Archived: Acorns Care Home

Updated 14 July 2017

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

The unannounced inspection was undertaken on 17 March 2017, it was conducted by one adult social care inspector.

Before our inspection we asked the registered provider to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the notifications we had received and reviewed all the intelligence CQC held to help inform us about the level of risk for this service. We also asked the local authority and Healthwatch (A national healthcare champion service) for their views prior to our inspection. We reviewed all of this information to help us make a judgement.

During our inspection we undertook a tour of the building. We used observation to see how people were cared for whilst they were in the communal areas of the service. We observed people having lunch and sitting in a lounge. We watched a member of staff giving out medicine. We looked at a variety of records; this included two people’s care records, risk assessments and a selection of medicine administration records,(MARs). We looked at records relating to the management of the service, policies and procedures, quality assurance documentation and the complaints information. We also looked at staff rotas, staff’s training plan and their supervision and appraisal records. We also looked at three staff‘s recruitment documentation.

We spoke with three people living at the service, two relatives and two visiting healthcare professionals. We spoke with the registered manager, deputy manager, with a member of domestic staff, a cook and three care staff who were on duty at the time of our inspection.

Were people were unable to communicate with us, due to the complexity of their conditions. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who could not talk with us. We were able to observe how staff interacted with people and the support they received at key times.

Updated 14 July 2017

This inspection took place on 17 May 2017, and was unannounced.

Acorns Care Home is registered with the Care Quality Commission (CQC) to provide accommodation for up to 27 older people, some of whom may be living with dementia. Accommodation is provided over three floors; the home is set in private gardens. There is a car park for visitors to use.

The service has a registered manager in place. 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.

Prior to our inspection in April 2016 Healthwatch (A national healthcare champion service) had recommended an area, other than the dining room be used for activities. At our last inspection of this service on 20 April 2016 we found light pull cords required cleaning to maintain infection control and there were issues with medicines and the safe storage of gloves.

During this inspection found most issues from the last inspection had been addressed. However, the concern with the safe storage of gloves in one area persisted and was not addressed until this inspection. The refurbishment was still on-going. We also found there were new shortfalls regarding infection control, consent and the non-notification of low level safeguarding issues. There were two breaches of regulations. A breach of regulation 18 of the Care Quality Commission (Registration) Regulations 2009 for non-notification of incidents regarding low level safeguarding issues and a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.There were ineffective quality monitoring systems in place to assess, monitor and improve the quality and safety of the service in relation to consent, the environment and infection control. You can see what action we told the provider to take at the back of the full version of the report.

Staff had training in how to safeguard people from abuse and knew how to raise concerns. Staff were recruited safely and in sufficient numbers to meet people’s needs. Medicine management at the service was robust.

Training was provided in a variety of subjects to maintain and develop the staff’s skills. Supervision and appraisals occurred, which helped staff to identify any further training needs and allowed discussion about their performance.

People’s nutritional needs were met. Staff contacted health care professionals for advice and guidance to help maintain people’s wellbeing.

We observed staff were caring. People using the service and their relatives confirmed this. People were supported to have choice and control of their lives. Their privacy and dignity was respected by the staff. People's personal records were held securely.

People had their needs assessed and care plans and risk assessments were in place, they were being re-written at the time of our inspection to make them more detailed and personalised. Staff understood people’s preferences for their care and support. There was a complaints policy in place, issues raised were addressed.

The service was still undergoing a programme of refurbishment and internal redecoration. Pictorial signage was in place to help people to find their way around. Pictures of local scenes and objects to aid reminiscence were being sought to improve the environment.

People we spoke with told us they were happy with the service they received. People's views were asked for and feedback received was acted upon. Service contracts were in place to maintain equipment so it remained safe to use.