Acorn House - Laindon

We found the following examples of good practice.

¿ The manager was following the government's guidance on whole home testing for people and staff. This included using rapid testing, and weekly testing for staff and monthly testing for people who used the service.

¿ Staff had received training on working during the pandemic in relation to COVID 19 and had received training in the correct use of personal protective equipment (PPE).

¿ Some communal areas in the service had been changed to encourage people to socially distance but this was difficult due to the layout and the service being small. ¿ There was clear guidance and signage in the service to help prompt staff and people to minimise the risk of spreading infection.

¿ Infection prevention control practices had been implemented such as a good supply of PPE and hand sanitisers. Information was cascaded to staff and reminders issued. Audits of cleaning were completed by staff and overseen by the deputy manager.

¿ People’s well-being was looked after by staff who knew them well. Staff continued to engage in individual activities of people's own choice.

Acorn House - Laindon is a care home providing personal care and accommodation for up to six people, with learning disabilities and autism. At the time of the inspection six people were living at the service.

People’s experience of using this service and what we found

People had a good quality of life at Acorn House. We received positive feedback from everyone we spoke to about the service. A relative told us, “My family member enjoys their life there. You can give them a big tick from us.”

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The registered manager was a strong and committed leader who promoted good practice and a person-centred approach. There was an open culture at the service. People, families and staff felt able to speak out and have the confidence they would be listened to and action would be taken. The provider and senior staff monitored the quality of care and learnt from mistakes and concerns to make things better.

The registered manager developed practical and effective systems to help people remain safe. Staff worked well with people to manage risk within a homely environment. The provider was investing in the property to ensure it met people’s changing needs.

Staff were skilled and knowledgeable. The registered manager worked with the provider to ensure staff had access to good quality and relevant training and guidance. Staff worked effectively as a team, stepping in well in the registered manager’s absence to ensure people were safe.

People’s needs were outlined in detailed and personalised care plans which provided staff with the necessary guidance to support people. Staff worked well with health and social care professionals to promote people’s health and wellbeing. There were safe systems to support people to take their medicines safely.

Many of the staff had been at the service for some time and knew people well. The atmosphere was calm and respectful, and people spent time relaxing together around their busy schedules. Each person had a varied and flexible timetable, based on their needs and preferences. Staff used a variety of inclusive communication methods to ensure people had maximum access to information.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of what can support services to improve.

As part of this thematic review, we carried out a survey with the registered manager of Acorn House. We considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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

Rating at last inspection

The last rating for this service was Good (published 26 January 2017 )

Why we inspected:

This was a planned inspection to check that this service remained Good.

Follow up:

We will continue to monitor this service to ensure people receive care which meets their needs.

Acorn House provides accommodation and support for up to six persons who have learning disabilities and other associated needs. There is safe access to a communal garden and homely communal rooms are situated on the ground floor.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good. The service people received was in accordance with fundamental standards of care.

The service was safe. Staff demonstrated good knowledge of how to keep people safe. Management responded to and appropriately managed safeguarding concerns. Recruitment procedures were robust to ensure staff suitability for their role and appropriate checks were completed. A recruitment drive was underway to ensure staffing levels remained sufficient to meet people’s needs within the service and out in the community. People’s individual needs were assessed, risks were identified and minimised with effective support plans in place. Medicines were stored, administered and managed safely.

The service was effective. Management had identified the need to ensure formal supervisions were undertaken regularly and staff refresher training was completed periodically. Plans had been initiated to rectify these matters immediately. The home manager and staff understood the Mental Capacity Act 2005 and how to support people’s independence and to have maximum choice and control of their lives. People were supported to eat and drink enough and maintained balanced lifestyles to meet their preferences. Health care professionals were liaised with in order to manage people’s changes in physical and mental health needs.

The service was caring. Positive relationships had been created within Acorn House. Staff were kind and patient towards people. Support workers understood people well and knew their personal preferences. People told us and we saw that privacy and dignity was respected.

The service was responsive. People and relatives were regularly involved in the planning of support for continued wellbeing. People chose what activities they wished to be supported with to enhance health, wellbeing, independence and social skills. Complaints procedures were in place and made readily available to people.

The service was well led. The service remained well led despite a period of disruption due to changes in management. The home manager felt supported by the provider to strive for improvements for people and staff, which displayed good leadership. The home manager and provider had a visible presence within the service and people, relatives and staff used the open door policy effectively. Quality monitoring systems for the service were in place and the home manager and provider were working together to develop systems to work more effectively within the service. Views of the quality of the service were sought from people, relative’s and health professionals.

Further information is in the detailed findings below.

Acorn House provides accommodation and support for up to six persons who have learning disabilities and other associated needs.

The service is required to and did have 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 had good knowledge of their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Management applied such measures appropriately.

Effective support was delivered by staff. People’s safety was ensured whilst independence and wellbeing was promoted by the staff providing the care. As part of a robust recruitment process staff were recruited and employed upon completion of appropriate checks. There were sufficient staff to meet people’s individual needs. People’s medicines were managed safely by trained staff.

People had enough to eat and drink and staff understood and met their nutritional needs. Staff and managers ensured access to healthcare services were readily available to people and worked with a range of health professionals to maintain good health of the people.

Privacy and dignity was valued by staff and were observed to be respectful and compassionate towards people. Staff understood their roles in relation to encouraging people’s independence whilst mitigating potential risks. People were provided support in a person centred way by staff who clearly displayed good knowledge of the people they supported. People were helped to identify their own interests and pursue them with the assistance of staff. These person centred activities took place within the service as well as in the community.

The service was well led and ran effectively using quality monitoring audits which the manager and deputy manager carried out to identify any improvements needed. A complaints procedure was in place and had been used appropriately by management. Systems were in place to make sure that people’s views were gathered.

People told us that they felt safe. They said that the manager and the staff were very friendly, caring and kind. Staff interaction throughout our inspection visit was good. Staff had been given information and training on safeguarding adults and they showed a good awareness of the procedures.

The provider had good quality assurance processes. Regular audits of the service's systems and practices had taken place. People received safe, effective and compassionate care from a well-led service that responded quickly to their changing needs.

The atmosphere within the service was calm and relaxed and staff interactions with people who live there were noted to be positive. Staff were able to demonstrate a good understanding of people's care and support needs. We spoke with two people who used the service. They told us that they were happy living at Acorn House and found the care and support to be appropriate and to meet their needs.

Records showed that the provider had an effective recruitment and selection process in place and this involved all relevant checks being carried out prior to the member of staff commencing employment at Acorn House.

One person spoken with who used the service, told us that they felt confident to raise issues with the manager and/or staff and that any concerns would be listened to and acted upon.