Acorn House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Outstanding.

This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 90 (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 was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

The inspection team were made warmly welcome by the registered manager, nominated individual and the whole staff team. The staff team had signed up for the service ‘dignity challenge’ which had 10 points for staff to follow, to ensure dignity for all was followed. These points included a zero-tolerance approach to abuse, alleviating loneliness and social isolation, and improving confidence and positive self-esteem. The service ethos was to, ‘promote dignity and respect for all’. One person explained how the staff approach made them feel, they said, “I find them all very nice and kind to me.” A relative gave feedback, “Our family member always say’s they are happy. The social aspect of living here has really helped a lot.”

We observed staff followed this ethos and implemented this in their daily practice. We saw examples of genuine warmth, kindness and respect being shown by the staff team, towards people, relatives and each other during our visit. For example, one person exhibited distress when they couldn’t remember something which was important to them. The staff member provided the person with reassurance, with a calming touch of the hand and the use of subtle redirection techniques. The person responded to the support of the staff member and was observed to be calm and settled after this interaction. Another person decided they wanted their hair to be tied up, due to the hot weather. We saw them happily chatting about this with a member of staff, and the person was seen shortly afterwards with 2 plaits, which had been their decision.

We saw the service had installed a touching tribute, in the form of a tree and a plaque on the garden wall. This was to honour the memory of the residents who had sadly passed away during the Covid-19 pandemic. The registered manager and nominated individual spoke of the importance of acknowledging and reflecting on the impact of this period on people, relatives and the staff team.

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The management team worked hard to share best practice and develop and embed overall staff knowledge, in order to better support people. This included information display boards, staff development, included face to face training days, and activities which centred around protected equality characteristics. The service promoted awareness through different cultural events in the service, such as strawberries and cream for Wimbledon, taster sessions of food for Diwali and celebrating the football World Cup.

People were supported to celebrate differences and express themselves in the way they wished to. The service embraced diversity, so the staff team showed a greater understanding of the needs and preferences of people. It also supported people to have more knowledge around religion and beliefs, created talking points and opportunities to nurture everyone’s values for others to acknowledge. This helped to foster a more inclusive environment where people and staff could feel safe, and where differences were celebrated.

Staff used a range of alternative methods to communicate with people about their choices when they did not use verbal communication or did not speak English as a first language. Objects of reference, language skills amongst the staff team and picture cards were used to ensure people could communicate their needs. Care records included information on how either through verbal or non-verbal means people were able to refuse or give consent for specific decisions.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People could choose where to spend their day and had the option to join in any activities. A good choice of meals and drinks were offered at all mealtimes. People we spoke with told us they were encouraged to remain independent with hygiene and dressing where possible and make decisions on where to spend their time. One person said, “I have a shower on alternate days and that’s ok for me. My room is kept clean and my clothes.”

People were treated with respect and kindness by a staff team who enabled people to make their own choices and decisions where they were able to. One person said, “They know I like my door just ajar day and night, so they respect that.”

People told us their preference of a male or female member of care staff were respected. One person said, “I will only have a female carer.” Whilst another person said, “I’m female staff only for care but I don’t mind if a male [staff member] is serving drinks or food.”

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Where any care concerns fell below the providers expected standards, management were prompt in their response to ensure improvements were made.

Outcomes for people, staff and overall impact were robustly assessed by the management team, to identify strengths and improvements required. For example, where people had given feedback regarding a delayed response to call bells, the management teams’ responsiveness provided evidence of a robust approach to care experience improvements.

People who were at risk of falls or required a high level of support from staff, were supported by staff who knew them well and understood their needs. One person said, “I’m not very steady on my legs so they assist me to stand but will pop me in a wheelchair to go anywhere far. I’ve not had any falls since I’ve been here.”

Where people could not communicate verbally, we observed genuine interactions between staff and people, which demonstrated relationships were caring and compassionate. This enabled staff to anticipate and meet people’s needs quickly and in ways that reduced and mitigated people’s discomfort and distress.

The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

The provider had a high level of staff retention, with many staff who had worked at the service for many years. The service no longer used agency staff, as they had a consistent and experienced staff team. The registered manager spoke of their long background at the service and how their multiple roles at Acorn House, prior to taking up a management position had given them a real insight into the challenges within each role. They told us, “We have a staff forum which we do every quarter. We always have a representative who arranges the staff meeting to speak and put forward how they can improve the service. Alongside this, there is a QR code for suggestions. This is anonymous and goes to HR. The feedback from the suggestions and staff feedback go into a ‘you said; we did’ document.”

The management team periodically, held 'cupcakes and conversation' sessions, so staff had an informal route to speak with them. The registered manager explained, “We always want to listen to our staff, they are our biggest asset.” A staff member told us, “I’ve been here since December last year. It is the best job I have ever had.”

The nominated individual expressed their passion for providing high quality care. They told us, “Acorn House is my baby. I feel a deep personal responsibility for every resident and every staff member.” The registered manager led by example, showing a dedication towards people, their staff team and a genuine passion for consistent improvement. They told us, “We regularly share a staff and leaders survey, which are linked to the CQC regulatory framework. This allows staff to understand the regulations and reflect on their own impact on care quality.”