This inspection took place on 18 August 2015 and was an unannounced inspection.
Acorn Lodge Residential Care Home provides personal care for up to ten people with enduring mental health needs. It offers long term accommodation within a residential area of Blackpool. There are eight single rooms and one double room. Communal areas include a dining room and lounge. The service requires people to be mobile on admission. There is no lift and limited access for anyone with mobility difficulties. Whilst staff would try to meet any changing mobility needs, they feel it would be difficult to accommodate anyone with long term limited mobility.
The service was last inspected in January 2014. The service was meeting the requirements of the regulations that were inspected at that time.
There was a registered manager in place. 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 told us they felt safe living at Acorn Lodge and almost all the people we spoke with were happy there. One person said, “We are well looked after and I am comfortable and safe here.” A relative said, “I have no concerns about [family member]. We know they are safe here.”
Almost all people said they could talk to the staff team, express any ideas or concerns and they would help. One person was not satisfied with the care they received and said that staff didn’t listen to them. We discussed this with the registered manager who told us that the staff team were aware of the comments and were working with the person to meet their care needs and preferences. Other people we spoke with were praising of the care they received. One person told us “The staff here, particularly the manager, listen. If we don’t like something they will do something about it if they can.” A relative commenting in a recent survey told the home, “My concerns, which are few, are always dealt with.”
Five of the six people spoken with about the meals provided said that the choices were good and the meals were plentiful. One person said they did not get enough to eat and the evening meal was too early. The registered manager said that they would discuss meals with people individually and at the next residents meeting.
Records were available confirming appliances and equipment in use by the home had been serviced and maintained as required. However we found that there was no master key for people’s bedrooms or the front door. This meant that in an emergency situation, staff would need to check which member of staff was carrying the keys before being able to enter bedrooms or exit the home.
Although there was a programme of refurbishment. There was an unpleasant odour in the downstairs toilet. The registered manager told us they were awaiting new flooring to resolve this problem and this would be dealt with quickly.
We talked with staff about how they supported people whose behaviour challenged services. We saw that there was information about one person who could have behaviour that challenged. However where there were restrictions in place to manage this behaviour, there was insufficient guidance in place.
The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff we spoke with knew the steps they would take if they became aware of abuse.
We looked at how the home was being staffed. People we spoke with were satisfied with staffing levels and said staff were available when they needed them. One person told us, “There are always staff about if you need anything.”
When we undertook this inspection visit, the service had not appointed new staff members for some time. They had appropriate procedures in place and were just starting the process of appointing a new member of staff.
Medicines were managed appropriately. They were given as prescribed and stored and disposed of correctly. People told us they felt staff supported them with medicines well.
People told us of regular health care visits. They said any changes in health were managed in a timely manner.
Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) which meant they were working within the law to support people who may lack capacity to make their own decisions.
Staff had been trained and had the skills and knowledge to provide support to the people they cared for. A relative said of the staff team, “They are an excellent care team – extremely competent”.
Staff took into account people’s individual needs and were person centred in their approach. They were proactive in making sure that people were able to keep relationships that mattered to them.
There were procedures in place to monitor the quality of the service. Any issues found on audits were quickly acted upon and any lessons learnt to improve the service going forward.