Acacia Lodge Care Home

Acacia Lodge is a residential care home providing care and accommodation for up to 60 people. The home provides care over 3 floors, with 1 floor specialising in caring for people living with dementia. The home is in the New Moston area of Manchester and is close to local amenities. There were 58 people living at the home when we inspected.

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

Risks to people's health, safety and wellbeing had been assessed and staff understood how to help keep people safe. Medicines were managed and administered safely, with regular checks completed. We were assured the measures taken by the staff team contributed towards the prevention and control of infections.

People told us they felt safe in the home and with the staff who supported them. Premises checks and all maintenance records were up to date. Required test and safety certificates were in place.

When accidents or incidents occurred, learning was identified to reduce the risk of them happening again.

The registered manager monitored staff deployment and ensured enough staff were always on duty. Processes in place ensured safe staff recruitment, with a range pre-employment checks completed. Risk assessments in relation to prospective new staff needed to be more robust.

Staff responded promptly and were attentive to people's needs. Care provided was personalised and supported people's preferences and wishes. People were supported by caring, friendly staff who knew their needs well. People told us staff were very kind and respectful.

People, their relatives, professionals and staff spoke positively about the management of the service. They had confidence in the leadership of the home. A range of audits and checks were completed to maintain and where required, implement any required improvements. The registered manager was keen to re-establish good working partnerships with professionals and local community groups following the COVID-19 pandemic, for the benefit of people living at the home.

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.

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

Rating at last inspection

The last rating for this service was outstanding (published 23 September 2019).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk in relation to the use of equipment. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe sections of this full report.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from outstanding to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Acacia Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

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

The service was focused on providing exceptional person centred care and support for people who used the service.

The registered manager and provider ensured that there was a clear vision for the service to deliver individualised care and support. They were supported by a strong staff team who were appreciated by people who used the service, relatives and professionals.

The registered manager had undertaken training which they used to enhance the well-being of people who used the service, staff and relatives. This had a positive effect on the people we talked to and helped provide the calm and happy atmosphere we witnessed.

There was high-quality leadership in the service, and a very high level of caring for and supporting staff. Strong links had been developed with other health and social care professionals which enabled the provider to deliver consistently person-centred care.

Plans of care were extremely person centred and the details gave staff the information they needed to deliver individualised care. There was a failsafe system for staff and managers to review and update the plans. People could make comments via the electronic system to inform staff of their care needs and any other wishes such as activities.

The service empowered people who used the service to make decisions about how the home was run. This included activities, the food they ate and the recruitment of staff. Family members were encouraged to participate in social events which ensured they were involved in the home and supported their relatives.

There were robust means of raising concerns or complaints. Action was always taken, and the provider saw all feedback as a learning opportunity which may improve the service further.

The service provided many meaningful opportunities for people to mix socially with each other and their families. The service made excellent use of their tea room and cinema. We saw how people were engaged with each other, their families and staff in the tea room, which was a happy social event.

The registered manager and provider actively engaged in research, which then benefitted people who used the service. This included involvement with an orchestra, which is known to provide stimulation to people with a dementia. The service had used the service of a nutritionist to trial different menus and the chef gave demonstrations about food to teach about the importance of good nutrition and hydration.

Staff were encouraged to undertake further training to become more involved in the running of the home. The extra knowledge they gained was hugely beneficial to people who used the service. There had been a reduction in falls and behaviours that challenge.

The comprehensive audits ensured the service maintained and improved standards. We saw action was always taken when improvements could be made.

People were assessed prior to admission to the home to ensure they were suitably placed. Risk assessments ensured any specialised care, equipment and treatment was provided by the relevant professionals.

The principles of the Mental Capacity Act (2005) were followed to help protect people’s rights. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People’s equality and diversity was respected. A history was taken of people’s past preferences and people were able to follow their religious or other needs to reflect their diversity.

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

Rating at last inspection

The last rating for this service was good inspection (published 20 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Acacia Lodge Care Home (Acacia Lodge) is a 60-bedded residential care home. The home provides care and support across three floors, with one floor supporting people living with dementia and the other two floors providing residential care. All rooms were single occupancy and contained en-suite bathroom facilities. The care home is located in New Moston, Manchester and is close to the motorway network and local amenities. Acacia Lodge is owned by Avery Healthcare Group, a national provider of residential, respite and nursing home care.

The service had a 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.

Everyone we spoke with told us they felt safe living at Acacia Lodge. All the relatives felt their loved ones were safe living there. Staff knew how to keep people safe and were aware of how and to whom they could report any safeguarding concerns. This meant that staff were aware of how to protect people from risk of harm.

Staff sought consent from people before providing care or support. The ability of people to make decisions was always assessed in line with legal requirements to ensure their liberty was not restricted unlawfully. Decisions were always taken in the best interests of people when necessary and applications were made for Deprivation of Liberty Safeguards appropriately.

Risk assessments were up to date. Care plans were written in consultation with the person or their families. People had been supported to be involved in identifying their support needs. Assessments included people’s likes and preferences and staff knew the people well.

People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the needs of the people and had received appropriate training in order for them to meet people’s needs. The recruitment process was robust and all required checks were in place prior to staff commencing work. People living at Acacia Lodge were involved in the recruitment process which showed the service was taking their view into consideration.

People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the needs of the people and had received appropriate training in order for them to meet people’s needs. The recruitment process was robust and all required checks were in place prior to staff commencing work. People living at Acacia Lodge were involved in the recruitment process which showed the service was taking their view into consideration.

Medicines were administered, stored and disposed of safely and in line with the required guidelines. There were appropriate guidance and protocols for staff when people needed ‘as required’ medicine.

Staff were observed as being kind and caring, and treated people with dignity and respect. There was an open, trusting relationship between the people and staff.

We saw people were fully supported to attend activities within the home. People had access to lots of different activities and were able to make choices about how they spent their time and where they went each day.

We saw people and their relatives had been asked for feedback about the service they received. There was a record of what actions had been taken to address any identified concerns. Staff worked well as a team; we saw them communicating with each other in a respectful and calm manner. There was an open and transparent culture which was promoted amongst the staff team.

Everyone knew who the registered manager was and felt the service was well-led. All staff said they felt supported and felt they could raise any concerns with the registered manager and they would be acted upon.

We viewed the policies and procedures and saw they were being followed. Quality assurance checks were being completed and when incidents had occurred action had been taken.

We observed how people were cared for and saw that they were looked after in accordance with their care plans.

We found that people felt safe living in the home.

We found that enough skilled and experienced staff were being employed to meet the assessed needs of those people using the service.

Records, including care plans and risk assessments were found to be up to date and were being reviewed on a regular basis.

At the last inspection visit it was judged that the home was not meeting the requirements of the regulations in relation to consent arrangements and record keeping. At this visit to the service we found the home was meeting the regulations in relation to consent arrangements, care and welfare, safeguarding, supporting staff and record keeping.

We spoke with several people who lived in the home and one relative of a person who lived at the home about the care provided. All the people we spoke with were very positive about the care they or their relatives received. One person who used the service told us: "We do different things every day". Another said:“They’d have a job to better it” and a third person said: “I don’t know anyone that comes here and doesn’t like it”. One relative stated: "We’ve been really pleased…They do quite pleasant things [referring to activities] …I’ve never had to complain". People confirmed that the home sought the views of people in the home and their relatives.

We found that the home was meeting the regulations in relation to care and welfare, nutrition, safeguarding, staffing and quality assurance. We judged that they were not meeting the requirements of the regulations in relation to consent arrangements and record keeping. We judged that this had (or may have had) a moderate impact on people using the service. Due to the action that the provider had already taken and previous evidence of action to make improvements, we have set compliance actions.

We found that the home was meeting the essential standards and people were well cared for.