Cherry Tree Care Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff had attended appropriate training in safeguarding and people told us they felt safe and knew how to raise any concerns. Risk assessments were completed, and people told us they were involved in decisions about their care. We saw the service learnt from accidents and incidents. There were enough staff to meet people people's needs however, some staff we spoke with felt they were not always been deployed effectively. Managers told us they would review this and communication around staff deployment. Safe recruitment practices were followed, however we found interview records could be improved so they were dated and photographs of staff should be obtained. Following our inspection, the administrator shared that this was now in place. Medicines were safely managed and people told us they received them on time. The service and equipment were clean and well maintained.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives we spoke with said they felt involved in all aspects of their care and how it was delivered. Relatives told us that they felt able to share their feedback about the service.

Staff told us the management team encouraged them to be open and transparent with people. They discussed how they prioritised their work to ensure people were safe and their needs were met first. Whilst reviewing care plans we saw a person had lost weight. We asked a staff member about this who went on to tell us how measures such as weekly weights and a change to their risk assessment had taken place for this person. They said, "We need to be really hot on risk assessments so we prioritise keeping people safe."

We saw the provider's audit system worked to share learning and a recent medicines audit had been used to undertake lessons learnt and training with staff to improve processes. The provider ensured lessons learnt were shared with staff via team meetings and supervisions. The registered manager could readily identify where gaps existed and acted swiftly to address them. They effectively monitored the quality and safety of the service and ensured people experienced positive outcomes from the support they received. Action plans were used to monitor whether the changes implemented had improved the service. They used all feedback to assist them improve the quality of care.

People felt the service provided safe care and were positive about the work is did with partners to support people to return to their own homes f they were able. One person told us, “I’ve only been here 4 weeks I think it’s very good. I had falls at home and went into hospital and I was worried about coming in. The physio comes in a few times a week to see me and I am getting stronger and more confident and they check on you during the night."

Staff understood when people required support to reduce the risk of avoidable harm and risk assessments were in place. One staff told us, "We make sure when people are in wheelchairs that the foot plates are in the right place. Also that people are sitting properly in chairs and in bed make sure they are in the middle. If someone is at risk of falls, we make sure a crash mat is in place."

Partners were positive in their feedback of how the service worked with them. A transformation manager from the local authority told us, "At the request of the provider we developed a Level 3 medication diploma that Cherry Tree staff have accessed and this has been offered to the wider network and has seen an excellent uptake since its introduction."

The service worked in partnership with other agencies to improve people's opportunities and wellbeing. Visiting professionals told us they were very impressed with the skills and dedication of the staff and how well they supported people. Staff worked as a team to ensure people’s support needs were met.

Everyone we spoke with told us they felt safe living at Cherry Tree Care Centre.

Staff were confident in raising concerns and were able to give examples of what abuse signs to look out for. Staff knew who was subject to DoLs and were aware of people's capacity and consent needs. Staff made safeguarding referrals when needed and one staff member told us how they had raised a safeguarding alert regarding someone's medical device.

We observed everyone received safe care and were supported by staff who spoke with them in a kind and polite way and ensured people's views were listened to.

The registered manager had safeguarding systems in place. When appropriate the service had made safeguarding alerts to the local authority safeguarding team and sent us the required notifications and reports. Staff said they had training and a good understanding of what to do to make sure people were protected from harm or abuse. We saw evidence staff had received safeguarding training.

People and their relatives told us that risk were well managed.

Staff knew how to support people to be safe and how to manage risks. Staff we spoke with knew about risk factors and took steps to reduce them. One staff told us, "Make sure people have the right footwear on - no hazards making sure everything is how It should be and make sure any arguments don’t escalate!"

A visiting community support worker told us, "They are good at communicating with us and it works well for people. I am here today to assess a lady in the kitchen. This lady tries to do too much for herself so the staff have put in more checks to make sure she is safe."

Risk assessments were regularly reviewed and we saw clear instructions were in place for the use of specialist equipment such as wheelchairs. We were told that care plans still needed further work to improve person centred care and this was an ongoing action for the acting manager. The acting manager worked with the team to identify where gaps existed and to address them.

People and relatives we spoke with told us they felt safe and that staff were confident and competent to use equipment safely. One person told us they had an accident with their leg on a wheelchair and staff immediately called the district nurse to attend to the wound. He said “The staff are really on the ball”.

Staff knew how to use equipment provided safely and received regular training in moving and handling.

We saw the service was clean, tidy and free from clutter. Housekeeping staff were knowledgeable about their work and knew people living at the service well.

The provider had policies and procedures in place for the maintenance of the service and ongoing refurbishment plans were in place. We also saw equipment was regularly serviced and maintained. The provider had effective oversight of health and safety at the home and regular audits confirmed this. The management team understood what risk assessments were needed to make sure staff followed health and safety guidance.

People and relatives we spoke with felt there were enough staff on duty to meet their needs. A relative told us, “I feel she is very safe here, the staff are very approachable and there is always enough of them around." One person said, “I like it here, I have my fears but they pass and I feel safe. There’s nearly always plenty of staff”.

Staff we spoke with said the provider was responsive if people's needs changed and more staff were needed. One staff on the ground floor told us, "Yes they do, we have 3 empty rooms and when all the rooms are full we would have 3 staff all the time." Some staff raised with us the deployment of a floating staff member which they found confusing. We fed this back to the provider who following our visit held a staff meeting with all staff and discussed deployment and our inspection feedback. Staff were recruited safely and supported by supervisions and appraisals.

People were supported by enough people to meet their needs safely. Staff appeared competent and confident in their interactions with people and professionals visiting the service.

The provider had a system to regularly review the dependency needs of people to ensure staffing was provided at safe levels. Recruitment was safe, however some improvements were needed for staff recruitment regarding the recording of interviews and photographs on recruitment records. The new administrator put these into action before we finished our visit to the service. DBS checks were carried out and refreshed every 3 years.

People we spoke with and their relatives told us the home and their rooms were clean and well maintained.

Staff were trained in IPC and knew how to keep people safe from infections. The head housekeeper said they were supported with equipment and training to ensure the service was clean.

We spoke with the head housekeeper and observed the domestic team engaging with people and ensuring the service was clean and well kept. We observed staff members using appropriate PPE during mealtimes. All areas of the service were clean and free from clutter. We did see one bathroom that had some mould but this had already been addressed as was awaiting re-tiling.

There were policies and procedures in place to support a safe, clean environment at Cherry Tree Care Centre. The management team undertook regular walk arounds as well as audits to ensure the service remained free from infection risks.

People we spoke with told us they received their medicines safely and on time. Relatives also told us they were happy with information about medicines. One relative told us, "I’m kept involved with changes in her medication."

Staff told us that they received training in how to safely administer medication.

People’s medicines were managed in a safe manner. Staff were trained in medicines management and processes were in place to assess whether staff were competent to administer people’s medicines. We saw medicines were stored correctly in clean rooms and trollies and records were well maintained. We saw the audit process had recently highlighted some areas for improvement for medicines management and the management team ensured this learning was shared with everyone. The operations director told us, "I have done a recent meds audit and it was poor. As a result we have done a lessons learnt, put staff on training and we have ensured that staff understand how they need to order medicines."