Archived: Acorn Manor Residential Care Home

Updated 19 February 2020

The inspection

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 checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Acorn Manor Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at 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

The first day of this inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service including the local infection prevention and control team and the fire service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection

During the inspection

We spoke with two people who used the service and were able to give us their views, two relatives and a visiting pharmacist about their experience of the care provided. We spoke with nine members of staff including the registered manager, nominated individual, senior care workers, care workers and the chef.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included eight people’s care records and four people's medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

Updated 19 February 2020

About the service

Acorn Manor is a residential care home that was providing personal care to 15 people at the time of the inspection. The home can accommodate up to 40 people over two floors with all communal facilities being on the ground floor.

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

The provider had not ensured they always took steps to effectively monitor and improve the safety and quality of the service people received. The provider had not fully implemented good practice recommendations made by external agencies in relation to the environment and equipment and to minimise the risk to people's health and safety.

Some areas of the service had not been well maintained and were in poor state of repair. These issues increased the risk of infection and of harm occurring.

The fire service has issued an enforcement notice which the provider must complete by the 2 March 2020.

We have made a recommendation about the adaptation of the environment to meet the needs of people living with dementia.

The provider no longer employed an activities organiser and the range of activities on offer to people was limited. People enjoyed the visiting entertainers and had a choice of where they spent their time.

Some improvements had been made to the governance of the service. Audits had been introduced, health and safety checks had been undertaken and people's confidential information was stored securely. Staff spoke highly of the registered manager and the changes that had been introduced.

Improvements had been made to the assessment and care planning processes. Each person had a care plan in place. People's needs had been assessed and a care plan implemented describing the support people needed. People's care had been planned with them, and where appropriate, their family members involvement.

People's mealtime experience had improved. People were receiving the support they needed to eat and drink. People's dietary needs and preferences were catered for and people enjoyed the variety of homemade meals and the snacks on offer.

The support staff received had improved. Staff had received the induction, training and supervision they needed to carry out their role. There were sufficient numbers of suitably qualified and safely recruited staff on duty to meet people's needs.

People were treated with dignity and respect by kind and caring staff that knew them well. People and their relatives were happy with the care people received. They had the opportunity to give their views and felt able to raise any concerns they may have.

People received their medicines when they needed them and referrals were made to healthcare professionals when people needed their support and advice.

There were systems in place to protect people from the risk of abuse and people felt safe living at the service. Accidents and incidents were recorded and monitored by the registered manager for themes and trends and action was taken to reduce the risk of re-occurrence.

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.

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

Rating at last inspection and update

The last rating for this service was inadequate with multiple breaches of the regulations (published July 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection some improvements had been made but the provider remained in breach of regulations.

This service has been in Special Measures since 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvement. Please see the safe, effective, responsive and well-led sections of this full report.

Enforcement

We have identified breaches in relation to the safety of the premises and equipment and the overall governance of the service. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.