Tree Vale Limited Acorn House

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 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 service scored 72 (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 promoted a positive and open culture of safety. Staff understood their responsibilities to report concerns and safety incidents. They told us they felt able to speak up, and records showed incidents were investigated and reviewed. Learning was identified to improve practice and reduce risks.

There were effective systems to investigate incidents and take action to prevent recurrence. The provider used these systems to identify risks and put measures in place to keep people safe. For example, when one person experienced a fall, staff recorded this and completed a body map to document injuries. Senior staff reviewed the incident, updated the person’s care plan the same day, and considered how to reduce the risk of it happening again. Learning from incidents was shared during staff handovers and recorded so all staff understood what had happened and what to monitor.

The provider worked well with people and healthcare professionals to maintain safe and coordinated care. Systems were in place to monitor people’s safety and ensure continuity of care, including when people moved between services.

Staff supported people to access healthcare services when needed. One person told us, “The doctor visits me to check I am okay. If I am unwell, they contact my [family member].”

People were referred to external professionals for specialist assessments where required, such as for skin integrity or risks of choking. Guidance from these professionals was clearly recorded and followed within people’s care plans to support safe care.

The provider worked closely with people and healthcare partners to understand what safety meant to them and how best to achieve this. There was a strong focus on keeping people safe while respecting their rights and promoting their wellbeing. Concerns were shared quickly and appropriately to reduce the risk of harm.

People told us they felt safe living at the home. One relative said, “The staff seem to know all the residents well.”

Staff knew people well and were able to recognise changes in their health or at times of distress may indicate they were becoming unwell. Staff had completed up-to-date training in safeguarding. Policies and procedures were in place to support safe practice. The provider demonstrated learning from a recent incident and described additional safeguards that had been implemented to prevent reoccurrence.

Where people lacked capacity, assessments were completed and appropriate steps were taken to involve them and their families in best interest decisions. Where restrictions were in place, appropriate Deprivation of Liberty Safeguards (DoLS) referrals had been made. Systems were in place to monitor and ensure any conditions attached to DoLS authorisations were being met.

The provider assessed and managed risks effectively. Staff provided care that was safe, supportive and enabled people to maintain their independence and do the things that mattered to them.

People’s needs and risks were assessed and used to develop clear care plans to guide staff on how to support them safely. People and their families told us they were involved in this process.

Care plans and risk assessments were reviewed each month, or sooner if people’s needs changed. Most risk assessments were accurate and reflected people’s current needs. People and their families spoke positively about the care provided. Several commented on a reduction in falls since moving into the home, showing risks were being well managed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. For example, safety checks were completed across the home and kept under review. Staff were aware to report any environmental safety concerns. However, more robust internal and external environmental risk assessments were required. This was actioned immediately by the registered manager. The home was looking tired but it was safe and the registered manager shared an action plan of proposed upgrades to the service.

People spoke positively about the environment. One person said, “It’s very pleasant here, very friendly, like a home should be and it’s very clean with no smells at all.” Another person told us, “I like to walk around the garden a few times a day to get some fresh air.” The service had a well-maintained secure garden, including areas for growing fruit and vegetables in raised troughs.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. For example, robust recruitment processes were followed, including appropriate pre-employment checks, to ensure staff were safe to work with vulnerable people. Staff received effective support through regular supervision, training, and ongoing professional development, enabling them to maintain the skills and knowledge required for their roles.

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. For example, staff had access to an adequate supply of personal protective equipment (PPE), which they used appropriately in line with current guidance. Staff had completed infection prevention and control (IPC) training and demonstrated an understanding of good infection control practices in their day-to-day work. The local infection and prevention control team had been into the service recently and scored an overall good rating for the service.

The provider did not always ensure medicines were managed safely or in line with people’s needs, preferences and capacity. Improvements were needed to recording, guidance and oversight of medicines management.

The times people were administered time critical medicine was not being recorded, staff could not be certain of the correct length of time in-between doses. Medicines such as creams, eye drops and liquid medicine were not always dated upon opening, making it difficult for staff to follow the manufacturers instruction on discarding the items once opened. The recording and disposal of medications were not in line with the National Institute for Health and Care Excellence (NICE) guidelines. As required medicines (PRN) protocols were not always person-centred and lacked personalised details for people. The registered manager was responsive to concerns found and took timely action to address the issues identified.

However, people received their medicines when needed and medicines were stored securely. Staff supported people to take their medicines in a kind and patient way.