Background to this inspection
Updated
5 February 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Acorn Retirement Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
We used all of this information to plan our inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, a new member of staff who was overseeing the implementation of new care records, care staff, the cook and a member of the housekeeping staff. 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 reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
5 February 2020
About the service
Acorn Retirement Home is a residential care home providing nursing or personal care and accommodation to 15 older people. The service can support up to 18 people.
People’s experience of using this service and what we found
Prior to this inspection, the provider has been rated as ‘requires improvement’ in the question, ‘is the service well led?’ on three previous occasions. We found at this inspection, concerns remain regarding the governance of this service.
We have made a recommendation that the provider consult and familiarise themselves with the latest NICE guidance with regard to the administration of medication.
Concerns were raised during the inspection regarding the amount of weight lost by a person living at the service and the lack of monitoring of this person which would have prompted additional help being sought to meet their needs. This resulted in the inspector raising a safeguarding concern in relation to this person.
There were a lack of effective systems and processes in place to assess, monitor and improve the quality and safety of the service provided. Systems were not in place which would provide the registered manager with oversight of the service. Risks to people were not consistently managed. Daily charts were not completed consistently.
People were supported to receive their medication as prescribed by their GP. Accidents and incidents were reported on but there was a lack of analysis of this information taking place which would identify potential risks and assist the provider to put actions in place to address the risks.
People told us they felt safe and were supported by staff who knew them well. Staff had been safely recruited and were aware of their responsibilities to act on any allegations of abuse they may be aware of.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported to access a variety of healthcare services, but there was a lack of consistency in how people’s healthcare needs were managed and responded to.
Staff felt well trained and supported in their role. People were happy with the care they received and felt it met their needs.
People were cared for by staff who treated them with dignity and respect and encouraged them to maintain their independence.
Care plans were in the process of being reviewed and re-written. People were involved in the planning of their care and had no complaints about the service. People were support to take part in activities and access the community.
Rating at last inspection
The last rating for this service was Good (published 3 April 2019).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Acorn Retirement Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance at this inspection. We have issued the provider with a warning notice regarding the concerns raised during the inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.