Acorns Health Care

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. However, the provider’s own governance systems had failed to identify people were not always receiving effective care and therefore prompt action had not been taken to make improvements.

The service was in breach of legal regulation in relation to good governance. This was a continued breach of regulation.

This service scored 64 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Processes were in place to promote equality and diversity for people and the staff team. We reviewed the provider’s statement of purpose which clearly set out their values.

The registered manager told us, “We want to support people, our goal is to share our expertise and support people who have come out of long stay hospitals. We want to empower people, we are massive on person centred care. Each person has their own staff team. We are going to grow at a safe rate and ensure new services are person centred to the person wherever possible, and to be as least restrictive as we can.”

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

We identified breaches of regulations and concerns in governance. Leaders had not independently identified and acted on all these concerns prior to our inspection. This meant some development was needed in their skills and knowledge to lead effectively.

Relatives told us they were informed of incidents involving their relatives and communication with staff and managers was good.

Staff members told us, the registered managers were visible, accessible and approachable.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People living in the services were asked for their views and were given the opportunity to speak up daily both informally, in meetings, and through surveys. We reviewed people’s daily support notes and noted people spoke up, and their decisions and choices were respected. We reviewed people’s surveys where they were encouraged to speak up. This meant people’s voices were heard.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff felt supported to give feedback and were treated equally, free from bullying or harassment. They told us they had access to relevant policies.

The registered manager told us about the organisations flexible working policy which meant staff could apply for adjustments in their work to be made if needed. They gave examples of when this had happened in practice.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes.

The provider’s own governance systems had failed to identify people were not always receiving effective care and therefore prompt action had not been taken to make improvements.

Quality assurance audits had been completed, however, these had not always been effective in identifying the shortfalls we found at this inspection, such as PRN protocols not containing the correct level of detail to support people safely, PBS plans not detailing the monitoring people required following some incidents and the concerns we found relating to recruitment practices. Although the registered managers were responsive to our concerns, they required time to embed them into practice.

People mostly received care and support in accordance with the principles of ‘Right care, right support, right culture’ guidance. People were supported to eat healthily and were supported to engage in meaningful activities both inside and outside of their home.

The registered manager was able to confidently tell us how they ensured safe record keeping by following the principles of General Data Protection Regulation (GDPR).

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Professionals, staff, and the registered manager shared with us positive examples of collaborative working in partnership. One professional told us, “Acorns Health Care have been particularly kind and supportive with my client who requires a lot of emotional support. They have always responded positively to other professional suggestions. They are keen to work in the least restrictive way and promote and protect people’s rights and wishes. They work well in partnership and reply promptly to my emails and calls. I feel Acorns Health Care are person centred and sensitive to mental health issues people have and I have no concerns.”

The provider strived to focus on continuous learning, innovation and improvement across the organisation and local system.

However, we found some concerns during the inspection which we have highlighted throughout our report. Although the provider was motivated to learn and improve the service for people, their overall ambition was limited by the lack of effective risk and quality monitoring systems. This meant they might not always be aware of shortfalls to enable prompt improvement and learning.

The provider was responsive during our inspection and told us what action they would be taking and how they were taking learning from this inspection and would be sharing this across their organisation.

The registered manager shared with us several examples of how they were improving people’s experience, these included involving people in training sessions to ensure it was bespoke to the person and organising regular organisation wide events for all people to attend which gave them the opportunity to meet other people and build friendships. They also invited relatives to attend meetings with the staff so they could share and discuss best practise for supporting their relative and also discuss any concerns and find resolutions.