The inspection of Cherry Tree House took place on 8 November 2016 and was unannounced. The location had been previously inspected during June 2015 and was found to require improvement at that time. The inspection of June 2015 found breaches of regulations in relation to the prevention and control of infection and safeguarding service users. During this inspection, we found improvements had been made and we found no breaches of regulations.

Cherry Tree House is a home registered to provide accommodation and personal care for a maximum of six people. The home specialises in providing care for people with a learning disability or autistic spectrum disorder.

The service had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and their relatives told us they felt safe living at Cherry Tree House. Staff were able to recognise potential signs of abuse and had received safeguarding training so they understood the appropriate policies and procedures in order to help keep people safe.

Staff were recruited safely and there were sufficient numbers of staff deployed to meet people’s needs.

Medicines were stored and administered safely and appropriately and staff who were responsible for administering medicines had been trained to do so.

Staff told us they felt supported and we saw staff received regular training, supervision and appraisal.

Where people lacked capacity and were being deprived of their liberty, the registered manager had made appropriate applications to the supervisory body in order for this to be authorised. The registered manager acted in accordance with the Mental Capacity Act 2005.

The design and layout of the home was appropriate to meet people’s needs and the home was fresh and clean with a homely feel.

People told us they liked their support workers and relatives told us staff were caring. We observed a pleasant, relaxed atmosphere in the home and people’s privacy and dignity were respected. Mutual respect was evident between support workers and people living at Cherry Tree House.

People were given choices throughout the day and we saw staff sought consent from people prior to providing care and support.

Care and support was provided in a person centred manner. Care needs were regularly reviewed and people were involved in their care planning. People told us they could make their own choices.

The home was well led by a management team that communicated well to people who lived at the home and to staff. Staff were motivated to provide good care to people.

Regular staff meetings and house meetings were held and the registered manager sought feedback from people.

Audits took place regularly and these resulted in actions, in order to continually improve the quality of care and support offered at Cherry Tree House.

This inspection took place on 18 June 2015 and was unannounced. We previously inspected the service on 23 July 2013. The service was not in breach of the health and social care regulations at that time.

Cherry Tree House is a home registered to provide care for a maximum of six people. The home specialises in providing care for people with a learning disability and/or physical difficulties. The home is located close to transport links and the facilities of South Elmsall.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe living at Cherry Tree House and the family members we spoke with also said they felt their relatives were safe.

Staff had received training in how to safeguard people and they were able to demonstrate an understanding of different types of abuse. Staff knew what to do if they had any concerns that someone was being abused. However we found that an incident was not reported correctly in line with safeguarding procedures. This demonstrated a breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that safe recruitment procedures were followed and safe numbers of staff were employed. Staff were supported in their roles.

We had some concerns regarding hand washing facilities and infection control. We therefore referred our findings to the local infection prevention and control team. This demonstrated a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards. We found that there was a lack of understanding of these safeguards. Authorisation had not been appropriately sought when people’s freedom or liberty was being restricted. This demonstrated a breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff at Cherry Tree House were caring and attentive to people’s needs. We saw evidence of this in the way that staff and the people who lived at the home interacted with each other. Staff knew the people who used the service well.

People were included in the running of the home and had choices about activities and meals for example. There was a variety of activities for people to join in with at Cherry Tree House. These activities took into account people’s likes and dislikes.

There was an open and transparent culture at the home. Staff felt well supported by the management team and they were given opportunities to develop their skills and contribute their ideas to the running of the home.

You can see what action we told the provider to take at the back of the full version of the report.

We spoke with two people individually and a group of people while they were involved in a craft session. People who lived at Cherry Tree House told us they were happy with their care. One person told us “I like it here. I go horse riding.” A health professional had written in a survey questionnaire “Cherry Tree House is an amazing home from home. Clients are well cared for and comfortable. No concerns at all”.

We saw that the provider had completed assessments of people’s needs and had written plans of care with specialist involvement where necessary. Risks assessments balanced a consideration of the right to freedom and choice against safety.

People were involved in their day to day care. They were consulted in reviews, in house meetings and in day to day conversations about choices and decisions. They were treated with respect.

The home handled medication safely.

We spoke with three members of staff. They told us that they had good support in their role. There were sufficient staff on duty to ensure people could live full and interesting lives according to their preferences.

The home had a system in place to monitor its performance. The home also carried out audits and other safety checks so that it could maintain and improve the quality of care people received.

On the day of this unannounced compliance visit there was not the opportunity to speak to people using the service as they had gone on a shopping trip to Doncaster.