We carried out a review of the data available to us about Acorn Lodge Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Acorn Lodge Care Home, you can give feedback on this service.
Acorn Lodge Care Home is a purpose-built residential care home providing accommodation and personal care for up to 60 people. The service provides support to older people, younger adults, people with a physical disability and people with dementia. At the time of our inspection there were 56 people using the service.
Care is provided across two floors known as Willow Way and Cherry Tree. People had their own bedrooms which all have an en-suite. There are large communal spaces on both floors and a large garden for people to use.
People’s experience of using this service and what we found
There had been significant improvements since our last inspection. The provider had responded to the issues we identified and improved governance systems ensured regulations were now being met.
There was a culture of continuous improvement within the home and from the provider. Quality assurance arrangements had been clearly defined at all levels which worked well to improve the overall care provided at the home. Audits and checks were undertaken on a daily, weekly, monthly or annual basis.
Improvements had been made to ensure accurate, complete and contemporaneous records for people were maintained. Care plans were regularly assessed and reviewed to ensure they reflected people’s changing needs. Staff were motivated by the management to provide high quality, person-centred care and there was a passionate and positive culture within the home.
Risks associated with people’s health and well-being were now managed safely. These risks had been identified, assessed and records clearly guided staff on how to minimise risks to keep people safe. Medicines were managed safely and in line with good practice standards.
People were safeguarded from the risk of abuse. Staff understood their responsibilities to provide safe care and treatment. There was an open culture where staff felt safe to challenge poor practice. People and relatives talked positively about the compassionate nature of staff who cared for them. Staff respected people’s right to be treated with dignity and respect.
There were enough staff to provide safe care. Staff received and induction and training to be able to support people effectively.
People received timely access to healthcare when they needed it. Staff knew people well and could identify any early deterioration in people’s health or well-being.
People were encouraged to maintain a varied and well-balanced diet. Menu’s contained a wide variety of meal options and people had a daily choice of what they wanted to eat. People provided positive feedback about the food and meals were presented nicely.
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.
There were a wide variety of activities available to enhance peoples emotional, social and physical well-being. People also had opportunities to go into the community where they could benefit from a change of scenery.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 14 August 2019) and there were breaches of the regulation.
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Acorn Lodge is a care home, providing personal care and accommodation for up to 60 people. It provides care to older people, some of whom are living with dementia. Care is provided over two floors. Each floor has communal lounges, dining areas and a kitchenette. The home has secure gardens that people can access. At the time of our inspection visit 54 people lived at the home.
What life is like for people using this service:
Risks were not consistently well managed. Medicines were not always stored safely, which posed risks of harm to people. Where people had identified risks of harm, or posed potential risks to others, risk management plans were not always in place to guide staff on actions to take to mitigate those risks. Staff did not always know how to protect people from identified risks of harm. For example, when dietary guidance had been given and was not followed by staff.
Overall, there were sufficient staff on shift. However, at times staff deployment meant people’s needs were not always met, such as during mealtimes on the first floor. Night staff felt there were sufficient staff on shift. Staff received an induction, training and support from within the staff team, the provider’s trainer and managers. Staff were trained in how to protect people from the risks of abuse. Further training was planned for staff where the registered manager had identified knowledge needed to be refreshed, this included skin care.
Overall, people had their prescribed medicines available to them and were supported with these by trained staff. The home was clean and tidy, and staff understood how to prevent risks of cross infection.
People had their needs assessed before they moved into the home. Whilst people had plans of care relevant to most of their needs, staff could often not find information. People’s care notes and care plans were not well organised, and some contained conflicting information. The registered manager and regional manager told us about their plans to improve care records and review people’s care plans before the end of July 2019.
Overall, people had opportunities to engage in group activities, however, there was limited opportunity on the day of our inspection visit because the activities staff member had taken four people out, which left limited opportunities for people at the home.
People had access to healthcare when required. On the day of our inspection we saw people were offered enough food and drink to meet their dietary requirements. However, important records related to people’s fluid intake reflected their needs were not always met.
Overall, positive caring interactions took place between people and staff, and people felt well cared for.
Overall, staff followed the provider’s policies, however, a few staff did not. One staff member told us they knew the dress code policy but had not followed it, another staff member told us they had forgotten to lock a door to secure medicines.
People made day to day decisions about their care and were supported by staff who worked within the principles of the Mental Capacity Act 2005. Mental capacity assessments had not always been completed for people.
Systems were in place for people to give their feedback on the service. Overall, people and relatives were happy with the services. A few people shared some concerns they had, such as about the quality of the food.
The provider had recognised they had gone through a period of instability when the previous manager had left. A new manager, who had registered with us, had started during January 2019 and was making improvements to the services provided. These needed to be embedded and sustained and some further improvements were required.
The provider had identified improvements were required to people's care records. However, they had not taken timely action to implement those to ensure staff had the information they needed so people received a safe service.
Overall, the provider’s quality assurance system identified where improvements were needed, and a service improvement plan was shared with us detailing the provider’s timescale for implementing the improvements.
We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
These were:
Regulation 12 Regulated Activities Regulations 2014 – Safe care and treatment
Regulation 17 Good governance
Rating at last inspection: The service was rated Good. (The last report was published on 26 January 2017).
Why we inspected: This was a planned inspection based on the rating of the last inspection. The service is now rated as ‘Requires Improvement’ overall.
Enforcement: Action provider needs to take (refer to end of report).
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Acorn Lodge is registered to provide accommodation and personal care for a maximum of 60 older people, some of whom had a diagnosis of dementia. There were 53 people living at the home on the day of our inspection visit. The home was a purpose built building and comprised of two floors which were accessible by a lift. The first floor was called the “Memory Floor” and supported people with a diagnoses of dementia. On this floor dementia friendly signage was used to help people to access the toilets or their rooms.
The registered manager had recently left their employment at the home following a period of not being at work. During their absence the deputy manager had acted as home manager. Following the registered manager’s resignation, the deputy manager had successfully gained the permanent role of home manager and was in the process of applying to be the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the
requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they felt safe and well cared for and staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe. People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people's safety and shared information so that people's safety needs were met.
People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. There were guidelines in place for people prescribed ‘as required’ medicines to ensure they were given safely and consistently.
There were enough staff to meet people’s needs. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who lived in the home.
The assessment of people's capacity to consent had been completed. People's rights and freedom were respected by staff. Staff understood people's individual care needs and had received training so they would be able to care for people effectively. However, risk assessments did not always contain detailed information about people’s care. There were good links with health and social care professionals and staff sought and acted upon advice received, so people's needs were met.
People and relatives were positive in their feedback about the home. People told us they enjoyed meal times and were positive about the choice of food they received. People said their privacy and dignity was maintained and our observations supported this.
People received care that met their individual needs. People were encouraged to express their views and give feedback about the service. People said staff listened to them and they felt confident they could raise any issues should the need arise. People were positive about the care and support they received and the service as a whole.
Staff spoke highly of the management team and of the teamwork within the service. Staff were supported through supervisions, team meetings and training to provide care and support in line with people’s needs and wishes.
The quality of service provision and care was continually monitored by the manager and the provider and actions taken where required.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by Care Quality Commission (CQC) which looks at the overall quality of the service. This inspection was unannounced.
Acorn Lodge is a residential care home which provides care to people who are older and to people who have dementia. The home offers care to a maximum of 60 people. The building is two storeys. People living with dementia are supported on the second floor of the building.
At the time of our inspection a registered manager was employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
People who lived at Acorn Lodge and the staff who supported them, thought people who lived at the home were safe. There were systems and processes in place to protect people from the risk of harm. These included robust recruitment practices, staff training, environmental checks, equipment checks, and building checks.
People told us staff were kind and respectful to them. We observed staff were caring to people throughout the time we inspected the home. We saw staff respected people’s dignity and privacy when providing care. We were satisfied there were sufficient staff on duty to meet people’s needs.
We saw people participated in a well-planned activity programme which included reminiscence sessions. People were supported to undertake individual interests such as crosswords.
We saw staff understood they needed to respect people’s decisions if they had the capacity to make those decisions. Assessments had been made and reviewed about people’s capacity. Where people did not have capacity, decisions were taken in their ‘best interest’. This meant the service was adhering to the Mental Capacity Act 2005.
The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). There was no one living at Acorn Lodge who had been assessed as requiring a DoLS, but we were aware the provider had referred a person to the local authority for their assessment.
We saw people’s health and social care needs were appropriately assessed. Care plans provided accurate and up to date information for staff to help them care for people effectively. Risks associated with people’s care needs were assessed and plans were in place to minimise the risk as far as possible to help keep people safe.
There were effective management systems to monitor and improve the quality of service provided.
Some people had complex care needs, which meant they might have had difficulty telling us what it was like to live at Acorn Lodge. We therefore also gathered evidence of people's experience of the service by observing the care they received from staff.
People told us they were well cared for and satisfied with the care received. One person said, 'I'm very happy. The manager and staff are always asking me if everything is ok.' A visiting family member told us, 'The care is outstanding.'
People had a range of assessments and care plans in place that detailed the care and treatment they needed. Records showed people's health and care needs were monitored and reviewed regularly.
The home was well maintained and decorated to a high standard. One person said, 'I love my room, it's very comfortable.' A visiting family member told us they 'couldn't have asked for a nicer room for their relative.'
Sufficient staff were available with appropriate experience and skills to meet the needs of people who used the service.
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager for the service on our register at the time.
People told us they liked living at the home. One person said, 'It's very nice here, I would definitely recommend it to anyone.' A visiting family member told us, 'I am more than happy with the care. As far as I can tell, everyone is well looked after.'
We saw staff respected people's privacy and dignity and promoted their independence. Staff gave people reassurance and talked through any care tasks that they were carrying out with the person they were supporting.
We looked at records which stated how people liked and needed to be cared for. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The care staff we spoke with demonstrated an understanding of people's needs.
People told us they felt safe and able to report any concerns they may have. One person told us, 'I have nothing to complain about.'
Staff spoken with told us that they were happy working at Acorn Lodge. They said that they had regular meetings with management to monitor their care practices and had access to training which kept their skills up to date.