Acorn Lodge

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 inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Initial assessments were conducted in people’s homes or previous care setting. The registered manager or nursing staff visited people to gain their views, preferences and wishes. Where appropriate, people’s relatives would also be involved. Relatives and where possible, people were shown around before making a decision to move in. A person told us, “They came to my home and a lady asked me all questions about what I wanted. I was asked if I would be happy to come and live here. I'm happy I did.” A relative said, “The home came to the hospital to talk with [person]. We went to the home and they showed us around.”

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. Nationally recognised assessment tools were utilised to establish risks to people’s health. For example, the Waterlow tool which is used to assess the risk of people sustaining pressure damage to their skin. Outcomes of assessments informed people’s care plans which guided staff on how to support them safely. Repositioning charts were completed and relevant equipment was put in place to minimise risk of pressure damage or deterioration. Antecedent,Behaviour, andConsequence (ABC) charts were completed for people who may display emotions of distress or anxiety. This helped staff understand why a person may experience these feelings and avoid future incidents. A staff member told us, “Risk management is reviewed continuously and adapted to resident’s changing needs.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff and managers sought health and social care professional advice when a need was identified. Visiting professionals provided positive feedback about how staff worked with them and how well staff knew people. Some comments included, “We always see patient’s with at least 1 member of staff which often does not happen in other nursing homes and they seem genuinely empathetic towards their residents. On the occasions that further follow up advice has been requested by Acorn Lodge; it does appear that they have adhered to the previous advice recommended but concerned that this has not been effective so have requested a review, so in that sense they have been very responsive.” Another said, “I have found the nursing team to have very good knowledge of the people who they are looking after. They are able to provide me with a comprehensive understanding of care needs. I have always been offered a chaperone when assessing residents who have never met me before. The residents I have met have always appeared clean, well looked after, and cared for.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. People’s dietary needs were clearly documented in their care records and shared with catering staff, this included intolerances, allergies and food to avoid due to medicine interactions. People received meals in line with the preferences and needs, for example, meals to suit people with diabetes or preferences to vegetarian food. We observed lunch time was calm, people were asked where they wished to eat their meals. One person requested a jacket potato off menu; their preference was adhered to. A person said, “I love lunch here, it’s my highlight.” Where weight loss in people was noted, referrals were made to GPs and dieticians. We saw staff had contacted the dietitian team when a person did not like their prescribed supplement. Activity sessions were held and included gentle exercises to help people stay active.

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. Improvements had been made to the way staff monitored people’s outcomes. Handover sheets had been adapted to capture ongoing clinical concerns which may require monitoring. For example, where people may experience constipation and at what point healthcare professional input would be required. People’s care plans now included more detail for staff to help them establish if people required any changes in their care or treatment plans. A healthcare professional commented on this and said, “Recently I attended for a resident who was deteriorating due to complex health and social care issues despite appropriate care and encouragement from staff. Staff recognised an issue with fluid intake for a resident who is still not drinking well despite encouragement from staff and family.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People and/or their legal representatives had completed consent forms for various decisions. We observed staff asking people consent before supporting them throughout our visit. Mental capacity assessments were now in place for each decision where a person lacked capacity, best interest meetings were held and documented. A relative told us, “[Person] lacks capacity. I’ve had ongoing conversations with the home. The nurses call sometimes to discuss pros and cons. If I disagree I will say so. They will phone me to say the GP is going to visit [person]. Most commonly they will let me know.”