This was an unannounced inspection that took place on 11 February 2016. Acorn Court Care Home is a nursing home for up to 86 people, with a range of support needs.
The home was split into four units; each unit had a head of unit managing the team of care staff. The units consisted of the ground floor with people who had an acquired brain injury and nursing needs, with a separate unit for people who had personal care needs only. The first and second floors were for people had nursing and end of life care needs and for people with a diagnosis of dementia.
On the day of our inspection there were 84 people living at the home.
The home was run by a registered manager. The registered manager was on annual leave on the day on inspection. ‘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 and associated regulations about how the service is run. The deputy manager oversaw the management of the service in the registered manager’s absence.
Some people’s human rights were affected as the requirements of the Mental Capacity Act 2005 was not always followed. Where people lacked capacity to make some decisions, people did not always have a mental capacity assessment or best interest meeting. Staff were heard to ask people for their permission before they provided care.
Where people’s liberty was needed to be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) and sent of the appropriate referrals to the local authority to ensure the person’s rights were protected.
There were not always enough opportunities for activities for people. Relatives and care staff told us that they felt there should be more activities on offer to people. The activity timetable indicated that one activity occurred daily whilst there was impromptu ‘our organisation makes people happy’ (oomph) session on the afternoon of our visit.
People’s, staff and relative’s views and opinions were sought on a regular basis. There was an annual staff and relatives survey.
People were safe guarded from the risk of abuse because staff had received training in safeguarding adults and were able to evidence to us that they knew the procedures to follow should they have any concerns. They knew of types of abuse and where to find contact numbers for the local safeguarding team if they needed to raise concerns.
Risks to people were managed and staff had knowledge of the risks and knew how to keep people safe. Staff knew how to respond to an accident or incident. The management team had no oversight of incidents and accidents that occurred in the home. Recording certain events such as incidents and accidents means that the manager can identify possible trends, learn from events and appropriately manage high risk situations.
Care was provided to people by a sufficient number of staff who were appropriately trained. Staff were seen to support people to keep them safe.
People were protected by the systems in place to manage medicines. Medicines were administered, disposed of and stored safely. Processes were in place in relation to the correct storage of medicine. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.
People had enough to eat and drink and was a choice of food and drink. People had access to fluids throughout the day.
People were supported to maintain their health and wellbeing as they were assisted to see health and social care professionals, such as a GP or dietician when required.
Staff treated people with kindness and maintained their dignity and respect. People and their relatives told us that they felt involved in planning their care. Staff knew peoples likes, dislikes and their preferences.
People received personalised care. People’s needs were regularly reviewed and updated when things changed. Peoples care plans were not always reflect the care that they were given.
People and their relatives told us they felt comfortable to raise a complaint and that it would be dealt with effectively. There were monthly people and relatives meetings to discuss activities, what was going on in the home and improvements planned.
People, relatives and staff told us that they felt the registered manager was approachable and supportive. There was an open and honest culture in the home.
There was a quality assurance programme in place to continually improve the quality of care provided.