This inspection took place on the 21 and 22 June 2016 and was unannounced.

The service provides accommodation and personal care for up to 58 older people, some of whom were living with dementia. At the time of our inspection there were 54 people using the service.

There was a registered manager in post. 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 were safeguarded from avoidable risk of harm and staff understood the process to follow and report any concerns regarding people’s safety. There were risk assessments in place which detailed how people could be supported safely and control measures were in place to minimise and to mitigate risks. Staff were trained to move people safely and meet their needs in order to keep them safe. People’s care plans were detailed, person-centred and included information regarding their backgrounds, preferences and activities they enjoyed. These had been reviewed regularly with involvement from people and their relatives where possible.

People’s healthcare needs had been identified and met. There were good links with community healthcare professionals where required. People had enough to eat and drink and their nutritional needs had been monitored so that their health and wellbeing was maintained. There was a creative and varied program of activities available to people including opportunities to visit local places of interest and outings.

People were treated with dignity and respect and their views were listened to and acted on.. The service were able to evidence the ways in which people gave consent to receiving care. Staff demonstrated an understanding of the Mental Capacity Act 2008.

Staff received a variety of specialised training for their roles. Staff completed a thorough induction programme when they first joined the service. The recruitment processes used to employ new members of staff were safe and ensured that staff employed had the skills, character and experience to meet people’s needs. There were enough staff to keep people safe and meet their needs. The service held regular team meetings and sent out staff surveys to provide staff with an opportunity to provide their feedback and contribute to the development of the service. Staff had been provided with opportunities to develop within their roles and had been supported through regular supervision and appraisal.

There was a robust quality monitoring system in place for identifying improvements that needed to be made across the service. The provider’s director carried out monthly monitoring visits to ensure that the quality of care and compliance was consistently of a high standard. The environment was clean and well maintained with robust systems in place for monitoring health and safety and controlling the potential spread of infection. Equipment was regularly checked and there were contingency plans in place in case of emergency.

We found that people and their relatives were generally happy with the service they received from the provider. One person’s relative said “I can’t tell you how pleased I am. This takes some beating, they are friendly, professional, I am really pleased with the care.” Another person who uses the service said “The food is quite nice, there is always something going on, all staff are nice and obliging.”

We found that people's privacy and dignity had been respected and that they or people acting on their behalf been involved in the decisions about their care. We noted that the provider had done an assessment of the number of staff needed to support people who use the service.People had an assessment of their needs carried out and the care plans we reviewed demonstrated that their needs were being met appropriately. We found that there were processes in place to ensure people's nutritional needs were being met.

Everyone we spoke with said they were happy with the care they received from the provider. However, people told us when they rang their emergency call bell, they had to wait a while for staff to attend to their needs.

We found that there were insufficient staff to engage with people who use the service. We also found there were insufficient staff to respond in the event of an emergency

People we spoke to were satisfied with the care they received and found the staff to be friendly and helpful. One person told us, “The staff are really friendly and helpful” and that, “I like to stay in my room, the staff always ‘pop’ in and check on me regularly”. Another person living at the home told us, their sister was really well looked after and that when they had a recent bereavement the home was very supportive.”

People told us that their privacy and dignity was respected when they received personal care. Another person said that they liked being in their room, however since the new building work started at the home in May 2012 they have had to keep their heavy curtains closed at times when they needed privacy as the work men could see into their room. We found evidence that this issue had been raised but not addressed.

People were satisfied that there were plenty of activities, although we observed minimal interaction between staff and the people. We saw that the people had been left alone without stimulation for long periods of time.

We observed the home to be visibly clean on the day of our visit. All the people appeared to have had their personal care needs met.

Staff told us how they enjoyed working at the home and felt supported by management.

We identified that people’s care needs were not consistently recorded and that nutritional needs were not always being met. We saw that people were left unattended for long periods of time.

When we had conversations with people who live in Cherry Tree Manor on the 14 March 2012 they told us that they were involved with decisions about their care and how it was provided as much as they wanted to be. A number of the people we spoke with told us that it was their relatives who made sure that their views and wishes were taken account of.

When we asked the people who live in Cherry Tree Manor that we spoke with specifically about the care choices open to them; for example what and when they ate or at what times they went to bed or got up in the morning, they said that they felt able to choose and that their wishes were almost always met.

People who live in Cherry Tree Manor told us that there are meetings held periodically for residents, at which they can raise any issues they may have.

Those people who live in Cherry Tree Manor that we spoke with were very complimentary about the care staff that provided their care and support and told us that they were treated with respect at all times.They told us that they received very good care and they told us that they felt able to ask care staff to help them when they needed care or support and that this help was always forthcoming, with only minor delays at some busy times.

When we asked people who live in Cherry Tree Manor about their care plans they were not always sure what we were talking about, however they told us that their relatives dealt with most things for them and they were satisfied with the way their care needs were met.

In conversations with people who live in Cherry Tree Manor and those people who are responsible for them they told us that they felt that they, or the people they were responsible for were safe and well-cared for and none of the people we spoke with raised any concerns with us about their health, safety or well-being.

When we spoke with people who live in Cherry Tree Manor or those responsible for them on the 14 March 2012 they confirmed that there are questionnaires that they are asked to complete at least annually and also meetings held throughout the year that they are able to attend to discuss any care issues and to share information.