Acorn Care Home in Birmingham demonstrates how substantial and sustained improvements can be done.
Background
CQC carried out unannounced inspections in February and March 2015. The home was rated Inadequate due to serious concerns in four areas. These related to the risk to people of unsafe care and abuse: people’s consent to care had not always been sought, people did not always receive their medicines as prescribed and the monitoring of the service was not effective.
When CQC re-inspected
By the next inspection in October 2015, the provider had made substantial and positive improvements, resulting in a new rating of Good across all areas. Inspectors noticed a culture of openness at the home and a willingness by management to get things right and improve.
People told inspectors that they felt safe in the home, there were sufficient staff to meet people’s identified needs, people received their prescribed medicines and immediate action was taken to improve the monitoring of medicines that needed to be stored in a fridge. Staff now understood their responsibility to take action to protect people from the risk of abuse and how to escalate any concerns they had.
Safe, supported residents and satisfied relatives
During the previous inspection, arrangements in place had not ensured that people were protected from the risk of abuse because the provider had not always followed safeguarding procedures.
People were now protected from abuse because staff had received the training that enabled them to identify the possibility of abuse and take appropriate actions. All staff inspectors spoke with were now aware of how to escalate concerns and were able to describe the different types of abuse. Records seen during our visit showed the provider had reported concerns appropriately to the relevant authorities.
Staff were able to tell inspectors about people’s individual support needs and interests. Care records had been improved and contained details about how people preferred their care to be delivered.
A relative said: “I am completely involved in my relative’s care. Every week they keep me updated and always tell me about any changes or concerns they have about them”.
One person told inspectors: “I feel safe living here and the staff are very good.”
A relative added: “There have been lots of improvements at the home. I am really pleased with how the home cares for my relative.”
A supportive manager and happier staff
All staff said they now felt fully supported in their roles. The changes in management had meant the service had experienced some difficult times; however, staff were very positive about the current management arrangements. Many reported that the manager was very approachable and supportive.
A staff member said: “It feels like a completely different home. There is now good communication”.
Other members of staff said: “I now feel much more supported in my role. I am really proud of what I am achieving and the training I have completed”.
“We work well as a team now and things are more organised which benefits the people living here".
Effective management of individual needs
Improvements had been made to people’s weight monitoring, meaning any investigation about weight loss or gain was identified and responded to. Staff could tell us how people’s diabetes and epilepsy was managed. Records sampled showed that effective management of people’s healthcare needs had taken place.
A relative said: “The staff pick up on health issues really quickly and act on it so my relative gets the treatment they need quickly. They always keep me informed of any medical issues or changes in their needs”.
Nick Richards, Operations Director at 1st Care Limited, said: “The warning notice issued by the CQC assisted Acorn Care Home to further develop its service provision in conjunction with the new manager who brought and nurtured a new, positive culture within the service. This, in turn, benefitted people living at the service through an improvement in global service standards, and the staff team working in the service by providing training specific to the needs of people living at the service along with the necessary support, supervision, guidance, governance and direction.
“The home, the manager and the staff team considered the CQC approach to be justifiably robust in helping to protect vulnerable adults and improve their lives and, despite a notice being issued, the positivity, sensitivity and determination of the home’s manager and the positive working relationship with the regulator ensured improvements were not only made, but were sustained”.
Jane Rumble, CQC inspection manager for Adult Social Care in the central region, said: “When the inspection team returned to the service, staff and residents alike commented how much things had improved and this was encouraging to see.
“We found that people and their relatives were happy with the care and support they received. They told us they liked and trusted the staff and their relatives were well looked after. Individual plans of care had been developed specific to each person and these were shared and discussed with the person and their relatives.
“All of these improvements led to us giving the home a new rating of Good and we will continue to monitor the service and will carry out future inspections.”
Sue Howard, Deputy Chief Inspector for Adult Social Care in the central region, said: “It is always disappointing when a service is rated Inadequate and in particular raises serious concerns about the safety and wellbeing of the people using the service.
“This example shows that it is never too late to turn a service around; that with hard work and determination a provider can make significant improvements to the quality of care being provided. CQC’s primary concern is always the people using a service and to know that they are now receiving good and support is the best outcome for everyone involved.”