Acorn Hove

Updated 6 April 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by an inspector.

Service and service type

Acorn Hove is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Acorn Hove is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The provider was recruiting to this post and an interim manager was providing current cover.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We used information gathered as part of monitoring activity that took place on 25 January 2023 to help plan the inspection and inform our judgements. 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed a range of records. This included 3 people's care records, a number of medicine records and the recruitment records for 4 members of staff. We carried out observations in the communal areas of the home. We spoke to 7 people who used the service and 5 members of staff. This included the manager and care staff. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We had contact with the nominated individual to highlight the concerns found at the inspection and requested immediate assurances regarding how these matters would be addressed. The nominated individual is responsible for supervising the management of the service.

Updated 6 April 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Acorn Hove is a residential care home which provides accommodation and personal care to 8 people at the time of the inspection. The service can support up to 12 people.

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

Right Support: People had their own individualised care plans in place, but they had not been reviewed for several months. Staff knew people well, but their needs were not always reviewed or updated regularly. Accident and incidents were not routinely monitored, which meant there were missed opportunities for learning. Robust recruitment checks were not being completed.

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.

Right Culture: The governance and quality assurance systems at the service were not robust. There were audits and action plans in place to improve the quality of care. However, these were not consistently completed and, in some cases, actions were not followed up or documented. This meant that improvements were not always implemented, the provider's governance systems were not always followed and issues around the quality of care and safety of the environment at the service were not always addressed. There was a positive culture at the service and both staff and people spoke of how approachable the interim manager was when raising concerns.

Right Care: There were sufficient staff to ensure people’s safety. People were supported in the way they wished and received care tailored to them to enhance and enrich their lives. Staff had a good understanding of people's needs and people were comfortable and happy in staff's presence. People were happy with the care provided and enjoyed living at the service. People were complementary about the staff team and the changes that had happened since our last inspection. One person commented, "[Staff] are all great. I can tell them anything. We’re like a family.”

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

Rating at last inspection

The last rating for this service was good (published 14 June 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service and in part due to concern we had regarding the governance at the service. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Acorn Hove on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe recruitment of staff and the quality and assurance systems in place at this inspection. We have made a recommendation about the management of some medicines.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.