Archived: Acacia Lodge - Staines

Acacia Lodge – Staines is a care home with nursing and is registered to provide accommodation and support for a maximum of 36 people. At the time of the inspection there were 10 people living at the service. People living at Acacia Lodge -Staines were older people, the majority living with frailty or dementia.

The service is a large building set over three floors with a lift to access rooms above the ground floor.

People’s experience of using this service:

People told us Acacia Lodge - Staines was a good place to live. We saw good practice during the inspection, when people were supported well by staff. Visitors were full of praise for the service.

There was established leadership at the service. Quality assurance systems and regular audits were in place to assess, monitor and improve the quality and safety of the service provided. Some areas of the service would benefit from redecoration or refurbishment.

Risks to people from living with long term health conditions were assessed, along with other risks such as from falls, choking, poor nutrition or pressure ulcers, and actions taken to mitigate risks where possible. The service learned from incidents to prevent a re-occurrence.

Systems were in place to safeguard people from abuse, and the service responded to any concerns or complaints about people’s wellbeing. People’s rights were being respected. Where people were not able to make choices themselves, we saw decisions had been made and recorded in people’s best interests. The service respected and supported individual people’s equality and diversity.

There was a recruitment process in place that checked potential staff were safe to work with people who may be vulnerable. Enough staff were in place to meet people’s needs, and staff received the training and support they needed to carry out their role.

Care plans were based on up to date assessments of people’s needs. They contained details about people’s wishes and guided staff on how the person’s care should be delivered. We saw people’s care plans were being followed in practice. Staff knew people well.

People received their medicines as prescribed, and there were safe systems in place to manage the storage, administration and disposal of medicines.

People told us they ate well, and enjoyed the meals served. We saw people had a daily choice, tailored to meet wishes, religious or dietary needs and preferences, such as Asian food and Halal meats.

Staff told us this was a happy place to work, and we saw staff working well as a team to support people. The building was older and in need of some cosmetic work. People told us “I am always concerned that because the place needs a lick of paint, on first impressions visitors would think that it reflects on the care given here, but it definitely does not ……the care is excellent.”

More information is in the full report

Rating at last inspection: This service was last inspected on 20 July 2016, when it was rated as good in all areas and as an overall rating.

Why we inspected: This inspection was scheduled for follow up based on the last report rating.

Acacia Lodge – Staines provides accommodation, nursing and personal care for up to 36 older people, some of whom are living with dementia. There were 19 people living at the service at the time of our inspection.

There was a registered manager in post. 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.

There were enough staff deployed to keep people safe and to meet their needs promptly. People were supported by staff that had the skills and experience needed to provide effective care. Relatives told us that staff knew their family members’ needs well and provided consistent care. Staff had an induction when they started work and access to ongoing training. Staff shared information about people’s needs, which ensured they received their care in a consistent way.

The provider made appropriate checks on staff before they started work, which helped to ensure only suitable applicants were employed. Staff understood safeguarding procedures and were aware of the provider’s whistle-blowing policy. People told us they felt safe at the service and when staff were providing their care.

Risks to people had been assessed and measures implemented to reduce these risks. There were plans in place to ensure that people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly to keep the premises and equipment safe for use. People’s medicines were managed safely. People were supported to stay healthy and to obtain treatment if they needed it. Staff monitored people’s healthcare needs and took appropriate action if they became unwell.

Staff were kind and sensitive to people’s needs. People had positive relationships with the staff who supported them. Relatives said that staff provided compassionate care and were professional and caring. The atmosphere in the service was calm and relaxed and staff spoke to people in a respectful yet friendly manner. Staff understood the importance of maintaining confidentiality and of respecting people’s privacy and dignity. Feedback obtained from healthcare professionals about staff was very positive. Healthcare professionals said that staff were friendly and caring and that they knew the people they cared for well.

The registered manager and staff worked closely with other healthcare professionals to ensure that people received good, individualised end of life care that reflected their wishes. People were given opportunities to discuss their wishes with staff and their next of kin and these were recorded in an advance care plan. A healthcare professional told us they and the registered manager regularly reviewed practice in this area to identify any ways in which improvements could be made. Healthcare professionals provided positive feedback about the care provided by staff. They said staff were skilled and knowledgeable about the people they cared for, which enabled them to provide people’s care in a consistent way.

People’s needs were assessed before they moved to the service to ensure their needs could be met. Staff understood the importance of treating each person as an individual and ensuring that the care they received reflected their needs and wishes. Care plans were person-centred and provided clear information for staff about how to provide care and support in the way each person preferred. Relatives said staff monitored their family members’ health and welfare closely, which meant they identified any concerns promptly. Healthcare professionals provided positive feedback about the responsiveness of staff when people’s needs changed. They said staff always responded promptly and were proactive in seeking advice from healthcare professionals.

The registered manager provided good leadership for the service and led by example in their values and approach to supporting people. People and their relatives had opportunities to give their views about the care they received and told us that the registered manager responded appropriately to any concerns they raised. Staff told us they had opportunities to express their views and raise any concerns they had.

The registered manager had implemented an effective quality assurance system to ensure that key areas of the service were monitored effectively. Records relating to people’s care were accurate, up to date and stored appropriately. Feedback obtained from healthcare professionals about the management of the service and the standard of record-keeping was positive. Healthcare professionals said the service was well run and that records were clear and accurate.

We spoke with two people living in the home. People told us that ' staff were friendly' and that ' they liked living there'. Staff told us that 'they provided tender loving care'.

We observed people being cared for by nursing staff with care and compassion.

We found that care was person centred, planned and delivered safely with regular reviews.

We saw that the provider had effective systems in place to monitor and assess the quality of the service, which took into account the views of the people, relatives and staff. We saw that the provider used this feedback to make service improvements.

We found that improvements had been made to the environment which resulted in a more pleasant and homely environment in which to live. The manager told us that these improvements would continue and a refurbishment plan was in place for this year.

The manager had also appointed an infection control lead person. We looked at the infection control audit that was near completion. The deputy told us any shortfalls that had been identified would have an action plan to ensure they would be addressed.