Archived: Acres Nook

Updated 3 March 2016

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 January 2016 and was unannounced.

The inspection team consisted of two inspectors, two specialist advisors who had specialist knowledge of nursing care for people with physical disabilities and older people and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We looked at information we held about the service. This included information received from commissioners of the service and notifications. A notification is information about important events which the provider is required to send us by law.

We spoke with 24 people who used the service, 9 relatives and a healthcare professional. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 12 members of care staff, two kitchen staff, the deputy manager, the registered manager and the assistant operations director. We looked at 12 people's care records to see if they were accurate and up to date. We also looked at records in relation to the management of the service. These included quality checks, six staff recruitment files and other documents to help us to see how care was being delivered, monitored and maintained.

Updated 3 March 2016

This inspection took place on 5 January 2016 and was unannounced.

The service was registered to provide accommodation and nursing care for up to 72 people. Care and support was provided to people from the age of 18 years upwards. Accommodation and care was provided over two floors. People who used the service had physical health and/or mental health needs. At the time of the inspection, there were 52 people using the service.

We carried out an unannounced comprehensive inspection of this service on 17 October 2014. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to protecting people from harm and abuse, staffing levels and assessing and monitoring the quality of the service provided. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements.

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.

People felt safe and were protected from avoidable harm and abuse by staff who knew how to recognise potential signs of abuse and how to report them appropriately. We saw that systems were in place and were followed to ensure that safeguarding adult’s investigations took place when required. However, people were at risk of not receiving their medicines as prescribed because staff were not always accurately recording what medicines had been taken.

There were enough staff to meet the needs of people who used the service and staff were recruited safely. People’s risks were assessed and managed to help keep them safe and we saw that care was delivered in line with agreed plans.

People were encouraged to make their own decisions and support was provided in line with current legislation and guidance.

People with provided with enough food and drink to maintain a healthy diet. People had choices about their food and drinks and were provided with specialist support when required to ensure their nutritional needs were met. People’s health was monitored and access to healthcare professionals was arranged promptly when required.

People were treated with kindness and compassion and they were happy with the care they received. People were encouraged to make choices about their care and their privacy and dignity was respected.

Staff were responsive to the needs of people who used the service. People were supported to follow their hobbies and interests in the home as well as in the community.

People knew how to complain if they needed to. A complaints procedure was in place and we saw that complaints had been thoroughly investigated and responded to in line with the provider’s procedure. People and their relatives were encouraged to give feedback on the care provided via questionnaires and meetings and the registered manager had an 'open door' policy. The registered manager responded to feedback and changes were made to improve the quality of the service provided.

We saw that improvements had been made to the systems in place to monitor quality and that the registered manager took actions to make improvements when required. However, there were some issues that had not been identified during quality checks. Effective systems were not in place to ensure that staff had access to and time to complete suitable training.

People, relatives and staff felt the registered manager was approachable and responsive. The registered manager understood the requirements of their registration with us.