The Acres

The Acres is a small care home situated close to Radcliffe town centre. The service is registered to provide personal care and support to up to four people with a learning disability and complex needs.

The Acres has been designed considering best practice guidance and the principles and values underpinning Registering the Right Support. The Acres is situated in a quiet residential area and provides spacious open plan accommodation. Bedrooms are available on both the ground and first floors. Aids and adaptation are provided depending on the individual needs of people. At the time of this inspection there was only one person living at the home.

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

Systems to help minimise risk and keep people safe had been improved.

A more robust pre-admissions assessment process had been introduced to help determine the suitability of placements at the home. People’s individuals support needs were clearly planned for and communicated to staff so that a consistent approach was offered.

Staff had a range of skills and experience in social, educational and special needs support. Further training in specific areas of support were also provided. Staff spoken with confirmed on-going training was provided and felt equipped to support people.

Good hygiene standards were maintained within the home. Management plans and adequate equipment were in place to help reduce the risk and impact of the COVID-19 pandemic.

Clear, defined management roles had been established. The registered manager completed a range of audits and checks providing good oversight of the service. Areas of improvement were appropriately planned for and shared with staff so ‘lessons were learnt’. People we spoke with and staff had confidence in the registered manager and their management of the service.

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

Rating at last inspection (and update) - The last rating for this service was requires improvement. (published February 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice and breaches we previously served in relation to Regulations 9, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met in relation to the assessment, planning and management of risk to people. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm. Please see the safe, 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 The Acres on our website at www.cqc.org.uk.

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.

The Acres is a small residential home providing personal care to one person with a learning disability at the time of the inspection. One person had left the service just prior to our inspection. The service can support up to four people. Each person had their own bedroom, two of which were en-suite, and shared the lounge and kitchen. There was a waking night member of staff overnight in case of an emergency.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. It is a small home which is not identifiable as being a care home. People are supported to be part of their local community.

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

People were not safe living at the service. Risk assessments had not been robust enough to prevent one person leaving the home unsupported. Staff had not followed the agreed care plan to engage and distract this person when they were anxious. Action had not been taken when there was a ‘near miss’ incident when the same person was seen leaving the home by staff and then encouraged to return.

A new manager had been appointed in September 2019. The nominated individual and quality manager were taking more of a ‘back seat’ role, with the manager taking responsibility for managing the service.

The manager had re-written care plans and risk assessments, introduced a more robust quality monitoring system and regular staff meetings and supervisions.

People’s needs had not been adequately assessed before they moved to the service to ensure The Acres was able to meet their needs and they were compatible sharing with the people already living at the home. The manager told us they would lead all future pre-admission assessments.

Staff felt well supported by the manager, who was approachable. Staff completed training to meet people’s needs, although we noted some of this had only been arranged after people had already joined the service.

People were supported to maintain their health and nutrition. People received their medicines as prescribed.

Relatives were positive about the staff team supporting their relative, saying they were kind and caring.

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.

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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

This service was registered with us on 1 December 2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on when the service was registered with us.

Enforcement

We have identified breaches in relation to managing the known risk of one person trying to leave the home unsupported, the lack of robust pre-admission assessments, the lack of engagement by staff to distract one person when they were anxious and not taking sufficient action following an incident to reduce the risk of the same thing happening again.

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

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.