Acorn Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There were effective systems in place to learn lessons from events because staff recorded accidents and incidents, and they looked at ways to reduce the risk of these happening again. These were analysed regularly to identify lessons and reduce the risk of recurrence. For example, there was a regular falls analysis undertaken which looked at potential contributing factors such as the location, time of day and the number of people affected so that staff could look at ways of reducing these.

The registered manager understood their responsibility to be open and honest when something went wrong. For example, we saw evidence that the registered manager apologised to relatives when a medicines error had occurred in line with the duty of candour. The duty of candour requires registered providers and registered managers (known as ‘registered persons’) to act in an open and transparent way with people receiving care or treatment from them.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had a business continuity plan in place and staff ensured safe transitions for people when this was necessary by working with people, their relatives and external professionals. The registered manager ensured sufficient information was obtained from external professionals before people moved into the service, helping to promote continuity of care and reducing the need for people to repeat information, for example by making sure relevant equipment arrived prior to the person moving into the service. External professionals told us staff provided them with the information required so transitions were as safe as possible. One professional commented, “They do make referrals and they refer straight to us when someone moves in. The referrals are appropriate, not excessive.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives told us they felt safe living at the service and staff treated them with respect. One person told us, “I am safe, you can call someone when you want, we have a bell. Staff are really nice.” A relative commented, “Never had to raise any concerns about safety.”

Staff told us they knew how to recognise possible signs of abuse and how to report these internally and externally. One member of staff described the potential types of abuse and what they would do, “Physical abuse, and it can lead to bruises. I’d report it to the nurse. I’d report it to the manager, CQC or the police.” Another member of staff said, “If I was concerned about safeguarding I would report to my line manager. I can also speak to the local authority about safeguarding.”

The registered manager understood their legal responsibility to safeguard people, staff completed training for safeguarding and whistleblowing, and there was a safeguarding policy and procedure in place which was created in line with legislation. Accidents and incidents were reported to partners appropriately and staff worked with external agencies to provide information when this was requested.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. The provider understood their responsibility in relation to safeguarding people’s rights and what would constitute a restrictive practice. Applications for DoLS authorisations were submitted to the local authority, and these had considered the least restrictive ways and involved all relevant partners in the decision-making process.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and their relatives told us staff managed risks in relation to their care appropriately. They told us staff involved them in the decision-making process by balancing risks and people’s preferences. One person told us, “They let me do as much as I can for myself and they help me with the things I can’t manage.” A relative said, “He has fallen a couple of times. He has a pressure pad alarm next to the bed. They call and tell us.”

Staff understood risks in relation to people’s care. Staff told us they had sufficient time to read people’s risk assessments and there was enough information in care records for them to follow. One member of staff said, “The main things I look out for is check their Zimmer frame ball joint, check if the rubber has worn off, make sure there’s no trip hazards, make sure they have their glasses on if they have glasses, make sure they have shoes on.”

People’s care records included information on how to manage specific risks, for example, in relation to developing pressure sores, smoking and the risk of falls. Where healthcare professionals provided guidance, care records included relevant information, including how to manage the risk of choking.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People and their relatives told us the environment was safe. One person told us, “I am comfortable here and really happy.” A relative told us, “The environment is safe. In the hot weather the curtains are closed and the fans are on.”

The service was purpose-built and staff undertook regular checks of the environment. For example, staff completed regular checks of equipment in line with legislation and the provider organised external inspections of fire safety. People had individual evacuation plans for the event of an emergency and there was an emergency bag which contained important information that could be easily shared with the fire service if this was necessary. There were systems in place to ensure maintenance issues were quickly remedied.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and their relatives told us there were enough staff to meet people’s needs during the day and at night. They told us staff were skilled and that the staff team was consistent. We observed there were sufficient staff throughout the assessment, they did not appear to be rushed and staff were knowledgeable about people’s needs. One person told us, “I have this button (call bell). I press it and they come to me.” A relative said, “They seem well organised and always enough of them.”

Staff told us there were enough of them on duty and that they had enough time to safely meet people’s needs. They told us they were able to speak to the registered manager if this was not the case. One member of staff told us, “There are enough staff on duty.” Another member of staff commented, “There’s enough staff.”

Staff had completed training to undertake their role and had received regular supervisions. There were systems in place to check staff competency in various areas such as dignity and moving and handling. One member of staff told us, “We have a monthly rota, I am trained to give medicines, and they check I am doing things correctly.” Another member of staff commented, “We have supervisions. We do quite a lot of training here all the time.”

Staff were recruited safely to the service. This included obtaining references from previous employers, right-to-work documentation, checking professional registrations and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and their relatives told us the environment was regularly cleaned and that staff used personal protective equipment (PPE) appropriately when this was required. The environment was clean throughout our visits. One relative told us, “They wear gloves and aprons when hoisting [person] and doing personal care.” Another relative commented, “The home is clean. They let me know if [person] needs vaccines.”

Staff told us they had sufficient PPE to undertake tasks in a safe way. We observed staff following effective infection prevention and control (IPC) procedures throughout our site visit. The provider had IPC policies and relevant procedures in place, and they undertook regular IPC checks of the environment. The registered manager demonstrated that they understood their responsibilities to report infection outbreaks to the relevant health authorities. One member of staff told us, “We have enough PPE. If we need more, we just go downstairs to the manager and request it.”

The provider generally ensured medicines and treatments were managed safely and met people’s needs, capacities and preferences. Staff involved people in decisions about their medicines, including when changes were made. We identified a minor area for improvement in relation to medicines storage, which the provider addressed promptly during the assessment.

Medicines were generally stored and disposed of securely. Where medicines required additional monitoring, this was done in line with legal requirements. However, on our first site visit we found fridge thermometers were not always reset daily in line with manufacturers’ instructions which meant there was a risk medicines may not have the desired effect. When we told the provider, they contacted the supplying pharmacy to ensure medicines were still safe to use, updated their systems and showed us evidence this had been completed on the second day of our site visits.

People and their relatives told us medicines were managed safely. One person told us, “I see the doctor when I need to, I am diabetic and I take medicines for this, they make sure I have what I need.” A relative said, “She does take a few things regularly but the staff deal with that and we have never had any issues.”

Medicines were administered by staff who had completed regular medication training and competency assessments. Staff followed the provider’s medicines management policy and received regular refresher training. Medicine administration records were completed electronically and included relevant information. Regular audits of medicines management were carried out by the management team, and actions were recorded.