or in driving improvements to the quality and experience of care being delivered.” from the report
- 01How are you making sure people at risk of weight loss receive the food, snacks, prompting and supervision in their care plans?
- 02How do you check that call bells are within reach and that people can make choices about bedtimes, privacy and daily routines?
- 03How are staffing levels and the use of agency staff being reviewed against people's actual needs?
- 04How do you check that care is delivered in line with each person's care plan rather than around staff routines?
- 05What action has been taken in response to the warning notices, and how will you show that improvements are lasting?
This was an unannounced follow-up inspection that considered all five key questions and infection prevention and control, after concerns and required actions from the previous inspection. This explanation was written from the published report of 5 July 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
10 rated inspections over 9 years: the service has improved, from Requires improvement to Good.
- February 2024Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2018Goodstayed GoodEffective: GoodWell-led: Requires improvement
- December 2016Goodup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2016Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- July 2013
Registered with the Care Quality Commission on 25 July 2013.
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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