Acorn Care Home

Acorn care home is a residential care home providing personal and nursing care to up to 4 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 4 people using the service.

People’s experience of the service and what we found:

People felt safe. There were processes in place to safeguard people from abuse. Risks to people's safety were assessed and reviewed. There was guidance for staff to keep people safe from harm. People received their medicines as prescribed. Staff wore appropriate Personal Protective Equipment (PPE) such as face masks and disposable gloves and aprons.

People's care needs were assessed and reviewed. Staff completed training to know how to care for people effectively. People enjoyed the food staff prepared. Staff knew and understood people's dietary requirements. 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.

Staff were kind and caring. People and relatives praised the caring and inclusive nature of the service. People's privacy, dignity and independence were respected and promoted. People and relatives were actively involved in their care planning and delivery.

People received care that was responsive to their needs and preferences. People's communication needs were assessed and met. People achieved good outcomes from their care. People, relatives and staff all spoke highly of the support they received from the nominated person. The nominated individual maintained daily oversight of people's care and was caring towards people and staff. They ensured they built and maintained a close relationship with people and their relatives.

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 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

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

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

Acorn is a care home. People receive accommodation and personal care support as a 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 is registered for four people. At the time of our visit four people were using the service.

The provider of the service is an individual who is responsible for the day-to-day management of the service. Therefore they are not required to have a separate registered manager. Therefore, the provider is the registered manager of the service. 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.

People continued to receive safe care. There were enough staff to meet people's needs. Staff were appropriately recruited. Sufficient staff were available to provide care and support to meet people's needs. People were protected from the risk of harm and appropriate risk assessments were in place to provide safe care. People received their prescribed medicines from competent staff who were trained to administer medicines safely.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. The policies and systems at the service support this practice. People continued to receive care and support that was responsive to their needs.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on going professional development they required to work effectively in their roles. People had access to healthcare professionals as needed and were supported to maintain good health and nutrition.

People and their relatives felt staff were kind and caring. Staff supported people to maintain their independence and respected their privacy and dignity. People were supported to take part in activities based on their own interests.

People, relatives and staff felt the service was well run and the registered manager was approachable. The registered manager worked well with other organisations to ensure people received the care and support they needed.

The registered manager had systems in place to monitor the quality of the service provided to people. People and their representatives were able to raise concerns or complaints if they needed to and felt these were listened to and acted upon.

Further information is in the detailed findings below.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found.

Is the service safe?

We met all three people who used the service and observed how they were supported by the staff. After the visit we spoke to three people's relatives. We saw that staff treated people with respect and dignity. Relatives told us that they were very happy with the service provided. They said people were safe and well cared for. One relative told us 'I do indeed feel that it's a safe service.'

Staff had received training to ensure that they supported people safely and appropriately. People's individual files indicated the risks to the person and how these could be minimised to ensure that they were supported as safely as possible.

Staff had received training in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager was aware that in some circumstances decisions needed to be made in a person's best interest.

The building was appropriately maintained and serviced to ensure that people lived in a safe environment.

The systems for the administration of medication were not robust and this placed people at risk of not receiving their prescribed medicines safely.

Is the service effective?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that as part of a quality assurance questionnaire a relative had commented 'staff take excellent care of [my relative].'

People were supported to receive the healthcare that they needed and a member of staff told us that they had good support from the local GP practice.

People's care needs were assessed and plans of care developed from these. Staff had a good understanding of how to meet people's individual and assessed needs and of individual preferences.

Is the service caring?

Relatives we spoke with were very positive about the care provided by the staff team. One relative told us '[my relative] is very well cared for." We saw that staff supported people in a gentle, respectful and kind way. They offered people choices and talked to them about what was happening or what they needed to do.

Is the service responsive?

Care staff we spoke with were knowledgeable about the needs of people they supported and how to meet them. The service was responsive to people's changing needs and wishes and changed the level of support provided accordingly. One relative told us 'they are proactive. They assessed [my relative] in hospital and then arranged for the district nurse to visit as soon as [my relative] moved in.' This was a three bed home for older people and all those we spoke with felt that people got a lot of individual attention that met their needs.

Is the service well led?

The provider was also the manager of the service. Staff we spoke with said they felt the home was well managed and that they received the support and guidance they needed to carry out their duties and to meet people's needs. In addition to working with people for most of the week the provider also carried out spot visits at different times to ensure that people received an appropriate service that met their needs.

People confirmed they consented to things on a daily basis. Their records showed they consented to the care they received and it was reviewed on a regular basis. Relatives told us their consent was sought for anything their family member was unable to understand.

We saw staff had a good understanding of people's individual care needs. One relative said, 'the staff always make my family member look nice, she has always cared about how she looks, and the staff maintain that.' Another relative told us the staff supported their family member in attending their temple.

The people living there were cared for in a clean, tidy and safe home which was accessible for people who used wheelchairs.

Staff felt supported and received training relevant to the care and support of the people living there.

The home manager actively sought the views of people that lived here and their families as to how this home was run.

The care plans had recently been reviewed involving each person their family and staff. This ensured care was, individualised and personalised. Choices were available at all mealtimes and a range of diets were catered for.

Relatives that we spoke to liked this home and were very happy with the care their family member received. They knew who to speak to if they had any concerns and found the staff to be approachable and caring.

Staff had worked here for a number of years and had received relevant training to provide care and support to people living at this home. The home manager actively sought the views of people that lived here and their families as to how this home was run.