Acorn House - Croydon

Updated 16 November 2022

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

Two inspectors carried out this inspection.

Service and service type

Acorn House – Croydon 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 House – Croydon 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 no registered manager in post. A new manager was appointed in June 2022 who was in the process of submitting an application to CQC to become the registered manager for the service.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since our 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 spoke with three people using the service and asked them for their views about the care and support provided to them. We also spoke to a visiting healthcare professional who gave us their feedback about the service. The majority of people using the service were living with dementia and unable to verbally communicate with us. So, we observed interactions between people and staff to understand their experiences. We spoke with the manager, two care support workers and the staff member responsible for maintenance at the service. We reviewed a range of records. This included three people's care records, records relating to medicines management, three staff recruitment files, staff training and supervision information and other records relating to the management of the service.

Updated 16 November 2022

About the service

Acorn House – Croydon is a residential care home providing personal care to up to thirty one people in one adapted building. The service provides support to older people, the majority of whom are living with dementia. At the time of our inspection there were twenty three people using the service.

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

Management and leadership of the service was not fully effective and consistent. The service did not have a current registered manager in post. Prior to the appointment of the current manager in June 2022, feedback from people, staff and healthcare professionals indicated the service was not being managed as well as it should have been after the previous registered manager left in November 2021.

After taking up their post, the current manager identified a number of areas the service needed to improve. They took action in response and appointed a deputy manager for the service, implemented a new records system, procured a new dispensing pharmacy to support the service and brought outstanding training and supervision for staff up to date. Some improvements had also been made to the external and internal environment to make the service a more comfortable and pleasant place for people to live.

However, more work was needed to improve management oversight of Deprivation of Liberty Safeguards (DoLS) applications to make sure these were submitted in a timely manner. This meant people were not consistently supported to have maximum choice and control of their lives and staff did not consistently support them in the least restrictive way possible and in their best interests; the policies and systems in the service at the time of this inspection did not always support this practice. The provider also needed to complete the refurbishment and redecoration of the home to fully meet the needs of all the people using the service.

People were safe at the service. Staff knew how to safeguard people from abuse and keep them safe from identified risks to their safety and wellbeing. There were enough staff to support people and meet their needs. Recruitment and criminal records checks were carried out on staff to make sure they were suitable to support people. Health and safety checks were carried out of the premises and equipment to make sure they were safe. The premises was clean and tidy. Staff followed infection control and hygiene practice to reduce the risk of infections.

People were involved in planning and making decisions about the care and support they required. People’s records set out their preferences for how their care and support needs should be provided. Staff were provided relevant training to help them meet people’s needs. Staff were well supported by the manager and encouraged to learn and improve in their role and to put people’s needs and wishes at the heart of everything they did.

People were supported to stay healthy and well. Staff helped people to eat and drink enough to meet their needs. We have made a recommendation about supporting people living with dementia to eat well. Staff made sure people took their prescribed medicines in a timely and appropriate way. Medicines were managed safely. Staff supported people to manage their healthcare and medical conditions and made sure people could access support from healthcare professionals when needed. The service worked well with other healthcare professionals to ensure a joined-up approach to the care and support people received.

People’s feedback indicated staff delivered good quality support. People and staff spoke well about the new manager. The manager and deputy manager undertook audits and checks to monitor, review and improve the quality and safety of the service. There were systems in place to obtain feedback from people, staff and others about how the service could be improved. Accidents and incidents were investigated and learning was shared with staff, to help them improve the quality and safety of the support provided.

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 20 September 2019).

Why we inspected

We received concerns in relation to the quality and safety of care and support provided to people, records maintained by staff, the cleanliness and quality of the environment, staffing levels, staff competency and management and leadership of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective 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. This is based on the findings at this inspection.

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

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

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 continue to monitor information we receive about the service, which will help inform when we next inspect.