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Inspection Summary


Overall summary & rating

Requires improvement

Updated 19 October 2019

About the service

Acorn Lodge is a residential care home providing personal and nursing care for up to 40 people, the majority of whom have a diagnosis of dementia; some have mental health needs and frailty of old age. At the time of the inspection, 37 people were living at the home. The home accommodates people in one adapted building.

People’s experience of using this service and what we found

Activities were not designed specifically for people living with dementia. Care was not always delivered in a person-centred way by staff. Some actions had been taken to arrange the environment in a way that was dementia-friendly.

Care people received was not consistently good. People were not always treated with dignity and respect.

There was a strong smell of urine in one part of the home which was persistent throughout the day. After the inspection, the manager sent us a copy of cleaning schedules and how the problem was being addressed.

Audits had not identified the issues that were found at inspection. Personal information about people was not always kept confidentially. Whiteboards in people’s bedrooms charted detail about people’s continence needs and whether they should be resuscitated or not. After the inspection, the manager informed us that these whiteboards had been removed pending a decision on how information should be managed in people’s bedrooms.

Records relating to Lasting Powers of Attorney and the authority to make decisions with regard to property and finances or health and welfare were not always accurate. During the inspection, the inaccurate records were removed from people’s care plans.

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.

The management team understood their responsibilities in relation to providing the regulated activity. Staff felt supported by the management team. People and their relatives were complimentary about the home and the care provided.

Staff completed a range of training to enable them to support people in line with their care and support needs. They had regular supervisions and attended staff meetings.

People enjoyed the food on offer. They had access to a range of healthcare professionals and services. People were safe living at the home. Risks were identified, assessed and managed safely with guidance for staff which was followed. Staffing levels were sufficient to meet people’s needs. Medicines were managed safely.

Care plans provided detailed information about people, their likes, dislikes and preferences. People’s wishes for the end of their lives were recorded in their care plans. Complaints were managed in line with the provider’s policy.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The rating at the last inspection was Good (published 5 January 2017).

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 Caring, Responsive and Well-Led sections of this report. You can see what action we have asked the provider to take at the end of this full report.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.

Inspection areas

Safe

Good

Updated 19 October 2019

The service was safe.

Details are in our safe findings below.

Effective

Good

Updated 19 October 2019

The service was effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 19 October 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 19 October 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 19 October 2019

The service was not always well-led.

Details are in our well-Led findings below.