Acorn Lodge Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 did not always make sure people’s health, care, wellbeing and communication needs were comprehensively assessed, to ensure people’s care was effective.

People’s care plans did not always include adequate details about their health and care needs or information about the specific support they required in different areas of their lives. One person had several mental health conditions but there was no information in their care plan about how this may present, or what support they required when they were unwell. Another person had ongoing health conditions; there was little information about how these impacted the person or what staff should do if their health deteriorated.

One person’s care plan had not been reviewed despite deterioration to their health and moods. Several care plans had not been completed at all for another person. For example, nutrition and hydration, pain, personal care and finance.

The manager confirmed social workers, healthcare partners and advocates were involved in care plan reviews when there were larger changes to people’s needs.

Following feedback, the manager acknowledged concerns and care plans were reviewed to include more robust information.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The manager kept themselves up to date with changes to best practice guidance and legislation by attending managers meetings. They explained they also worked closely with contacts from the local authority and mental health services, and planned to attend upcoming forums.

Staff prepared meals for people, and alternatives were provided in line with people’s preferences. When asked what a person liked most about living at Acorn Lodge they said, “The food.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing information when people moved between different services.

The home had a communication book which was used to record information about changes to people’s care needs, outcomes of appointments and any concerns. Regular handovers took place to share changes to people’s health and wellbeing. A staff member said, communication at the home was, “Very good.”

Health and social care partners gave positive feedback about information sharing. A social care partner said, “Staff can provide extensive information about [person’s] day to day activities, preferences, needs and any other relevant information. Staff work collectively to provide this information. Handovers of information are very detailed.” Another added, “Handovers are always very good. I also get emails to keep me up to date with any changes.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The home had good links with the local health centre, who carried out weekly clinical rounds at the home, and helped facilitate medication reviews or changes to prescribed medicines.

There was evidence in the communication book and daily records staff responded quickly to signs of clinical deterioration and the emergency services or healthcare partners were contacted within a timely manner. A healthcare partner said, “[Staff] can identify any changes or deterioration in health quickly. Staff have established excellent relationships with the person I support, which would help them feel able to communicate any health concerns to staff.”

Staff were prompted to monitor and escalate concerns if people seemed not to be their usual selves. A staff member told us, “We monitor people closely and report any changes in their health to senior staff. We are trained to recognise concerns such as urinary tract infections or pressure ulcers, and follow the correct procedures to ensure people received the appropriate care.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The manager explained that recognised monitoring tools were used at the home such as MUST (to monitor risk of malnutrition) and Waterlow (to monitor risk of pressure injuries). Other tools were routinely carried out to monitor signs of depression, confusion and frailty.

There was a good level of detail in people’s nutritional intake records and people were weighed monthly, with any concerns about malnutrition being raised with the appropriate healthcare partners.

People were consulted regularly about their care, with actions taken to improve their outcomes and quality of life where possible. One social care partner explained how staff had supported a person to achieve several positive outcomes to their health and wellbeing. They told us the person was now more settled having made, “Unprecedented progress” whilst living at Acorn Lodge.

The provider did not always tell people about their rights around consent, but did respect their rights when delivering care and treatment.

The provider did not always ensure consent forms and contracts were signed by the person receiving care, or their representatives as per best practice guidance. Care plans did not always include information about the level of capacity people had, and the types of decisions they could make for themselves.

Staff we spoke to had an understanding of the principles of consent but had not had MCA training. A staff member said, “I understand it is about supporting people to make their own decisions where possible and acting in their best interests if they cannot. I follow this practice by promoting choice and seeking consent before care.”

The home worked with the local authority to ensure capacity assessments were carried out appropriately and best interest decision making meetings were held when required. There was evidence social care partners, advocates and relevant persons representatives were involved in decision making for people who lacked capacity.

Following feedback, the manager confirmed that arrangements had been made to ensure staff had the appropriate MCA training.