Cherry Trees is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Cherry Trees is registered to provide accommodation for up to 89 older people. Accommodation is provided over three floors, accessed by a passenger lift. Communal lounges and dining areas are provided. On the day of the inspection there were 76 people living in the home.

Our last inspection at Cherry Trees took place in 16 October 2016. At that inspection, we found five breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in Regulation 9; Person centred care, Regulation 17; Good governance, Regulation 18; Staffing, Regulation 11; Need for consent and Regulation 14; Meeting nutritional and Hydration needs. Following the last inspection the registered provider sent us an action plan detailing how they were going to make improvements.

At this inspection, we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of these Regulations.

This inspection took place on 3 April 2018 and was unannounced. The meant the people who lived at the home and the staff did not know we would be visiting.

The service had a registered manager. 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.

Staff were knowledgeable about people living at the home and understood how to meet their diverse needs.

We observed warmth and affection between staff and people who used the service. We saw people were treated with dignity and respect.

People told us they felt safe at Cherry Trees and staff told us they would report any concerns to the registered manager. Systems and processes were in place to ensure that people were protected from abuse and improper treatment.

We found the home was clean and odour free. Bedrooms had been personalised and communal areas were comfortably furnished. The home was well maintained and equipment had been serviced to make sure it was safe to use. However some areas of the service were not adapted to meet the needs of people living with dementia.

We have made a recommendation that the service considers current best practice guidance on dementia friendly environments.

Staff recruitment procedures were robust and ensured people’s safety was promoted.

Sufficient numbers of staff were provided to meet people’s needs.

Staff were provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

Wherever possible, people were involved in decisions about their care and were offered choices. People told us they, and their relatives, had been involved in their plan of care and had participated in regular reviews.

We found systems were in place to make sure people received their medicines safely so their health was looked after.

People were supported to take part in a variety of activities.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies in the service support this practice. However, we found improvements could be made to in the recording of peoples consent in care records

We have made a recommendation about staff training on Mental Capacity Act 2005 and the D

Cherry Trees is registered to care for 89 people requiring personal and nursing care in the categories of dementia, old age and physical disability. On the day of our inspection there were 76 people living in the home.

There was a manager at the service who 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.

On the first day of the inspection we found care plans were not in good order and confusing. Care plans we saw were in different formats, on a range of different paperwork and were incomplete or out of date.

On the day of our inspection people who used the service were supported by sufficient numbers of staff to meet their care needs.

When we looked at supervision and appraisal records we saw these had been carried out.

We found there some concerns about the availability of specialist food, for example on the day of the inspection people who were on a gluten free diet did not have gluten free bread available.

People had access to a range of healthcare professionals, including GPs, district nurses, opticians and chiropodists. We did find however that people who were living with some conditions were not being adequately monitored to ensure their conditions were stable.

We found some systems were in place to monitor the quality of service provision. However these were not effective and did not always identify concerns. When concerns had been identified there was little evidence to show what actions had been taken to address them. The program of audits carried out by the home manager were ineffective and not carried out regularly.

The home had a complaints procedure and people we spoke with knew how to raise concerns if they needed to. We saw the manager had taken appropriate action when complaints had been received and had resolved them in a timely and effective manner

Staff we spoke with were knowledgeable about safeguarding people from abuse. They told us they would report any concerns straight away.

The provider had system's in place to make sure people were recruited in a safe way. The provider was currently working through staff files to ensure all the correct documentation was present.

During the inspection we found six breaches of the health and social care act. You can see what action we told the provider to take at the back of the full version of the report