Care Home: Cherry Tree Lodge

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What the care home does well The staff provide clean, comfortable and bright accommodation for the residents. They have bedrooms that they have personalised and feel comfortable in. The people are kept occupied and interested in various activities throughout the day, with staff engaging with them. Different activities are provided in the two lounges so that people can choose to be lively or can sit more quietly. Some go out to activities during the week days. Staff have received enough training to know how to care appropriately for people who live at the home. What has improved since the last inspection? The people`s care plans are evolving to become more personalised, although this process needs to be evaluated on an ongoing basis to ensure that they continue to tell staff simply and easily how to provide the care that the individual person requires. Staff numbers on duty in the daytime are enough to meet the needs of all the people in their personal care needs and leisure pursuits. The caring staff numbers should not include the manager as a nursing or care staff member. What the care home could do better: No requirements were made at this inspection. A recommendation was made for the incoming manager to be given sufficient time for managerial duties so as not to feel under pressure for completing the paperwork, managing the staff, making sure she knows her client-groups` needs and communicating with relatives, visitors, healthcare professionals and the company managers, rather than then having to put more than half her hours of work in as the nurse on shift. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cherry Tree Lodge 133 Macaulay Drive Lincoln Lincs LN2 4ET     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vanessa Gent     Date: 1 5 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Cherry Tree Lodge 133 Macaulay Drive Lincoln Lincs LN2 4ET 01522545580 F/P01522545580 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Life Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 19 Number of places (if applicable): Under 65 Over 65 19 learning disability Additional conditions: 19 No one falling within categories LD, LD(E) to be admitted into Cherry Tree Lodge when there are already 19 persons acommodated within these categories/combined categories in the home The maximum number of persons to be accommodated at Cherry Tree Lodge is 19 Date of last inspection Brief description of the care home Cherry Tree Lodge is registered to provide nursing and personal care for up to nineteen people of either sex, with a learning disability. It is a large, detached, two-storey house situated on a residential housing estate approximately one and a half miles north of the city centre of Lincoln. It is close to local shops, pub and schools, and has public transport links to the city centre. Accommodation is provided over the two floors. The first floor is reached by stairs and a passenger lift. There are fifteen single bedrooms and two double rooms, none of which are en-suite, although each room has a washbasin. Communally, there are two Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home lounges, a dining room, one bathroom and two wetrooms with toilet and four separate toilets within easy reach of both communal areas and the residents bedrooms. The grounds are enclosed, private and secure. They are laid mostly to lawns at the front and side of the property, with small area for car parking at the rear. The weekly fees currently charged range from £411 upwards, depending on the individuals assessed needs. Extra costs are charged to the individual for hairdressing, chiropody, reflexology, alternative therapies, personally-chosen outings, holidays and transport to various activities the people choose. Information about these costs as well as the day-to-day running of the care home, the statement of purpose and a copy of the last inspection report is available from the managers office. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We made an unannounced visit as part of this services key inspection. It started at 12.00 and lasted five hours. The people who live at the home as well as the staff stated that, at the home, they are known as residents or clients and are happy for the term of resident to be used in this report. The manager who was in post has been on sick leave and will not be returning to her post. They are awaiting a new manager to come to run the home. The previous manager completed a questionnaire called an Annual Quality Assurance Care Homes for Adults (18-65 years) Page 6 of 28 Assessment (AQAA) giving important information about the service and this was used towards the inspection process. Information from this as well as that which the Care Quality Commission (CQC) holds about the service was used to plan the visit and produce this report. The main method of inspection used is called case-tracking. This involves selecting a number of people, and looking at the care they receive through the checking of records, discussion with them, any relatives available and the care staff, and observation of care practices. The visit to the home focused on how the people felt about the service provided and how the care was delivered to them. We looked at the care received in detail for three people to ensure their health, safety and welfare is checked and that they are allowed dignity, autonomy and choice. We looked round the premises and looked at other records. We spoke with the staff on duty, the person in charge at the time of the visit, the companys operations manager and the people who live there. Any comments we received from staff or those who live there will be mentioned in the main body of this report. The operations manager was present throughout this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information available and the introductory process is detailed enough to help people decide if they want to move into the home. The measures in place for assessing the needs of prospective residents, and checking that the right care is given once they move in, ensures that their needs and wishes can be met. Evidence: The statement of purpose we saw was basic in its information but described the facilities at the home for any who may want to go to live there. The previous manager, in her self assessment said, The information is available in a simplified pictorial format or if necessary braille, although we did not see this during the visit to the home. We saw, in the care plans, that people who go to live at the home have an assessment of their needs and wishes before being accepted or accepting that they want to move in. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: We were told and saw that people who are interested in going to live at Cherry Tree Lodge are encouraged to visit and meet the people already living there before making a decision to move in. They may stay for a trial period to ensure they can settle in and get along with the other residents. We were given a document entitled, Meet and Greet, which is to be used to ensure that new clients referred to Prime Life facilities are introduced properly, fully informed, are appropriately assessed and that we commence our service in a positive fashion. Although we had a limited ability to communicate with most of the people we spoke with, they were able to show us, in their unique way, that they were happy living at the home. The previous manager told us, in the self assessment she returned to us, On admission we ensure that clients are introduced to their Key Worker and that they are available to help them through the settling in period in particular. And, Because the commitment we make to assisting the clients in choosing their home, we have a very low client turnover, and our home enjoys a high level of occupancy. Some have lived there a long time. The staff we spoke with confirmed that each person has a keyworker to ensure they know them well enough to help them attain a degree of independence and choice, within their abilities. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning and risk assessments in place help to keep the people safe and healthy. People are supported to live the life they choose and to participate fully in the daily life of the home. Evidence: We saw that there are comprehensive care plans in place for everyone living at the home. These have been created from a base-line initial assessment, done before and when the person moved into the home. Any issues that have been identified are reviewed each month, or more often as necessary, with the nurse and the persons keyworker. Staff told us they are encouraged to be aware of what is in the care plans and to write in them, to ensure they know how to care safely and well for the people. A staff member showed us that some of the information in the care plans has been over-simplified, resulting in them not always explaining thoroughly how to complete tasks for the individual. However, we saw that staff are in the process of filling the Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: care plan issues or needs in more details to describe each task more clearly and make sure the instructions are easy to follow by all staff. Otherwise, the care plans are very well laid out with the relevant risk assessment attached to each care plan issue, making it very easy to understand, follow and review. We saw and checked the peoples financial statements where they needed support to manage them, and found that they were clear and safely documented records, showing all incoming benefits and outgoing payments. Staff told and showed us that people were encouraged to make decisions about their lives, to participate fully in the daily life of the home and take risks within their capabilities. We saw that limitations on where people could go or what they could do, such as activities to do with running of the home, were only made when it was their best interest for their safety or well-being, such as keeping the laundry and kitchen areas for staff access only and giving their medications to them. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in their chosen activities and lifestyles. People are able, with support, to make choices about how they want to live their lives, and what they want to do. They benefit from a varied, fresh, homemade diet that is based around their needs and preferences. Evidence: The previous manager said, in her self assessment, We are acutely aware that many of our clients have disabilities, we put forward the concept that disability should not be a barrier to participation ... We were told that a minority of people go to a local day centre several times during the week. Most stay at the home and join in the various activities provided for them. To enable people to go out into the community, the previous manager said, in her selfCare Homes for Adults (18-65 years) Page 14 of 28 Evidence: assessment, we are enhancing the transport provision that we have available to ensure clients can [access] the community, in providing wheelchair friendly transport where appropriate to overcome the obstacles of disability. In the morning, people chose their own activities, some being occupied with their own possessions or individual items, some being entertained or encouraged in activities by the staff. In the afternoon, we saw, in one of the lounges, people putting on music of their choice and all joyfully joining in the fun, dancing either on their feet or from their chairs, moving their arms and bodies in time to the music beat, many laughing and smiling. A staff member joined in with the dancing, much to the amusement of the people in the room. In the quieter lounge, people were enjoying watching a film on the large screen television whilst a person was knitting, supported by a staff member. Staff bring in shopping catalogues and we saw one discuss the pictures with a person, who was smiling appreciatively. Endeavouring to become an active part of the surrounding community, we were told, It has always been a challenge to harness the local community spirit, and to encourage them to see Cherry Tree Lodge as having value and worth, and to receive the clients into their community, and to offer their support, in old fashion words, the community are excellent grafters and doers, the trick has been to ... gain their commitment and support, this has certainly happened. Staff confirmed that the people who live on the estate have accepted the residents as very much part of their community. Staff told us that most of the people have visits from family and friends who, staff say, are happy that their relative lives there. The former manager said, in her self assessment, that by assisting clients to return home, we appreciate the importance of family support and positive links. At a previous occasion, a frequent visitor had said he was very satisfied with the care and support given. He said he always received a warm and friendly welcome and had no concerns. At the mealtime we observed, the staff showed that they understood the wishes of people with restricted communication skills and catered for them and treated them with dignity, as they wished. People said that the food was good and as they wanted and liked. Staff told us that the cook makes homemade meals with fresh vegetables and produces homemade cakes and puddings. The people were given a fresh fruit snack in the mid-afternoon and drinks were available throughout the time we were visiting. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs met in the way they want them to be. They are respected in a dignified manner and are happy living at the home. Evidence: We saw that people were assisted in their personal care and encouraged to do things for themselves where possible, with staff support. The previous manager said, in her self assessment, Where appropriate we provide aids and equipment, we ensure that they are appropriate for purpose and serviced, and that staff have the specialist training necessary to safely use the same. People indicated to us that they were happy living at the home. One person told us, Im happy here. I like living here. We observed staff treating residents in a friendly, affectionate and respectful manner during the visit. People said, and we observed, that the staff are friendly and respectful to them and treat them with dignity. We saw in the care plans that each individuals healthcare needs were clearly explained and visits by healthcare professionals all listed and documented separately Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: to provide a clear audit trail for monitoring and keeping up to date peoples health needs. The previous manager said, We have restructured our training under the banner of the Learning Partnership to ensure that we deliver the support to gain the skills that are necessary to reflect the needs of our client group. We have improved the environment in which we provide care to better promote the principals of individuality, privacy and dignity. None of the people see to their own medicines. They want the staff to see to that. The nurse on duty gave out the medicines. The medication practices that we saw the staff follow were seen to keep the people safe. They kept clear records to show when and to and by whom the medicines had been given. All the staff, whether they give medicines out or not, have training from the pharmacist who supplies the homes monthly medications so that they know the effects and side effects of the medicines given to the residents. The local pharmacist visits the home regularly and audits the service provided. The pharmacists last few reports have not identified any issues and have found everything to be satisfactory. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people feel safe and enjoy living at the home, with staff who are concerned, caring and well-trained to keep them safe and happy. Evidence: We have not received any complaints from any source since our last main inspection of the service two years ago. We saw the file where the complaints, concerns and compliments are kept. It had no complaints or concerns but had letters and cards thanking the manager and staff for their loving and thoughtful care. The previous manager in her self assessment form told us, We set ourselves strict standards with regard to the receipt and processing of complaints, comments and concerns, to ensure that they are addressed by the relevant person, speedily and efficiently, and that the outcomes are communicated with the source of the concern. In response to how much they have improved for protecting the people, she added, Substantially, by extending our training and awareness programme, and providing clear simple information on the process to follow. We saw evidence of this at our visit. The people living in the home each have a named nurse and keyworker team. Staff said this helps them understand each person and meets their needs and wishes better. They also hold Residents meetings where people are encouraged to take part and express their wishes, even though some peoples communication is limited. Staff have Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: managed well to understand and interpret the peoples wishes and keep them happy. Staff told us they have received training in how deal with any complaints they may be aware of, how to protect the people from harm and who to inform if they became aware of any harm coming to people from any other source. Their staff files confirmed the safeguarding and Mental Capacity Act training they had undertaken and they expressed their understanding of their training in these aspects of care. The former manager showed that she dealt efficiently and without delay with an issue that was brought to her attention regarding the safe care of a person who lived there. We were shown that the outcome was satisfactory to all concerned and the issue was used to further encourage and train staff to be alert and aware of peoples vulnerability. People indicated to us that they are happy, content and safe and that they have a close rapport with the staff. The atmosphere in the home during our visit was of contentment and cheerfulness. Everyone smiled a lot and expressed a happy attitude, especially when around the staff. One staff member said, Im very happy working at this home. Another said, I wouldnt want to work anywhere else. Ive always been very happy here. I love the residents. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a clean, comfortable and homely environment, which is well maintained. Measures are in place to maintain the homes hygienic and safe surroundings. Evidence: The home was clean, tidy, bright and fresh at our visit. People were pleased to show us round the home and their rooms. The bedrooms were personalised to demonstrate the individuality of each resident. People said they like their rooms. People who were in shared rooms said they shared because they wanted to. Extra privacy was accorded by a curtain or blind to partition each persons bed space, if they wanted to use it. Outside, the garden, which covers three sides of the outside property, is laid mostly to lawn. The person in charge of the home at out visit showed us that it is safe, pleasant to walk and sit in and enjoyed by most of the residents. During our visit, people went out into the garden freely and enjoyed watching things going on outside the safety of the garden fences and gate. We saw in the records and the regional manager confirmed, that the maintenance man attends regularly to undertake repairs and regular maintenance tasks and checks. He keeps records of any repairs done and the safety checks for fire, water, heating and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: electrical safety in the home. We saw and the pervious manager told us in her self assessment, that they were up-to-date. The records kept in the home and the reports by the Environmental Health Officer and the Fire Safety Officer showed us that it is maintained in a safe, hygienic state. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by staff who are safely recruited, skilled, knowledgeable and caring, and who are available in sufficient numbers to meet their needs. Evidence: We saw that enough staff were on duty to enable them to have quality time with the people living at the home and not be rushed in their duties. Staff were on hand to attend to the peoples needs promptly and were attentive to them at all times. People indicated to us that they had a very close rapport with the staff. Each person had a keyworker who, staff told us, knows their needs, preferences and wishes well and can interpret these to keep the people happy and content as much as possible. We saw a pamphlet produced by Prime Life for new staff to instruct and reassure them. It was comprehensive and easy to read and understand. It told new staff, You should know how you will be supported through the early days and weeks of your new role - possible the most important time for information gathering throughout your employment with us. We were not able to talk with any recently-recruited staff, but staff told us that the recruitment and induction process is very thorough. We saw in the staff records that the recruitment process was safely conducted, and all the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: requirements by law were in evidence. Staff told us, and their records confirmed, that there is plenty of training available and that they undertake. They said that this makes them feel able to deliver a good quality of care to the residents. This was evident during our visit, in their safe and effective practices and the gentle and loving way they interacted with the people, whilst not being aware they were being observed. Records we saw confirmed that the staff had regular, formal, one-to-one sessions with the manager or a senior staff member. They told us that the meetings helped them to look at their personal development, and they felt able to voice their views and opinions. One staff member commented, I wouldnt want to work anywhere else. Ive always been very happy here. I love the residents. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the interests and for the benefit of the people and staff. The people feel safe, happy and enjoy living at the home. Their views are listened to and they are involved in decisions affecting them. Staff work in a close team with a supportive regional manager and company. Evidence: The manager had been on sick leave and it had become apparent that she was not returning to her post. A new manager had been selected but was not yet in post. Staff said that since the former manager had been in post, she was supportive and helpful to them and had instigated many improvements to the home and their practice. The responsible person visits the home every month, unannounced, to check that everything in the home is acceptable, and that staff practices are safe and to the satisfaction of the people. They report their findings to the manager each month. Staff told us they had regular staff meetings with the previous manager where their Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: views can be expressed and they could share with each other and the manager how the service could be improved. The home was well-maintained and records were in order to further protect people. Staff also confirmed this. The Environmental Health Officers and the Fire Safety Officers reports showed that everything was satisfactory at their inspections. We saw that comprehensive health and safety testing took place regularly, including environmental health, electrical, water and equipment testing and management, fire drills and fire alarm testing and food management. People were very complimentary about the service and the home. Comments included, I want to take this opportunity to congratulate you and staff on your continuing hard work. I would like to thank all the staff at Cherry Tree Lodge for the care and consideration they gave to [the resident] throughout his stay with them, particularly emphasised in the professional manner in which all the arrangements were made for the funeral. Following work experience by student nurses at the home, the manager received a letter saying, All of our students had an excellent time and their chosen experience has certainly given them food for thought for their futures. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 38 The incoming manager needs to be given sufficient time for managerial duties so as not to feel under pressure for completing the paperwork, managing the staff, making sure she knows her client-groups needs and communicating with relatives, visitors, healthcare professionals and the company managers. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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