CQC report explained · a nursing home
What the CQC found at Cherry Trees
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, medicines were generally stored and given safely, and recruitment checks were completed. They also found one as-needed medicines record without a protocol, missing signatures and some communal areas that were not clean enough.
- Effective?
- Good
- People's needs were assessed and staff had training and support. However, inspectors said records of food and drink and the consistent use of dietician or speech and language advice still needed improvement.
- Caring?
- Good
- People and relatives said staff were kind, respectful and attentive. Inspectors observed positive interactions and people being offered choices about their care and daily lives.
- Responsive?
- Good
- Care plans were clearer and included relevant risks, preferences and professional advice. Activities and stimulation could still be improved, although the report says the COVID-19 pandemic and visitor restrictions had affected these.
- Well-led?
- Good
- Inspectors found better audits, management oversight and staff culture than at the previous inspection. The management team was described as approachable, and feedback was used to check progress.
What inspectors found, September 2021
Cherry Trees was rated Good overall; inspectors found clear improvements, with some remaining concerns about cleanliness, medicines records and care documentation.
Inspectors visited on 17 August 2021. They spoke with people, relatives and staff, reviewed care and medicines records, and checked recruitment, infection control, complaints, risks and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People and relatives described improvements in care, communication and management since the previous inspection.
The home had addressed the previous breaches about safe care and treatment and good governance. Inspectors found some remaining shortfalls, including unclean communal areas, incomplete medicines guidance and care records that needed more detail.
Kind and respectful care
People and relatives spoke positively about how staff treated them. Inspectors observed friendly communication and people being supported with dignity.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Improved management
The report describes better leadership, communication and oversight than at the previous inspection. Audits and checks were being used to identify and monitor improvements.
“Regular audits and quality checks were completed with oversight through internal compliance checks.” from the report
Better care planning
Care plans were clearer and staff had a more consistent understanding of people's needs and risks. Health professionals were involved when needed.
“Care plans were clear and included risk assessments that covered all activities of daily living.” from the report
People involved in choices
People were offered choices about where to spend time, what to do, where to sit and what to eat or drink.
“People were involved in how their care was provided and able to influence how they lived their lives.” from the report
Cleanliness in some areas
needs fixingSome communal areas, furniture and fridges were not clean enough. One fridge contained out-of-date milk.
“Some communal areas although regularly cleaned, were not cleaned to the required standards.” from the report
Some medicines records
needs fixingOne record for as-needed medicines did not contain clear guidance for staff. Missing signatures added to the uncertainty.
“We found one medicines record for as and when medicines, did not have a protocol to safely guide staff when to administer.” from the report
Risk assessments needed more detail
minorSome assessments, including those about specialist equipment, were not fully personalised. The manager said this would be addressed.
“some risk assessments, such as those relating to specialist equipment, required more detail to be fully personalised.” from the report
Nutrition records
needs fixingInspectors said the home needed a better understanding of how much some people ate and drank. Advice about special diets was not always followed consistently.
“improvements were still required to provide better understanding of how much people were eating and drinking” from the report
Activities and stimulation
minorPeople and relatives said activities could be improved. The home continued some hobbies and celebrations, but the range of interests and stimulation had been affected by pandemic restrictions.
“People and relatives shared comments that this could be improved.” from the report
- 01What has been done to make sure communal areas, furniture and fridges are cleaned and checked to the required standard?
- 02How do you make sure as-needed medicines have clear protocols and that all medicines given are recorded with the correct signatures?
- 03How are specialist equipment risk assessments personalised and kept up to date?
- 04How do you record what each person eats and drinks, and make sure dietician or speech and language advice is followed?
- 05What activities and social opportunities are currently available for people, including those living with dementia?
This was a follow-up inspection covering all five key questions, including infection control, previous improvement actions and risks linked to two choking incidents. This explanation was written from the published report of 11 September 2021 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, October 2019
Rated Requires Improvement; inspectors found risks with nutrition, staffing, medicines and management systems.
Inspectors visited on 3 and 4 September 2019. They spoke with people, relatives, staff and managers, observed care, and checked care plans, medicines records, incident records and audits. The inspection was prompted by concerns about staffing, agency workers, weight loss, and people not receiving enough food and fluids.
The home had enough staff on duty during the visits, but staffing was not consistently maintained. High use of agency staff meant some workers did not know people's routines. Inspectors also found incomplete food and fluid records, unclear guidance about thickened drinks, unsafe food hygiene, an expired pain relief medicine, and problems with consent and restrictions on movement.
The new manager had introduced an improvement plan and staff spoke positively about the manager. However, inspectors found that improvements were not yet embedded. Care plans and quality checks were not reliable enough, and similar concerns had remained since the previous inspection.
The home was rated Requires Improvement overall and in all five areas: Safe, Effective, Caring, Responsive and Well-led. This means the service was not consistently providing good care, and there was an increased risk that people could be harmed.
Access to healthcare
People were supported to access a range of health professionals when needed. The manager also reported improved communication with a local GP practice.
“People were supported to access healthcare professionals such as district nurses, GP's, dieticians and speech and language therapists for healthcare support when needed.” from the report
Some caring interactions
Inspectors saw staff using appropriate communication and offering reassurance at some times. This included adapting their approach to people's needs.
“Staff adapted their communication with people appropriately, for example getting down to their level, holding people's hands or referring to the person by their preferred name.” from the report
New manager's visibility
People, relatives and staff spoke more positively about the new manager. Staff said morale and support had improved, although the changes were still being established.
“Since the manager's appointment in July 2019, staff felt morale was better.” from the report
Communication support
Care plans included communication profiles, and staff used pictures, menu cards and gestures to help people make choices.
“Each person had a communication profile in their care plan which gave staff an indication of how people communicated and what certain gestures meant for that person.” from the report
Nutrition and hydration risks
seriousFood and fluid records were incomplete and did not reliably show what people had been offered or consumed. Some people lost weight, and guidance about thickened drinks was inconsistent, creating a choking risk.
“The person had lost 9kg in weight between April 2019 and September 2019.” from the report
Staffing and delayed support
seriousHigh agency use meant some staff did not know people's needs and routines. People described waiting for help, including one person who said they were left for two hours after a call bell problem.
“They haven't got enough staff to be able to respond…I rang the bell but it didn't work. I was left lying there for 2 hours.” from the report
Medicines records and expiry
seriousMedicines were generally administered safely, but records and instructions were not always clear. One person received pain relief that was two months out of date.
“One person had been administered a liquid pain relief medicine that had passed its expiry date by two months.” from the report
Respect and dignity
needs fixingPeople did not always receive prompt, respectful support. Inspectors saw call bells left unanswered and staff moving one person without explaining where they were going.
“In other examples, people's call bells rung for around five minutes while staff carried on with other non-care related tasks, instead of responding.” from the report
Weak quality checks
seriousAudits and care records did not reliably identify inaccurate risk information or ensure that actions were completed. Inspectors found 60 recorded falls between May and 3 September 2019, most of them unwitnessed.
“Systems and processes had not always been effective in identifying inaccuracies in care plan records.” from the report
- 01What has changed since the inspection to make sure people at risk of weight loss or dehydration receive the right food, fluids, snacks and monitoring?
- 02How many permanent and agency staff are usually on each floor, and how do agency staff learn about each person's routines and health risks?
- 03How do you now check that thickened-fluid instructions, care plans and specialist advice all match?
- 04What safeguards are now used when medicines are given covertly, and how are expired medicines prevented?
- 05How have you reviewed the coded door and other restrictions to make sure each person's freedom is not unnecessarily limited?
This was a comprehensive and responsive inspection covering all five key questions, prompted by recent concerns; the previous rating was Good, but all five ratings changed to Requires Improvement. This explanation was written from the published report of 29 October 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.
Every inspection of Cherry Trees
5 rated inspections over 5 years: the service has held its Good rating throughout.
- September 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Warwickshire
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 £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
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.