We carried out a review of the data available to us about Acacia House - Peterborough on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Acacia House - Peterborough, you can give feedback on this service.
We found the following examples of good practice.
A safe process was in place for any visitors to the service including a rapid test for COVID-19, regular temperature checks, a health questionnaire and wearing personal protective equipment (PPE). Staff implemented their training about the correct use of PPE, they had enough supplies of this and a separate area to put it on and take it off.
The home was tidy and clean. Strategies were in place to inform people about the virus such as social stories to enable people to continue to live safely. Plans had been implemented to help ensure people could socially distance including ensuring they still went out on essential journeys.
The provider had contingency plans in place to manage any potential future outbreak of COVID-19. These included additional staff resource for staff to work in a group. Only these groups of staff would support a person if there were any infection outbreaks.
People who needed to leave the service and return for any reason had additional COVID-19 testing and attention to detail about hygiene practises. There was a cleaning programme in place with deep cleans and frequent disinfecting and sanitising of frequently touched items.
Visits to people were planned and limited to one visitor. Where people needed regular visits, the were facilitated such as in a local park or walk in the local area. Other means of staying in touch with relatives and friends included the use of phone calls, social stories and pictures.
There was an effective process to ensure people, staff and visitors had regular COVID-19 tests. This included risk assessments to manage any person or staff member at an increased risk and best interest decisions to help keep people safer by emphasising things to them which could remain normal.
Although the service has been running for many years prior to the Registering the Right Support best practice guidance; we saw the service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service did support people effectively in line with positive behaviour support principles. Staff were trained to support people using positive behaviour support.
People’s experience of using this service and what we found
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 service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People and a relative felt reassured by having their, or their family member’s, care provided by staff at the service. Staff understood their duty to report any concerns they had about poor care and potential harm to people. However, the registered manager had not notified one safeguarding incident to the CQC that they were legally obliged to. Individualised risk assessments were in place to identify possible risks to people. Staff had information available to them to refer to on how to monitor and reduce risks to people. Staff worked in conjunction with guidance from external health care professionals to help support and maintain people’s well-being.
Staffing levels were looked at and determined to make sure they met the needs of the people using the service for example people who required one-to-one support at the service and within the community. Trained staff safely managed medicines. However, completed medicine administration records were not kept on file.
To develop their skills and knowledge, staff received training, competency checks, supervisions and appraisals. People were supported to maintain their independence where appropriate. Staff promoted people’s food and drink intake.
Staff respected and promoted people’s privacy and dignity. Staff knew the people they supported well. People had developed good relationships with staff who understood their individual and sometimes complex care and support needs and wishes.
People and a relative said staff were kind. People’s personal information was kept confidential in the services office. People, where possible, and their relatives were involved in discussions and reviews of their, or their family member’s, care. The registered manager told us there had been no complaints; a guide on how to complain was available in a pictorial easy read format. This helped aid people’s understanding.
Staff felt well-supported. Audits were carried out to monitor the service and address any improvements required.
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 25 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection was carried out on 22 February 2017. It was an announced inspection and was undertaken by one inspector. At the last inspection on 14 October 2014, the service was rated as ‘good.’ At this inspection we found the service remained ‘good.’
At the time of our inspection a registered manager was in place. However, they were not available during this inspection. 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 and associated Regulations about how the service is run.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected as DoLS applications had been submitted to the authorising agencies. People were supported to have the most choice possible and control of their lives and staff supported people in the least restrictive way.
People had health, care, and support plans in place which took account of their needs. These recorded people’s individual choices, their likes and dislikes and any assistance they required. Risks to people who lived at the service were identified, and plans were put into place by staff to minimise these risks and enable people to live as independent and safe life as possible.
We saw that people who lived at the service were assisted by staff in a way that supported their safety and they were treated with respect. Staff assisted people in a caring and warm manner. Staff promoted people’s choices.
Staff understood their roles and responsibilities and were supported by the registered manager to maintain and develop their skills and knowledge by way of supervision, observations, and appraisals. Staff were trained to provide safe and effective care which met people’s individual needs and knew people’s care requirements well. Staff had the necessary training and used recognised techniques to lessen people’s anxiety.
Relatives were able to raise any suggestions or concerns they might have with the registered manager and team of staff. They said that they felt listened to as communication with the registered manager and staff team was good.
Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. We found that people who lived at the service and their relatives were encouraged to share their views and feedback about the quality of the care and support provided.
This inspection was carried out on 14 October 2014. It was an announced inspection and was undertaken by one inspector. We gave the provider and staff 24 hours notice that we would be visiting. This was because the service was small and people were often out attending college or taking part in social interests and hobbies. We needed to be sure that they would be in. The last inspection took place on 19 August 2013, during which, we found the regulations were being met.
Acacia House is a registered care home for a maximum number of five people with autism and learning disabilities. It does not provide nursing care. The home offers accommodation over one floor. There are five single occupancy bedrooms with ensuite facilities. The service was fully occupied when we inspected it.
At the time of our inspection a registered manager was in place. 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 and associated Regulations about how the service is run.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected as DoLS applications were in progress and were being submitted to the authorising agencies.
We saw that people who lived in the home were assisted by staff in a way that supported their safety and that they were treated with respect. People had health care and support plans in place which took account of their needs. These plans recorded for staff people’s individual choices, their likes and dislikes and any assistance they required. Risks to people who lived in the home were identified, and plans were put into place by staff to minimise these risks and enable people to live as safe and independent life as possible.
We saw that staff cared for people in a warm and caring manner. We saw staff using distraction as a technique to calm people down when anxious, as documented within people’s care and support plans. These techniques helped people to carry on with their day in a more relaxed manner.
Staff were trained to provide effective and safe care which met people’s individual needs and wishes. Staff understood their roles and responsibilities and were supported by the manager to maintain and develop their skills and knowledge by way of regular supervision, appraisals and training.
Relatives we spoke with told us they were able to raise any suggestions or concerns they might have with the manager. They said that they felt listened to as communication with the manager was good.
Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. We found that people who lived in the home and their relatives were encouraged to share their views and feedback about the quality of the care and support provided.
Our review of people's plans of care demonstrated to us that people's care was person centred and based upon their most up-to-date needs. We saw from our observations that people were spoken to with genuine warmth and respect. We also saw that everyone appeared happy and were engaged in various activities throughout our inspection visit.
We saw from our review of records that the provider had arrangements in place to protect the health, safety and welfare of service users where responsibility for the care of service users was shared or transferred to others.
Staff were supported to gain additional healthcare qualifications. Staff were supervised regularly and provided with support and guidance by the manager and provider to maintain a good standard of care.
The provider used a variety of methods to measure people's satisfaction with the quality of care and support they received at the service. The provider also used the same methods to review the experience of people who used their service who received external care and support, such as day services or community activities.
We saw that staff members took time to understand what people were communicating in the way that people had requested. It was clear from our observations that the staff knew each person well enough to be able to provide support in a way that the person easily understood. People were praised in a respectful manner and provided with reassurance where this was required.
One relative who we spoke with said, "The manager keeps me informed of anything that affects my son's health, even if this late at night."
We noted that each person had their opinions respected and were included in the general conversations that occurred. We saw that staff responded well to the needs of people, gave them individual attention, listened and spoke to them in a positive manner and encouraged them to make choices.
Staff were providing with training and information that ensured people were protected from abuse.
We looked at records for safety checks for items such as gas, water and electrical safety and found that these were all satisfactory and up to date.