Cherrywood House

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Action was taken to understand why a person had become distressed or why an incident occurred and what could be changed to prevent further occurrences. Staff were notified via their work apps when there were incidents or important updates for people, and the service had regular safety huddle meetings to share learning. A safety huddle meeting is a short staff meeting where recent safety events, for example accidents or incidents, are discussed. Staff and leaders were aware of the warning signs that may suggest a closed culture was developing. The registered manager and deputy undertook unannounced spot checks and encouraged staff to raise any concerns they had.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People were consistently supported when they were distressed. There were care plans in place to support people to have a good day, and strategies to help prevent distress. Staff told us they had received training on supporting people to manage periods of distress and were able to explain approaches they would use to support people.

People had been supported with hospital visits and overnight stays where this was required. Where this was difficult for people to cope, their relatives, staff and health professionals had been involved in planning for the visit and clear communication had ensured a consistent approach for people.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately, they reported safeguarding concerns appropriately and monitored concerns for any themes. A professional told us the registered manager’s investigation of a safeguarding incident had been “responsive and thorough”. The registered manager regularly reviewed and monitored any restrictions in place for people with them, their relatives and other relevant professionals. Staff had received safeguarding training and knew how to report any concerns, they told us “If there is anything of concern or harm to a resident, I need to report it” and “The deputy and manager are always supportive and available if something is raised.”

The service worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff understood risks to people well and told us people’s risk assessments contained the information they needed. People were supported and empowered to take positive risks in areas they wanted to and to enhance their lives, for example one person had recently been tobogganing.

A professional told us, “I feel risks are managed well, staff adapt flexibly to [person’s] needs, they can be different on a day-to-day basis.”

A relative told us “I don’t think [person] is at risk. They have been there so long that they know all their triggers and avoid them. If [person] gets stressed, they talk to them calmly.”

Care plans had information for staff to support people including risks to people and behaviour support plans. However, risks and control measures to support people to manage risks were not always clearly recorded in care plans, which had recently been transferred to an electronic system. We fed this back to the registered manager who told us they would address this. Some care plans for oral care did not have enough detail about the risks to people such as infection. There were also some care plans where critical information for people needed more detail to be added. Individual activity risk assessments we viewed contained detailed information.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

At our last inspection we found some areas of the environment needed repair or remedial work which meant they could not be cleaned effectively. At this assessment we found these areas had been refurbished and the environment was clean and well maintained. Regular checks were conducted on fire, electric and water safety systems. Drills took place to ensure people could be evacuated safely in the event of a fire. Personal Emergency Evacuation Plans (PEEPs) assessed the level of support people required. Staff told us some improvements were needed in how long it took for some repairs to the service to be made.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The service operated safe recruitment processes to ensure staff employed were suitable for the role.

Staffing levels were planned based on people’s dependency and individual needs. Rotas demonstrated staffing levels were maintained and people were being supported by a consistent staff team. The registered manager told us bank staff and occasionally agency staff covered any shortfalls in staffing requirements. Staff told us staffing levels were generally good.

There were systems to implement and monitor new staff induction, ongoing training and staff supervisions. Staff were trained to support people in the service and shared how they put their training into practice. For example, staff told us how they supported people with specific eating and drinking needs.

We observed interactions between people and staff where people appeared to be in control of their day and relaxed. Staff appeared to know people well and encouraged them to be independent and make their own choices.

A professional said, “The service “works well for [person] with the size, mix of people and staff ratio.” A relative said “I think the staff look after [person] extremely well, no complaints. They always have someone with them.”

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Improvements had been made to the layout and hygiene practices of the premises since our last inspection. The service was clean and well maintained. Cleaning schedules and records were in place and quality checks were completed daily. Staff told us they had access to enough personal protective equipment (PPE) and knew how and when to use and dispose of it correctly and safely. A relative told us “As far as I know, the home is very clean and well maintained, the carer supports [person] to keep their home clean.”

The service made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff had received training to administer people’s medicines safely and as prescribed. People’s care plans provided information to staff about how to support a person to take their medicines. Where people were prescribed as required medicines, for example for when they may be in pain, there was a clear protocol for staff to follow.

Relatives told us people were supported to take their medicines by staff. One said, “There haven’t been any problems. When [person] comes home, they are very organised, and I record what tablets I have given [person].”

There was a commitment at the service to STOMP, which is national best practice guidance on stopping the over-medication of people with a learning disability and or autistic people when distressed. People had regular medicine reviews with health professionals.

Not all medicines we saw were labelled with an opened and expiry date, this meant it was not clear when the medicine needed to be used by to ensure it was safe and effective, we fed this back to the registered manager.

Senior staff members had overall responsibility for daily medicines administration and checks of medication administration records. We found an error had occurred 2 weeks before our inspection which had not been identified or raised to management. We fed this back to the registered manager who took immediate action to investigate the error and share learning with their team. Where other medicines errors had occurred, these had been investigated and any lessons learned shared.