Archived: Acorn Grange Care Home

Acorn Grange is a residential care home providing personal care to up to 46 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 37 people using the service.

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

Medicines were mostly managed safely. The management team took immediate action during the inspection to address a lack of robust arrangements around one person’s medicines. The premises were clean and there were good infection control practices in place.

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, although we have made a recommendation around documenting best interest decisions more thoroughly.

People told us they felt safe living at Acorn Grange. People and relatives told us they were happy with the quality of care provided. Staff had completed safeguarding training and knew what action to take to keep people safe. Risks to people were identified and detailed assessments were in place, to ensure risks were managed safely.

The registered manager had good oversight of the service. Quality checks were effective in identifying and generating improvements to ensure the safety and quality of the care people received. People and relatives said the service was well managed and they would recommend the service to others. Staff worked effectively alongside other health and social care professionals to ensure people's needs were met and their health promoted and maintained.

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 (31 January 2018).

Why we inspected

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

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains good.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Acorn Grange on our website at www.cqc.org.uk

Follow up

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

We found the following examples of good practice.

¿ Systems and procedures were in place to prevent all types of visitors from spreading and catching infection. Only essential visits could take place at the time of inspection. Robust screening was in place for visitors, which included temperature checks, hand desanitisation in a separate allocated washroom and completion of a health declaration.

¿ The home supported social distancing wherever possible. Chairs and tables in communal areas were spaced out for people to enable them to share these spaces safely. Staff break times were staggered. The home utilised the adjoining daycare centre, which was not currently in use, to assist staff to socially distance during their breaks.

¿ The home admitted people safely and in line with best practice guidance. People were required to have a negative COVID-19 test before admission and they were isolated in their rooms for 14 days.

¿ The home had ample supplies of personal protective equipment (PPE) and staff were trained in how to put this on and take it off safely. Staff were observed to be wearing appropriate PPE and were bare below the elbow. Systems were in place to safely dispose of used PPE.

¿ Staff and people were regularly taking part in the COVID-19 testing programme. Best interests decisions were in place for people who lacked capacity to consent to the test.

¿ The home was clean, tidy and well ventilated. The home had introduced additional cleaning of frequently touched areas such as door handles. The home had purchased a fogging machine which was used to deep clean rooms and communal areas.

¿ The home considered and supported the wellbeing of people and staff. People were encouraged and assisted to have telephone and video contact with relatives. Staff were well supported by management and had access to wellbeing resources.

Acorn Grange is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Acorn Grange accommodated 37 people at the time of the inspection.

The service was last inspected on October 2015 and the rating for this inspection was Good. At this inspection we found the service remained Good.

Risks to people arising from their health and support needs as well as risks associated with the premises were assessed, and plans were in place to minimise them.

People received their medicine safely and were supported to access the support of health care professionals when needed. People were protected from the risk of abuse because staff understood how to identify and report it.

There were enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff received effective supervision and a yearly appraisal.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received a varied and nutritional diet that met their preferences and dietary needs.

The interactions between people and staff showed that staff knew the people well.

Care was planned and delivered in way that responded to people’s assessed needs. Care plans contained detailed information about people’s personal preferences and wishes as well as their life histories.

The management team were approachable and they and the staff team worked in collaboration with external agencies to provide good outcomes for people. People, relatives and staff felt any concerns would be taken seriously and acted on. Processes were in place to assess and monitor the quality of the service provided and drive improvement.

Further information is in the detailed findings below.

We considered our inspection findings to answer questions we always ask:-

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

Below is a summary of what we found. If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

People were cared for in an environment that was clean and hygienic. People told us that they were happy living at the home and were supported to remain independent as safely as possible.

Appropriate risk assessments were in place, and the registered manager had suitable arrangements to safeguard people from foreseeable emergencies.

People told us that they felt safe living at the home and their relatives confirmed this. At the time of the inspection, there was no one at the home subject to an authorisation made under the Deprivation of Liberty Safeguards.

There were regular quality checks and audits completed to make sure that the home provided a safe and suitable environment for people to live in.

Is the service effective?

All of the people we spoke with, told us that they were happy with the care that was delivered and their needs were met. Staff had received training to meet the needs of the people who lived at the home.

We saw that care records held specific information on health conditions, for example diabetes or vascular dementia which further supported staff to care for people who lived at the home.

Is the service caring?

We asked eleven people if they had any concerns about the care provided by the home and those that could told us they were happy with the care provided and that the staff were caring. One relative told us, “I am happy with the care provided here.”

Observations during the visit showed staff were compassionate and caring to the people they supported. During the day we found positive interactions taking place and staff responding in a thoughtful and kind manner to people who lived at the home.

Is the service responsive?

Regular reviews were carried out with the people who used the service and their representatives to make sure the person’s care and support needs had not changed. This helped ensure staff supplied the correct amount of care and treatment.

Information collected by the service also gave staff an insight into the interests, likes and dislikes and areas of importance to the people in their care. This meant that it helped staff to provide social activities that people could choose to be involved with.

Regular meetings took place with staff to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people who used the service.

People who lived at the home held regular meetings with staff to discuss their views on living at the home. This meant that people were involved in communications about the running of the home and staff listened and took action. People we spoke with confirmed they felt that they were listened to and knew who to contact if they had a problem.

Is the service well-led?

There was a registered manager in post at the home and a deputy manager too.

People who used the service had regular contact from the registered manager and other senior staff to check their wellbeing. The quality of service provided by care staff was monitored and this was done through quality audits and also through meetings arranged with the people who used the service.

One relative told us that they were kept regularly updated by the staff team if any changes occurred to their family members health. The relative told us, “Staff will ring me if they need to tell me anything, they are very good like that.”

The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans. Each person was supported to take appropriate risks to promote as much independence as possible.

The relationships between staff and the people who they supported were good and personal support was provided in a way that people had consented to. This promoted and protected their privacy and dignity. This was confirmed when we spoke with six people who used the service.

Suitable arrangements were in place for handling complaints and for protecting people from abuse.

There was a competent staff team who had been appropriately recruited and had the training, skills and experience to meet the specific conditions of the people who they supported.

There were a range of effective systems in place to monitor the quality of the service that people received.

Suitable arrangements were in place for people to take part in activities in line with their needs and preferences.

The relationships between staff and the people who lived there were good and personal support was provided in a way that promoted and protected their privacy and dignity.

Suitable arrangements were in place for handling complaints and for protecting people from abuse. One person told us they could share any concerns with the staff and felt their views were listened to. Another person said “This place is just wonderful. I like living here because all my needs are taken care of and I feel safe.”

There was a stable and competent staff team who had the training, skills and experience to meet the specific conditions of the people who lived there.