Cherry Tree Lodge

The provider was previously in breach of the legal regulation in relation to person-centred care and safe care and treatment. Improvements were found at this assessment, and the provider was no longer in breach of these regulations.

The provider was previously in breach of the legal regulation relating to good governance. Leaders had taken action to address previous concerns and improvements had been made in some areas. However, governance systems had not been effective in identifying and addressing all issues identified during this assessment. This meant leaders did not always have effective oversight of the quality of support people experienced. Therefore, the provider remained in breach of this regulation.

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

People were supported by staff who knew them well and relatives were positive about the care provided. Improvements had been made since the previous assessment, including staffing levels, care planning and environmental safety. People were supported to access health services when needed and medicines were generally managed safely. Staff worked with external professionals to support people's health and wellbeing.

However, people did not consistently experience care that was person-centred. Observations identified differences in the quality of support people received at different times. Whilst warm and positive interactions were often seen, some support was task-focused and organised around established routines rather than people's individual needs and preferences. People were not always supported in response to what they were communicating at the time, particularly where they relied on non-verbal communication to express choices.

Care plans and risk information had improved but further work was required to ensure guidance was clear, consistent and translated into practice. Staff knowledge of people was often strong; however, this was not always reflected in the support people experienced. Opportunities to promote independence and community involvement were limited, and support was often focused on maintaining people's current circumstances rather than supporting people to develop skills and experience a broader range of opportunities.

Governance systems were in place, and leaders had demonstrated a commitment to improvement. However, oversight arrangements had not identified all the concerns found during the assessment, including inconsistent experiences across the service, aspects of the culture of care and weaknesses in the oversight of medicines used to manage distress. As a result, improvements were not always embedded, and people did not consistently benefit from the changes leaders had introduced.

We have asked the provider for an action plan in response to the concerns found at this assessment.