The inspection took place on 25 October 2018 and was announced. Acorn Community Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides support to younger adults, older adults and people living with learning disabilities or autistic spectrum disorder. Acorn Community Care is situated in the market town of Norton and provides large care packages to those living in the local area. At the time of inspection three people with a learning disability or autism were receiving a service from the provider. All three people received care over a 24-hour period in their own homes.
The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
A registered manager was in post. 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.
Since our last inspection the local authority had identified minor concerns with the provider following a visit from their quality assurance and contracting team. The provider had developed an action plan to remedy these issues and was still working to improve their practice.
At the last inspection in April 2016 the service was rated good. At this inspection the service had not maintained this rating and required improvement. This is the first time it had been rated requires improvement.
The provider did not consistently maintain complete records for staff and people that use the service. Records of staff interviews, identification documents, proof of their right to work in the UK and vehicle documents were not always kept showing how their suitability for their role had been assessed. Staff induction and probation reviews were not consistently recorded to show how they were introduced to their role and responsibilities and how this had been monitored. Staff completed training to provide them with the knowledge and skills required to support people. There were some gaps in training records, including Mental Capacity Act 2005 training. The staff we spoke with demonstrated an awareness of this legislation.
The provider had not always completed and recorded assessments prior to people receiving support from the service to consider their needs and how they would meet these.
The provider had started to introduce a system of audits to monitor safety and quality in the service.
Safe recruitment practices were not always followed. A member of staff had started work before their Disclosure and Barring (DBS) check had been returned. We have made a recommendation about this.
Processes were in place to support the proper use and safe handling of medicines. The provider had recently started to complete medication competency checks to assess staff’s knowledge and skill to administer medicines.
Risk assessments were used to identify and manage risks to people. They were reviewed to ensure they remained appropriate. New risk assessments were completed when new risks were identified. Positive behaviour support plans were in place to support people with behaviours that could challenge the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People received support to lead healthy lives. Care files contained details of the health professionals involved in people’s lives. Staff supported people to access support from health and social care organisations when needed.
People were treated with dignity and respect. They were encouraged to lead independent lives. People had their own tenancies; a contract between themselves and their landlord and were able to personalise their property.
People had the opportunity to pursue their hobbies and interests, accessing community amenities. They were supported to maintain their existing relationships and extend their friendship network with others accessing the provider’s services.
People and staff engaged with the provider through meetings and quality questionnaires. Relatives and representatives knew how to raise complaints and felt assured these would be listened to.
We found the provider was in breach of one of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.