Acorn House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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

This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The management team understood there were areas where consistent improvement required embedding and showed a robust, proactive approach. The management team were open and responsive to ensure improvement where any care quality had fallen below the providers expected standards.

Acorn House had an open culture, which embraced diversity and was inclusive for all. The management team led by example, and staff understood the importance of upholding the values of the organisation. People’s human rights were fully embraced and supported. The service had a strong focus on how they could enable people to be fully involved in life as part of their community.

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The providers were fully engaged in the running of the service and knew people and their relatives well. The registered manager led by example, and showed compassion, empathy and strong, capable management skills. Their vast experience of working with people living with dementia and cognitive impairment informed their practice. One staff member described the registered manager as, ‘always calm’, saying, ‘they soaked up pressure like a sponge.’ Another staff member explained, “I can always go to the manager. They will listen and help where possible.” Another staff member told us, “Management are really good at listening to us and people.”

The service had recently been awarded a ‘10’ rating on a national care choices website. This was the highest score possible and was obtained from user voice shared directly by people and relatives. The nominated individual explained how proud they were of this achievement. We saw a balloon display in the main foyer to celebrate this, and the providers were sharing this through their internal and external media channels. The nominated individual explained how this was a total team effort.

Staff we spoke with told us they had learnt from the registered manager and the management team. Staff felt they were supported to continually improve their practice and bring the best of themselves to work each day. In relation to feeling supported by the management team, one staff member said, “The home care about our wellbeing and we feel strongly supported by the management, so we can do our jobs well.”

The provider fostered a positive culture where people knew they could speak up and their voice would be heard.

Most of the people and relatives we spoke with had not felt a need to raise a complaint.

We saw there was regular engagement with people and their representatives. People and their relatives were encouraged to share their concerns or complaints. The management team had an open-door policy and ensured people and their relatives were listened to. No one we spoke with could recall a need to raise a proper complaint. One person said, “I’ve had no need at all. Little things are quickly sorted by carers.” A relative gave feedback, “There is lots of communication, and responses to queries are prompt.”

Staff understood how to whistle blow if they felt the management team had not satisfactorily responded to them or people. We found the culture of Acorn House was open and transparent, led by a management team who actively encouraged feedback. This feedback was used effectively to improve care quality across the service.

The provider always valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The service employed staff from the local area, as well as from overseas. The background and culture of all staff was acknowledged and celebrated by the management team. The service had an open and transparent, positive culture.

The values of the organisation were set out for the staff team as, ‘everyone in the staff team should treat each other with mutual respect. Recognising each other’s value and status, and that of the residents we care for.’

The service recognised the skills of the staff team and championed internal progression. The service had a robust recruitment strategy in place and worked consistently to give opportunities for development and progression, which in turn supported staff wellbeing and retainment. One staff member explained how they had been supported to progress through the National Vocational Qualifications (NVQ) tiers. The registered manager had been supported to achieve their management qualifications, by the nominated individual, who had an extensive clinical background. This supportive learning approach ensured staff felt valued and this had allowed strong staff retention to be achieved by the provider.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The providers for Acorn House were fully committed to ensuring future development and to maintaining high quality standards of care. They gave their full support to the management and staff team and ensured robust accountability.

The management team had weekly operations meetings, following which, clear actions for any required improvements were detailed. The management team ensured these actions were included in an exceptionally detailed service improvement plan. This ensured the service were continually working to improve care outcomes for people.

The provider compliance team completed daily compliance checks, to ensure the service remained fully compliant with regulations. This included review of a 24-hour report, which showed what incidents had happened, reviews of care plan and risk assessments, medicines errors, hospital admissions or readmissions, wound checks, and any concerns shared by people or relatives. However, call bell response times had not always been acted upon and the provider had not always responded to concerns from relatives about staffing shortages.

The service championed 'lessons learned' and had fully embraced learning from events to ensure continual adaptations and improvements. This learning helped the management team to understand the expectations upon staff. Staff were supported with routine supervisions and development feedback. Surveys were used to understand what people wanted and areas they felt needed improvement.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The management team understood the importance of investing in a fully collaborative approach to supporting people. We saw the management team shared regular feedback forms with external partners, and used this feedback to consistently review, and where needed, improve their standards. We saw the most recent partner engagement forms had given positive feedback. One partner had shared, ‘The home is very flexible. If we come across any problems, we will discuss this and come up with a solution.’ Another partner had given feedback, ‘Acorn House have always worked well with us, as an external professional, supporting their residents.’

The management team worked effectively with people, their representatives and staff to build a culture that focused on enabling people to enjoy their lives and retain community links. We saw people were supported to have wishes and dreams, which staff encouraged them to achieve. People and their relatives told us they would recommend the service to others. One person said, “Yes I would, you couldn’t do better.”

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The service had a strong focus on continuous learning to improve care outcomes for people. Themes from any incidents or complaints had been robustly analysed by the management team to look for any themes and trends. Actions taken by the service included: sharing of this analysis during team meetings with staff for them to understand the root cause. Lessons learned showed where the service could improve, this may include documentation, changes to the electronic care planning system, or the need for changes to practice. We saw the management team had implemented additional training to reduce the likelihood of future incidents, including sepsis awareness and dysphagia training.

The provider compliance team used a continuous learning approach to improve care quality at Acorn House. A current project one of the leads was working on looked at the use of benzodiazepines (a specific type of controlled medicine), and how many times it had been given. Where there were any issues, it looked at any increase in use and why this was. The compliance team used the clinical notes and antecedent, behaviours, consequences (ABC) forms. These were then used to look at any behaviours displayed by people, what lead to this, and how they could provide better support for people where needed. This included multi agency meetings with external teams, including the prescriber, to look at a more holistic approach to support people.

This showed the provider had a strong, proactive approach to evaluation and learning, which in turn, improved care outcomes for people.