CQC report explained · a nursing home
What the CQC found at Cherry Tree Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments, safety checks, safeguarding arrangements and recruitment checks were in place. Inspectors found unsafe medicines recording practice and recommended further medicines guidance.
- Effective?
- Good
- People's care needs, nutrition and hydration needs were assessed. Staff received training and worked with outside health professionals when people needed specialist support.
- Caring?
- Good
- People were treated with dignity and respect. Inspectors observed patient, kind and gentle interactions, and people could take part in decisions about their care.
- Responsive?
- Good
- Care plans covered people's needs and preferences, and complaints were dealt with effectively. Inspectors found mixed views about activities, including delays with some promised trips.
- Well-led?
- Good
- Management oversight, records and quality checks had improved since the previous inspection. Audits were being used to identify and drive improvements.
What inspectors found, April 2019
Rated Good; inspectors found kind, safe care and clear improvement, but medicines were sometimes recorded before they were given.
Inspectors visited on 28 and 29 March 2019. They spoke with people living in the home, relatives and staff. They observed care and checked care plans, medicines records, recruitment files, meetings, audits and safety records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that records, risk assessments, safety checks and management oversight had improved since the previous inspection.
There was one medicines concern. Staff signed some medicines records before the medicine had been given. Inspectors recommended getting further advice and guidance about safe medicines administration.
The home was previously rated Requires Improvement in February 2018. This inspection found improvements in all the areas previously identified, including record keeping and quality assurance.
Improved records and oversight
Records and management checks were much better than at the previous inspection. Audits were being used to support further improvements.
“Records had improved in quality and in their usage.” from the report
Kind and respectful care
Inspectors saw staff treating people with patience, kindness and respect. People were involved in everyday choices and decisions about their care.
“Staff were patient, kind and gentle with people when supporting them with care.” from the report
Food and nutrition
People's dietary needs and risks were assessed. Food choices and extra support were provided, including fortified food and specialist advice where needed.
“Food appeared to be appetising and nutritious. People appeared to enjoy their meals.” from the report
Health support
The home worked with several health professionals to support people's physical and mental health needs. Advice and appointments were recorded in care files.
“Records showed staff were responsive to people's health needs and when needed support was arranged from a number of external sources.” from the report
Medicines records
needs fixingA nurse and another nurse signed medicines records before the medicine had been given. The medicine had to be destroyed when it was discovered that the person was out of the building.
“Medicines should not be signed as "given" until they are.” from the report
Activities and promised trips
minorSome people said they had been waiting for a promised shopping trip and had not received confirmation. Views about the range and usefulness of activities were mixed.
“Two people told us separately, they had been promised to be supported on a shopping trip to Marlow.” from the report
- 01What changes have you made to ensure medicines are signed for only after they have been given?
- 02How do you check that medicines records are accurate every day?
- 03How do you record and follow up promised trips and activities?
- 04How are residents' individual interests used to plan activities?
- 05How do you keep care plans and health records accurate and up to date?
This was a planned inspection of the overall quality of the home and covered all five CQC questions, including whether improvements promised after the February 2018 inspection had been made. This explanation was written from the published report of 25 April 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 Nursing Home was rated Requires Improvement; inspectors found kind care but unsafe records and weak oversight created risks.
This was an unannounced inspection over three days. Inspectors spoke with people, relatives, staff and a healthcare professional. They reviewed care documents for 19 people, medicines records, audits, recruitment files and other records.
The home was rated Good for Effective, Caring and Responsive. People generally received kind and respectful care. Staff were trained, healthcare needs were supported, and people knew how to complain. However, activities were limited and a new activity programme was only being planned.
The home was rated Requires Improvement for Safe and Well-led. Risk assessments, care plans and some medicines records were not always accurate or complete. There had also been weak management oversight and poor auditing. The home had no registered manager at the time, although a new manager had started the week before the inspection.
Staffing and response
Inspectors found enough trained and experienced staff. They saw staff respond quickly when people used their alarm bells.
“We observed there were sufficient numbers of trained and experienced staff to enable people to receive care when they needed it.” from the report
Kind and respectful care
People spoke positively about staff. Inspectors saw gentle, supportive and respectful interactions that protected privacy and dignity.
“We saw staff caring for people in a gentle and supportive manner.” from the report
Food and healthcare
The home supported people's eating, drinking and healthcare needs. External professionals were involved where needed.
“People had drinks in their rooms and were offered drinks regularly.” from the report
Safeguarding people's rights
Mental capacity assessments and best-interest processes were used where needed. Applications had been made where restrictions on liberty required authorisation.
“Records showed where it was suspected people lacked the mental capacity to make decisions for themselves, a mental capacity assessment had been completed for specific decisions.” from the report
Incomplete risk information
seriousSome people did not have risk assessments or care plans for important health conditions. Contradictory information in care records could lead to inappropriate or unsafe care.
“Without clear risk assessments people were at risk of receiving inappropriate care.” from the report
Medicines and diabetes records
seriousSome diabetes records were confusing or incomplete. Body maps for a medicine patch were usually not completed, and diabetes care plans did not explain key risks or what staff should do.
“The care plans for people with diabetes whether insulin, diet or tablet controlled were inadequate.” from the report
Weak management oversight
seriousAudits did not reliably identify risks or check whether improvements had been made. The home had no registered manager when inspectors visited.
“There had previously been a lack of management oversight of the service.” from the report
Too few activities
needs fixingPeople and relatives said there were not enough activities or trips. A new activity worker had been recruited, but the planned programme was not yet in place.
“Through our observations and from what people told us we were aware of the lack of activities being offered to people in the home.” from the report
Poor complaints records
needs fixingPeople knew how to complain, but the complaints log did not contain enough detail about the complaint, actions taken or the outcome.
“We looked at the complaints log we found the information to be inadequate.” from the report
- 01What changes have you made to risk assessments and care plans for people with diabetes, seizures or a colostomy?
- 02How do you now check that medicines records, blood glucose charts and body maps are complete and accurate?
- 03Is there now a registered manager, and how are audits being used to identify and fix problems?
- 04What activities and outings are currently available, and how are people's interests used to plan them?
- 05How are complaints now recorded, investigated and followed up with the person who made the complaint?
This was an unannounced inspection of the home, its premises and care, covering all five CQC questions and including records for 19 people. This explanation was written from the published report of 5 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 Nursing Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 8 June 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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