Acorn Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had developed a positive learning culture within the care home. People were supported to raise safety concerns with the registered manager and staff. Any safety concerns or incidents that did occur were investigated and when lessons needed to be learnt this was used to continually improve staff practice.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Information was obtained from people, and others involved in their care, about people’s individual needs and risks to their safety. This was used to develop individualised care and risk management plans to ensure people received safe and appropriate care and support from the moment they started to use the service. The registered manager told us they were working closely with one person using the service whose needs had changed, their family and all the relevant external health and social care professionals to help this individual move to a more suitable placement.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living in the care home and with the staff who supported them there. One person told us, “Yes, I do feel safe here. The staff look after us.” The registered manager and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. The registered manager had worked proactively with the relevant agencies, when concerns had been raised, and took appropriate action to safeguard people from further risk, when this was required.

Managers and staff had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (Dols) training. The service was working within the principles of the MCA. Appropriate legal authorisations were in place to deprive people of their liberty where this was deemed necessary to ensure their safety.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Systems were in place to ensure risks people might face were routinely assessed, monitored and reviewed. People’s care records contained sufficiently detailed information for staff to follow to ensure risks to people were mitigated, so people remained safe when taking part in activities and events of their choice. Staff were fully aware of the potential risks people might face and the steps they needed to take to reduce or safely manage them. Risk assessments and management plans were reviewed at regular intervals and updated according to reflect any changes in people’s needs.

The service did not always detect and control potential risks in the care environment. They did not always make sure the environment was well-maintained and learning disability friendly.

Contrary to recognised best health and safely practice none of the care home radiators were covered and windows in communal toilets and a bathroom on the first floor were not fitted with suitable window restrictors. This had not been risk assessed which had placed people living in the care home at risk of potential harm of being burnt or falling from height. We discussed these health and safety issues with the registered manager who responded immediately during and after our assessment. On our second site visit to the care home, we saw all the windows on the first floor fitted with suitable devices to restrict how far they could be opened. Radiators were in the process of getting made to measure covers, thermostat control was in situ to ensure the safety of people.

People told us the care home was a comfortable place to live. One person said, “I like my bedroom, it has everything I need in it.” The bedrooms we viewed with people’s permission were personalised and spacious. The care home environment was free from unnecessary slip or trip hazards. This enabled people to safely and freely move around the care home even if they had mobility needs. Safety systems and equipment was maintained and serviced at regular intervals. Staff told us they had clear guidelines available to help them deal with emergencies. Personal emergency evacuation plans were in place to help staff evacuate people in the event of a fire.

The service made sure there were enough staff, who received effective support, supervision and development however, there were some gaps in staff training. They worked together well to provide safe care that met people’s individual needs.

Staff were supported to continually improve in their role. They received a mixture of e-learning and in-person practical and theoretical training and competency-based assessments.

However, staff did not always receive all the relevant and most up to date training they needed to meet people’s needs. For example, no staff had received any training in relation to supporting people living with a learning disability, including Oliver McGowan, which is mandatory for all care staff working in adult social care to receive. We found no evidence that people had been harmed by these gaps in staff training and had placed people at risk of harm. We discussed this training issue with the registered manager at the time of our assessment. They acknowledged this was a failure and agreed to ensure staff would receive all their mandatory training within the next 3 to 6 months.

The service did not use any agency staff and continued to use the same small group of staff they had employed for many years. This meant people received continuity of care from the same small group of staff who were familiar with their individual needs, preferences and daily routines. Staffing rotas were planned based on people’s dependency and individual needs. Staffing levels matched the staff duty rota. Staff were visible throughout the service during the assessment and were quick to respond to people’s questions and requests for support. People told us the care home was adequately staffed and that there was always at least one member of staff on duty in the service when people were at home.

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with the registered manager.

The provider operated safe recruitment practices and only suitable staff were employed to work at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People lived in a clean, hygienic environment. An external care professional told us, “The care home is well kept, clean and appears to be a lovely place for the residents to live.” Staff followed current best practice to reduce the risk of infections spreading. Staff were provided with relevant training to help them prevent and control the risk and spread of infection in the care home. They had access to resources and equipment to help them reduce infection risks and used this appropriately, which included adequate supplies of personal protective equipment (PPE). We observed staff wear PPE when they were preparing to give people any personal care.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their prescribed medicines as and when they should. People confirmed they received their medicines as they were prescribed.

Care plans included detailed guidance for staff about how people needed and preferred their medicines to be administered. Staff demonstrated an understanding of handling-controlled medications and how to store these, however there was no controlled drugs on site at the time of the inspection.