Archived: Acorn Hill Nursing Home

Updated 31 May 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We planned this inspection to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

An inspector, an assistant inspector, a specialist advisor (nursing), and an expert by experience carried out the inspection. A specialist advisor is a person with professional expertise in care and/or nursing. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Acorn Hill Nursing Home 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 we looked at both during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We carried out the inspection visit on 10 April 2019. It was unannounced.

What we did

Before the inspection visit we looked at information we held about the service and used this information as part of our inspection planning. The information included notifications. Notifications are information on important events that happen in the home that the provider must let us know about.

We looked at information received from local authority and health authority commissioners. Commissioners are people who work to find appropriate care and support services for people and fund the care provided.

During our inspection visit we saw how the staff interacted with people who lived at the home. We spoke with three people using the service and three relatives. We spoke with the registered manager, deputy manager, the lead nurse, two nurses, two care workers, the administrator, the cook and the activities co-ordinator. We also spoke with two visiting professionals who were at the home on the day of our inspection visit.

We looked at records relating to all aspects of the home including staffing, medicines, accidents and incidents, and quality assurance. We also looked at eight people's care records.

Updated 31 May 2019

Rating at last inspection

At our last inspection of Acorn Hill (report published on 16 November 2018) we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We rated the service as Requires Improvement. At this inspection we found the breaches were met but further improvements were needed to ensure people received safe, effective care that met their needs.

About the service

Acorn Hill Nursing Home is registered to provide accommodation, nursing and personal care to up to 59 people, some of whom are living with dementia and/or have complex physical and mental health needs. At the time of our inspection there were 29 people using the service.

People’s experience of using this service

Since our last inspection the registered manager, provider and staff have made many improvements to the home. People, relatives and staff were positive about the home and told us about some of the improvements they had seen.

However further improvements were needed in the following areas: infection control; care records; staff following care plans and risk assessments; people and relatives’ involvement in care reviews; and the home’s audit system. The registered manager, provider and staff were working to address these issues.

People and relatives said the home was safe. A relative said, “[Person] is definitely safe. I can see how the staff look after [person] and I’ve seen them ensuring the safety of other residents here.” Staff were trained in safeguarding and knew how to protect people from abuse and harm and who to report any concerns to.

Staff were kind and caring when supporting people and offered them choices. People told us staff encouraged them to express their views and make decisions about their care and support. Care plans focused on people’s abilities and what they could do for themselves.

Staffing levels had improved. A relative said, “There is more staff than there used to be. I’m happy with it now and I have no complaints about the staff.” During our inspection visit there were enough staff on duty to meet people’s needs and spend quality time with people, assisting them with activities and socialising.

Staff were knowledgeable and experienced. A relative said, “I’m happy with staff skills. [Person] has as good a quality of life as they could get.” Improvements had been made to the storage, management and administration of medicines. People had the medicines they needed at the right time.

People and relatives said they liked the food served. A person said, “The food is good and we always have lots of drinks.” A relative told us, “[Person] loves the food. I’ve eaten it and it’s very nice. Very good portions, seconds offered.” Staff monitored people’s nutrition and hydration tools and ensured they had enough to eat and drink.

Staff ensured people’s healthcare needs were met. People saw GP’s and other healthcare professionals when they needed to. Staff monitored people’s well-being and took action if they were unwell. The home was working within the principles of the Mental Capacity Act 2005 and staff knew how to support people in making decisions and choices.

Improvements had been made to the premises to ensure they were fit for purpose. Better signage was in place to help people find their way around and staff had made the environment more stimulating using tactile objects, pictures, and murals.

People and relatives said they thought the home was well-led and the managers and staff kind and approachable. A relative said, “I chose this home because I like the lay out, the food, and the friendliness.” People, relatives and staff were invited to share their views about the home at meetings, through surveys, and on a one-to-one basis. They were listened to and changes and improvements made because of their input.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.