Acorn Court is a home for up to 86 people. The home was split into four units; each unit had a head of unit managing the team of care staff. The units consisted of the ground floor with people who had an acquired brain injury and nursing needs, with a separate unit for people who had personal care needs only. The first and second floors were for people who had nursing and end of life care needs and some people had a diagnosis of dementia. On the day of our inspection, there were 85 people in the home.

There was 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.

There were sufficient staff to keep people safe. There were recruitment practices in place to ensure that staff were safe to work with people.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

People’s medicines were administered, stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant and accurate records. For people who had ‘as required’ medicine, there were guidelines in place to tell staff when and how to administer them.

Staff had written information about risks to people and how to manage these. Risk assessments were in place for a variety of tasks such as falls and moving and handling. The registered manager ensured that actions had been taken after incidents and accidents occurred to reduce the likely hood of them happening again.

People’s human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 were followed. Where people lacked capacity to make some decisions, mental capacity assessment and best interest meetings had been undertaken, however they lacked details. Staff were heard to ask people’s consent before they provided care

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had sufficient to eat and drink. People were offered a choice of what they would like to eat and drink. People’s weights were monitored on a regular basis to ensure that people remained healthy.

People were supported to maintain their health and well-being. People had regular access to health and social care professionals.

Staff were trained and had sufficient skills and knowledge to support people effectively. Staff received regular supervision and an annual appraisal.

People were well cared for and positive relationships had been established between people and staff. Staff interacted with people in a kind and caring manner.

Relatives and health professionals were involved in planning people’s care. People’s choices and views were respected by staff. Staff and the management knew people’s choices and preferences. People’s privacy and dignity was respected.

People received a personalised service. Care and support was person centred and this was reflected in people’s care plans. Care plans contained information for staff to support people effectively.

There were mixed views about activities. Improvements had been made since the last inspection. There was an activity programme in place, for people who did not like to join in with group activities had 1:1 sessions. The registered manager recognised that further work needed to be done in this area.

The home listened to staff, people and relative’s views. There was a complaints procedure in place. Complaints had been responded to in line with the provider’s complaints procedure.

The management promoted an open

This was an unannounced inspection that took place on 11 February 2016.

Acorn Court Care Home is a nursing home for up to 86 people, with a range of support needs.

The home was split into four units; each unit had a head of unit managing the team of care staff. The units consisted of the ground floor with people who had an acquired brain injury and nursing needs, with a separate unit for people who had personal care needs only. The first and second floors were for people had nursing and end of life care needs and for people with a diagnosis of dementia.

On the day of our inspection there were 84 people living at the home.

The home was run by a registered manager. The registered manager was on annual leave on the day on inspection. ‘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 and associated regulations about how the service is run. The deputy manager oversaw the management of the service in the registered manager’s absence.

Some people’s human rights were affected as the requirements of the Mental Capacity Act 2005 was not always followed. Where people lacked capacity to make some decisions, people did not always have a mental capacity assessment or best interest meeting. Staff were heard to ask people for their permission before they provided care.

Where people’s liberty was needed to be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) and sent of the appropriate referrals to the local authority to ensure the person’s rights were protected.

There were not always enough opportunities for activities for people. Relatives and care staff told us that they felt there should be more activities on offer to people. The activity timetable indicated that one activity occurred daily whilst there was impromptu ‘our organisation makes people happy’ (oomph) session on the afternoon of our visit.

People’s, staff and relative’s views and opinions were sought on a regular basis. There was an annual staff and relatives survey.

People were safe guarded from the risk of abuse because staff had received training in safeguarding adults and were able to evidence to us that they knew the procedures to follow should they have any concerns. They knew of types of abuse and where to find contact numbers for the local safeguarding team if they needed to raise concerns.

Risks to people were managed and staff had knowledge of the risks and knew how to keep people safe. Staff knew how to respond to an accident or incident. The management team had no oversight of incidents and accidents that occurred in the home. Recording certain events such as incidents and accidents means that the manager can identify possible trends, learn from events and appropriately manage high risk situations.

Care was provided to people by a sufficient number of staff who were appropriately trained. Staff were seen to support people to keep them safe.

People were protected by the systems in place to manage medicines. Medicines were administered, disposed of and stored safely. Processes were in place in relation to the correct storage of medicine. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People had enough to eat and drink and was a choice of food and drink. People had access to fluids throughout the day.

People were supported to maintain their health and wellbeing as they were assisted to see health and social care professionals, such as a GP or dietician when required.

Staff treated people with kindness and maintained their dignity and respect. People and their relatives told us that they felt involved in planning their care. Staff knew peoples likes, dislikes and their preferences.

People rece

Some of the people who used the service had dementia or other complex health needs so were not able to tell us about their experiences; our judgements were informed through observation and talking to representatives of people who used the service and staff. We spoke with three people who used the service and with four representatives of people who used the service who told us that they were very happy with the service provided by the home. Comments included “Its lovely here” and “I walk out of here calm in the knowledge that my relative is being looked after really well”. Representatives of people who used the service that we spoke with told us that they had been involved in the planning and reviews of their relatives care plans and were kept informed of any changes to their relatives care or treatment. People told us that they or their relatives were treated with respect and dignity. People we spoke with told us that they felt they or their relatives received nutritious food and were given a choice and they were offered drinks throughout the day.

Staff told us that they enjoyed working at Acorn Court and liked the team atmosphere. They said they felt well supported and would not hesitate to raise concerns. People we spoke with told us that they or their relatives felt safe and secure at Acorn Court and would have no qualms about speaking to the staff or the registered manager if they were concerned about anything.

This inspection was undertaken to look at one outcome area. This was to support the previous inspection that was undertaken on 10 May 2012 which looked at four outcome areas.

We spoke with the registered manager who told us that the service was proactive in dealing with concerns expressed by people who used the service and their representatives. A relatives’ group meeting took place monthly and was run by a relative of a person who used the service. This meeting gave people the opportunity to discuss any concerns or to make suggestions to improve the service with the management of the home.

Information was made available for people who used the service and their representatives on the various ways they could make their views known and to make a complaint if they wished to do so. This information was displayed in and around the home on all floors and also contained in the service user guides.

We spoke with people using the services but their feedback did not relate specifically to the standards we looked at. However, we observed that people were relaxed, comfortable and content in their surroundings and there were sufficient competent and motivated staff on duty to meet their needs.

We spoke to representatives of the people who used the service and they told us they had no concerns about the care and support their relatives received at Acorn Court and they had complete trust in the staff. One representative told us, “The staff are just absolutely lovely and so kind. They really care about the residents. They are very respectful of people’s dignity and privacy.” Another relative told us, “I am very involved in my mother’s care plan and they always call me if something happens or if they do something differently. I wouldn’t have any hesitation in recommending the home to anybody.” People spoke highly of the home’s management team. A relative said, “What I really like about the home is the openness of the manager and senior staff. In fact, they make you feel just as important as the residents and they support you too".