About the serviceFour Acres is a purpose-built residential home registered to provide accommodation and personal care for up to 66 people, including people living with dementia. At the time of our inspection visit there were 58 people living at the home. Care is provided across two floors. Communal lounge and dining areas were located on both floors. People’s bedrooms were en-suite and there were further communal bathroom facilities located on each floor.
People's experience of using this service
At our last inspection we found improvements were needed in the management of some risks. At this inspection we found further improvements were still required to ensure staff had the information they required to manage risks associated with catheter care and people at risk of skin damage.
Some people’s health could impact on their emotional and mental wellbeing causing them to become distressed or agitated with themselves or others. The provider was providing extra guidance and training to support staff in meeting those people’s needs.
Staff were not confident that staffing levels accurately reflected the level of care and supervision some people required, especially on the units where people with more complex needs lived. Following feedback at our inspection visit, the provider confirmed staffing levels had been reviewed and had been increased to ensure people’s individual needs were consistently and safely met.
The home was clean and tidy and infection control practices minimised the risks of infections spreading.
The provider had processes in place to assess and monitor the quality of care provided at Four Acres. However, these were not consistent in identifying areas where improvements were required to ensure good outcomes for people.
The provider responded immediately to our feedback both during and after the inspection and implemented an action plan to address those areas we had identified as requiring improvement.
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 Requires Improvement (published 4 December 2019).
Why we inspected
The inspection was prompted in part due to information received about the management of risks, particularly those associated with people’s emotional and mental wellbeing and record keeping within the service. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
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.
The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Four Acres on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified a breach in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.