Archived: Acacia Care Home

The provider was in day to day charge of the home. As the registered person they had legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s ability to make decisions had been assessed in line with the Mental Capacity Act 2005 (MCA) and staff sought verbal consent from people before providing care. However, the provider had not always followed legislation designed to protect people's rights and applications to the local authority for approval of restrictions on some people's liberty had not been made where required.

Safe and effective recruitment processes were not always followed with gaps in employment history not being investigated.

People received their medicines as prescribed, however, systems in place to ensure that medicines were stored at the correct temperature and not beyond it’s safe to use date were not robust. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

People and their families told us they felt the home was safe. Staff and the provider had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.

People and their families told us they felt the home was well-led and were positive about the provider who understood the responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

There was an opportunity for families to become involved in developing the service and they were encouraged to provide feedback on the service provided both informally and through an annual questionnaire. They were also supported to raise complaints should they wish to.

We found two breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of this report.

The provider was in day to day charge of the home. As the registered person they had legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People lived in a homely environment and were treated with kindness and compassion. We observed supportive positive interactions between people, staff and the provider. There was an open, trusting relationship; it was clear they knew each other well.

People felt safe at Acacia Care Home. The provider and staff had received appropriate training in a range of subjects, including how to protect people from the risk of abuse and meet their individual needs. The home was meeting the requirements of legislation designed to protect people's rights.

Staff were available when people required them.

People's needs were met effectively and they were supported to make their own decisions.

The risks relating to people's health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. People were involved as far as possible in planning the care and support they received.

There were suitable systems in place to ensure the safe storage and administration of medicines.

Healthcare professionals such as GPs, chiropodists, opticians and dentists were involved in people's care where necessary.

People enjoyed their meals and received a choice of suitably nutritious home cooked meals based on their needs and preferences. People were supported to engage in a range of planned and ad hoc group and individual activities of their choosing.

People were happy with the way the service was run. The provider sought informal feedback from people and had a process in place to deal with any complaints or concerns.

Is the service safe?

Is the service well led?

Is the service safe?

We found the service was safe because staff kept accurate records of the medication people were taking. Systems were in place to ensure people received their medication as prescribed. We spoke with four people who confirmed they were given their medication when they needed it.

People who use services would only be deprived of their liberty when this had been authorised by the Court of Protection, or by a Supervisory Body under the Deprivation of Liberty Safeguards. At the time of the inspection, the safeguards were not needed to protect anyone.

Is the service well led?

We found the service was well led as the provider had an effective system to regularly assess and monitor the quality of service that people received. The provider regularly sought people's views and received positive feedback. The manager made changes in the service after gaining people's views.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

People's needs were assessed and these were reviewed and updated regularly. Staff followed people's care plans and demonstrated they were aware of people's needs and how to support them. People's nutritional needs were monitored and staff responded when a person required support to eat and drink adequate amounts. Security checks on prospective new staff were carried out in a timely manner and relevant information as to the suitability of new staff was recorded. The provider failed to ensure that Deprivation of Liberty Safeguards were applied for appropriately.

A lack of guidance to staff regarding when to administer 'as required' medication could result in people being given medication when it was not needed. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service effective?

People told us their care needs were met. One person said 'It's all nice here. I'm looked after very well.' Staff told us they had enough time to care for people and we observed staff to be attentive to people's needs. People had expressed preferences and these were respected. Staff recorded the care they provided and ensured a handover was made to staff at the beginning of their shift. This meant staff were up to date with the needs of people and how to meet them.

Is the service caring?

We observed staff interactions with people. These were caring and kind and a friendly atmosphere was promoted in the home. Staff were aware people's needs may change on a daily basis and were prepared to offer additional assistance should this be needed. Activities that were advertised did not take place and activities people had suggested they would like to take part in were not arranged. The provider told us they would address this.

Is the service responsive?

Daily records of care showed people's needs were met according to their care plan. Action had been taken following incidents within the home which reduced the risk of the incident recurring. Where required health professionals were contacted to ensure people's health care needs were met. We saw this was done in a timely manner and advice from health care professionals was recorded, communicated to staff and acted on.

Is the service well-led?

A number of actions were identified by a local authority quality assurance audit and not all of these had been addressed by the provider. A lack of formal auditing procedures meant it could not be ascertained where issues had arisen and been addressed. Feedback from people using the service was not always acted on. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

We spoke with all staff on duty including the provider/manager. Staff were aware of how people should be supported, individual likes and dislikes and the help they required. Staff stated they felt they had sufficient time to meet people's needs and had completed relevant training.

We observed staff were courteous and respectful of people's views and choices were offered. The care we observed corresponded with care plans and risk assessments viewed.

Sufficient staff were available and they had received appropriate training and supervision. There were systems in place to monitor the quality of the service provided.

We observed that staff were courteous and respectful of people's views and where necessary consent was obtained. We also observed that moving and handling assistance was provided, that medication was appropriately stored and administered and that good staff recruitment procedures were undertaken. Care plans were relevant to people and other necessary records were maintained.