Acorns Health Care

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We assessed 1 quality statement in the well led key question and found areas of concern. The provider had not identified through their own monitoring they failed to evidence the best interest process had been followed in accordance with the Mental Capacity Act 2005, including where appropriate the use of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards, where people were restrained for their safety. This has resulted in a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below. We found the provider was motivated to improve the service and started making improvements during our assessment.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Leaders did not always understand their roles and responsibilities under the Mental Capacity Act 2005. Through our discussions with the provider, we identified a lack of awareness and understanding for some decisions in relation to capacity and informed consent where restrictions had been imposed on people. The provider had not always ensured people’s human rights had been upheld where restrictions had been placed on them and had not been aware of their responsibilities. Senior leaders, service managers and staff were passionate about delivering person-centred care which promoted people’s independence and improved their quality of life. The senior leadership knew people and staff and told us how they ensured they had effective oversight of the services. One staff member told us, “They know each service user really well and offer bespoke advice, not a generic answer, a considered answer for each person.” The senior leadership team told us how they strived to continuously improve and valued partnership working with people, staff and other professionals and organisations. They valued opportunities to learn and develop and supported staff to do so as well. Staff were exceptionally positive about the senior leadership team. They told us they felt supported, valued and seen as individuals and that the senior leaders were visible and known to them. Comments included, “[Registered Manager’s name] is very knowledgeable. They are a genius” and “I see [Registered Manager’s name] they come around a lot. The other day we were on shift with [Person's name] … [Registered Manager’s name] and [Director’s name] were there.” The provider was passionate about exploring new ideas and approaches and were open and willing to try anything which may result in a positive outcome for people. The senior leaders had a good understanding of service improvements that were being worked on. They discussed these in detail and were responsive to concerns shared with them throughout the assessment.

There were some governance systems in place. However, they had not always been effective at identifying the areas of concern identified during this assessment. The provider had not identified through their own monitoring they could not evidence the best interest process had been followed in accordance with the Mental Capacity Act 2005, including where appropriate the use of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards, where people were restrained for their safety. Another example was the gaps found in staff employment records. There were shortfalls in records viewed, such as team meeting minutes, which had been identified by the provider through their assurance processes and had been addressing at the time of the assessment but needed time to become embedded within the service. Such as providing additional support and training to staff. We found the provider was motivated to improve the service and started making improvements during our assessment. The senior leadership team engaged with local partners to ensure they were kept up to date on best practice and cascaded this knowledge. The provider had processes and systems in place to identify, promote and celebrate people's individual achievements and positive outcomes. The provider accessed external resources to ensure they were continuously learning and aware of new approaches, changes and learning from other organisations.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.