Background to this inspection
Updated
28 October 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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.
This inspection took place on 13 July 2015 and was unannounced. The inspection team consisted of four adult social care inspectors, a specialist advisor with a background in nursing, and an expert by experience with a background in care of older adults. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
At the time of our inspection there were 36 people using the service. During our visit we spoke with seven people who used the service and two relatives/visitors to the home. We also spoke with seven members of staff, the registered manager, the deputy manager, the regional manager and the unit manager. We spent some time looking at documents and records that related to people’s care and the management of the service. We looked at people’s care records. We also spent time observing care in both lounge areas and dining room areas to help us understand the experience of people living at the home. We looked at all areas of the home including people’s bedrooms and communal bathrooms.
Before the inspection we reviewed all the information held about the home. We contacted the local authority before the inspection. The provider had not been asked to provide a provider information return (PIR). This is a document that provides relevant up to date information about the home that is provided by the manager or owner of the home to the Care Quality Commission
Updated
28 October 2015
We inspected the service on 13 July 2015. The visit was unannounced.
Our last inspection took place on 18 and 23 February 2015 and, at that time we found the
service was not meeting the regulations relating to care and welfare of people who used the service; they did not have enough trained staff to meet the needs of the people in the home. Staff did not receive effective supervisions, medication was not given in a safe way and families were not supported to review care plans. The home had not made any applications for Deprivation of Liberty Safeguards (DoLs) and Mental Capacity assessments (MCA) were not completed for anyone who used the service. The home was not clean and the provider did not have effective systems in place to monitor the quality of the service. We asked them to make improvements. The provider sent us an action plan telling us what they were going to do to ensure they were meeting the regulations. On this visit we checked and found improvements had been made in all of the required areas.
Acre Green provides accommodation and care for up to 50 older people. At the time of our inspection there were 36 people living in the home. The home is purpose built and there is car parking available. The home is divided over two floors and people living there have en-suite rooms. Both floors have communal lounges, dining rooms and bathing facilities. The home has a garden to the rear of the building which is secure.
At the time of our inspection there was a registered manager in the home. 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.
During our visit we saw people looked well cared for. We observed staff speaking in a caring and respectful manner to people who lived in the home. Staff demonstrated that they knew people’s individual characters, likes and dislikes.
We found the service was meeting the legal requirements relating to Deprivation of Liberty
Safeguards (DoLS).
The service was meeting the requirements of the Mental Capacity Act 2005 (MCA). We felt staff had confidence in using the MCA to make best interest decisions for people who lacked the capacity to make decisions in relation to their care. We looked at two capacity assessments which had been completed in the home with family involvement.
Medicines were administered to people by trained staff and people received their prescribed medication when they needed it. Appropriate arrangements were in place for the ordering, storage and disposal of medicines.
We spoke with staff who told us about the action they would take if they suspected someone was at risk of abuse. We found that this was consistent with the guidance within the safeguarding policy and procedure in place at the home.
People told us the food at the home was good and that they had enough to eat and drink. We observed lunch being served to people and saw that people were given sufficient amounts of food to meet their nutritional needs.
We saw the home had a range of activities in place for people to participate in. Staff were enthusiastic and people’s relatives told us the activities had made a positive impact on the lives of their family members. This meant people’s social needs were being met.
We looked at five staff personnel files and saw the recruitment process in place ensured that staff were suitable and safe to work in the home. Staff we spoke with told us they received supervision every two months and had annual appraisals carried out by the registered manager. We saw minutes from staff meetings which showed they had taken place on a regular basis and were well attended by staff.
We saw the provider had a system in place for the purpose of assessing and monitoring the quality of the service. This showed through monthly and weekly audits that this was an effective system.
We found that staff had training throughout their induction and also received annual refresher training in areas such as moving and handling, Mental Capacity Act 2005, DoLS, safeguarding, health and safety, fire safety, challenging behaviour, first aid and infection control. The home had an action plan in place to ensure that staff were booked in for the relevant training when required. This meant people living at the home could be assured that staff caring for them had up to date skills they required for their role.