Archived: Acorn Care and Nursing Limited

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' 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 caring?

People said the care workers who supported them were 'friendly' and 'kind'. We saw that care workers were respectful, patience and encouraging when supporting people. Care staff were aware of people's individual needs and preferences.

The people we spoke with said they were satisfied with the care provided by this agency. One person told us, 'They help me with everything, like medication, meals, shopping and going out. It's a very good service.' Another person told us, 'I'm very pleased with them. They always ask if there is anything else they can do before they go.'

Discussions with people and records we looked at told us that individual wishes for care and support were taken into account and respected.

Is the service responsive?

People were asked for their views on a regular basis. People told us they felt listened to and felt comfortable about contacting the agency to request changes to their care package.

People's care plans were individually designed around the times and support tasks that each person needed.

People and their relatives told us they could approach the manager at any time and described office staff as 'friendly' and 'lovely to deal with'. People said they were confident that any comments would be looked into and put right.

A palliative care representative told us that the agency was "very responsive to urgent cases' and able to provide care workers at short notice.

Is the service safe?

People told us they felt 'comfortable' with the agency staff. People who used the agency were provided with clear, written information about how to raise any concerns or complaints.

Before anyone received a care service their needs were assessed by the registered manager of the agency. The manager visited each person in their own home and carried out assessments of their care needs, their medication, moving and assisting needs, and the safety of their home environment. This meant risks to people's safety had been identified and assessed to ensure that appropriate care and support was provided to keep people safe.

The agency made sure there were sufficient staff to carry out all the visits to meet people's needs. There were also contingency arrangements to cover any gaps or emergencies.

The provider and manager understood people's rights to make their own decisions about their care, in line with the Mental Capacity Act 2005.

Is the service effective?

Each person had an individual care plan which set out their specific care needs. People told us they had been fully involved in the assessment of their care needs and had their own care plans.

People told us they were 'in control' of the service they received. One person commented, 'I've got my own copies of agreements that I've signed and the office has a copy.' This meant that people were sure that their individual care needs and wishes were planned and agreed.

The people we spoke with said they had a regular team of care staff which meant they had good continuity of care. One person told us, 'I have the same carers who come on the same days each week. They all know what I need.'

A palliative care representative felt continuity was not always achieved for short notice care packages and that staff had little experience in supporting palliative care.

Is the service well-led?

The agency had a registered manager who managed the daily care service. The provider was based at the agency office so they were able to continually assess the service. The provider had a system to assure the quality of the service they provided.

People and staff felt they were regularly involved and were consulted about the service. One person told us, 'The manager or co-ordinator rings me all the time to ask if everything is still ok.'

People felt their comments were taken into account and any changes they requested were made promptly. This meant the provider used people's comments to continually improve the service they received.

A local authority officer described the provider as 'open and amenable'. They told us the provider was receptive to advice and worked collaboratively with other agencies.

People told us the agency was flexible and responsive to any requests for changes. Staff were described as being "Reliable and always on time", as well as being "excellent" and 'really kind and helpful'. They told us that there had never been a time when the carer did not visit. One person said, "They gave me information about who to contact if the carer doesn't arrive and they would make sure I was okay."

The care records were detailed and up to date and staff knew about their content. Staff told us that they could discuss concerns they had with the manager or the supervisor. They told us they were confident that the management team would take action to protect people.

There were procedures to reduce the risk of anyone coming to harm and the agency had made relevant referrals to the safeguarding team at the Local Authority when they were worried about anyone. Staff told us they would report any concerns to the manager.

People told us the agency was flexible and responsive to any requests for changes. Staff were described as being 'Reliable and punctual', as well as being 'Really nice'. One person told us 'When we agree a time they are never late' and 'We don't have to wait for them'. They told us that there had never been a time when the carer did not visit one said 'The manager told me that if there was ever a problem she would come out herself'.

One relative told us they had confidence in their care workers and that their relative felt safe and relaxed when staff were in the house and that the management listened to their views and acted upon them. No one spoken with had any concerns and none could suggest any improvements the agency could make.

The records were detailed and up to date and staff knew about their content. Staff told us that they could discuss concerns they had with the manager or the supervisor. They told us that they were confident that they would take any action necessary to protect people.