Archived: Acorn Hill Nursing Home

Updated 10 February 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This site visit was carried out by two inspectors. Phone calls to people’s relatives and staff were undertaken by another two inspectors.

Service and service type

Acorn Hill Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service notice of the inspection just before we entered the home. This supported the service and us to manage any potential risks associated with COVID-19.

What we did before the inspection

We reviewed information we had received about the service since the new company registered the home. We sought feedback from the local authority and used all of this to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three people at the inspection and observed the interactions between people and staff. We reviewed a range of records. This included people’s care records and multiple people’s medicine records. We looked at three staff files in relation to recruitment and a variety of records relating to the management of the service, including audits and regular tests. We asked the registered manager to send documents we were unable to view on the inspection.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We made telephone calls to six relatives and five staff.

Updated 10 February 2021

Acorn Hill Nursing Home is registered to provide accommodation, nursing and personal care to up to 59 people, some of whom are living with dementia and/or have complex physical and mental health needs. At the time of our inspection there were 36 people using the service. The home has recently changed owners and the new company took over in October 2020, since then the Langdale Group have launched an extensive refurbishment and improvement programme.

People’s experience of using this service and what we found

People were not always provided with safe care. There were some medicines that were not managed safely, however, we did not find anyone had been harmed by this. Staff were mostly issued with the correct personal protective equipment, though a small number of staff were not wearing the appropriate type of disposable headwear. The provider took steps to order this following our inspection.

People did not always have their needs re-assessed. That meant we could not be assured the care plans were up to date with the latest guidance for staff. Staff had yet to ensure people’s deprivation of liberty (DoLS) restrictions were applied for or updated, which meant we could not be confident peoples’ liberty was assured. Some people’s needs had not been fully planned for and training had not been put in place for those specific needs.

The service was not always well-led. Leadership and oversight of the service was poorly coordinated and records to support effective quality assurance of the service were not in place. Information in some documents was inconsistent.

Environmental risks were assessed and staff’s awareness to infection control had been heightened. Storage areas for equipment and chemicals had been identified and made more secure.

Staff were recruited safely and employed in sufficient numbers to care for the current people in the home. Staff were supported in their roles and training had been arranged for all staff. Supervisions, appraisals and team meetings were undertaken to ensure staff were informed of changes.

Relatives we spoke with had mixed opinions about the home in relation to communication from the new management team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This is a first rating inspection.

Why we inspected

The inspection was prompted due to the provider request to use part of the home as a designated service. A decision was made for us to inspect and examine any risks.

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 the service can respond to coronavirus and other infection outbreaks effectively.

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this report for details.

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 breaches in relation to people’s safe care and treatment and poor governance. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.