Acorn Residential Home is a care home that provides personal care and accommodation for up to eight adults. At the time of the inspection there were six people living at the home, all of whom had learning disabilities. Acorn Residential Home is a family run home, the registered manager and deputy, are wife and husband respectively. Their son and daughter-in-law also work in the home. Other staff are employed to work during the night and at weekends.
At the last Care Quality Commission (CQC) comprehensive inspection in November 2014, we found some areas of concern and rated the service as ‘requires improvement’ in two questions we asked of providers, ‘Is the service safe?’ and ‘Is the service effective?’. Overall the service was also rated ‘Requires improvement’.
Staff had received training in line with their roles and responsibilities; however it was not regularly refreshed and some mandatory training such as medicines administration had not been refreshed for several years. Also the provider was not up to date with current guidelines and practices for safeguarding adults at risk. We asked the provider to write to us and let us know what action they would be taking to make improvements in the service.
In June 2015 we visited the service to make sure they had made the improvements we had asked them to. We saw evidence staff had refreshed their training. Additionally, measures had been taken to ensure the service was in line with current practice regarding safeguarding adults at risk. The service had re-written their policy and procedures for safeguarding adults at risk to make it clear what staff were required to do if they suspected anyone was at risk from harm; acquired the ‘London Multi-Agency Adult Safeguarding Policy and Procedures on safeguarding adults’ and the registered manager had refreshed their ‘safeguarding adults at risk’ training. As the service was meeting legal requirements and had made the necessary improvements, we changed their rating in the two key questions and overall from Requires Improvement to Good.
The service did have a registered manager in post. 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.
At our inspection in March 2017, we found people continued to be safe living at Acorn Residential Home. There were enough staff on duty and they had received sufficient training and support to meet people’s needs.
The provider had undertaken checks prior to the employment of staff to ensure as far as possible only suitable people were employed. Staff had received training to recognise the signs of possible abuse and knew what action they needed to take to keep people safe.
People were supported to maintain good health. They had access to healthcare professionals as and when they needed them. People received suitable nutrition and their medicines as prescribed to maintain their well-being.
Staff were kind and caring. They provided care in such a way to maintain people’s privacy and dignity. They were knowledgeable about people’s individual needs and how best to meet them. Staff were attuned to people’s communication and sought consent from people before providing care.
The provider put assessments in place so any risks associated with daily living could be identified and action taken to minimise them. In this way, they were promoting people’s independence where possible.
People were supported to be involved in a range of activities in line with their interests and preferences. This included volunteering and being involved in organisations representing people with learning disabilities.
The provider sought to gather stakeholders’ views about the service. People were encouraged to complete satisfaction surveys or to take comments to the registered manager if they had any concerns. People told us they thought the registered manager was open and approachable and would respond to any comments made.
There were audits and checks in place to monitor the quality of the service. If there were any accidents or incidents, they were clearly documented, and action was taken to minimise the risk of re-occurrences.