Acacia Lodge Care Home

Updated 15 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

Acacia Lodge Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Acacia Lodge Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 6 February 2023 and ended on 9 February 2023. We visited the location on 6 and 7 February 2023.

What we did before the inspection

We reviewed information we had received about the service and sought feedback from local authority commissioners who work with this service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We gave the provider opportunity to share this information during this inspection.

During the inspection

Some people found it difficult to communicate with us about their experiences of support due to their complex support needs. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 6 people and 5 relatives of people who used the service about their experience of the care provided. We spoke with 15 members of staff including care assistants, nurses, kitchen staff, housekeeping staff, maintenance staff, administrative staff, operations manager, a representative of the provider and the provider. We observed the lunchtime meal to understand people's dining experience. We reviewed care plans and records for 6 people. We also reviewed a sample of people's medicine records, various records relating to the day to day management of the service, quality assurance and key policies and procedures.

Updated 15 March 2023

About the service

Acacia Lodge Care Home is a nursing home providing accommodation, nursing and personal care for up to 40 people. The service provides support to older people, some of whom may be living with dementia. At the time of our inspection there were 25 people using the service.

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

There was a lack of effective monitoring in place and this had resulted in poor outcomes for people using the service. There was a lack of management and leadership within the home.

The provider did not always ensure there was staff deployed who were knowledgeable about people and the home to meet people's needs. Staff had not had all the required training to meet people’s needs, for example training to meet people’s needs who were living with dementia. High numbers of agency care and nursing staff were deployed, who were not always familiar with the people they were caring for and the health and safety procedures of the home. The provider placed both staff and people at risk.

People experienced task led care which resulted in their dignity not being promoted or protected. People were not always supported to maintain their independence and have the opportunity to take part in activities and access the local community.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not support this practice.

People's communication needs were recorded, and staff understood people's preferred communication. There was some evidence that people had been involved in making decisions about their care. However, people also told us they felt isolated and did not have the opportunity to be involved in activities in the home or local community.

Medicines were well managed. The home was clean and tidy, and measures had been taken to reduce the risk of the spread of Covid-19. Learning from accidents and incidents took place to prevent recurrence.

Systems in place helped safeguard people from the risk of abuse. Assessments of risk and safety and supporting measures in place helped minimize risks. people accessed other health care professionals as and when required.

The provider was open and transparent and developed an action plan to mitigate the concerns found on the inspection.

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 the service under the previous provider was requires improvement (published on 8 January 2021). We also undertook an infection prevention control inspection (published 21 January 2022)

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.

The overall rating for the service is requires improvement.

You can read the report from our last comprehensive inspection under the previous provider, by selecting the ‘all reports’ link for Acacia Lodge Care Home on our website at www.cqc.org.uk

Enforcement

We have identified breaches in relation to safe care and treatment, person-centred care and governance and leadership at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.