The unannounced Inspection took place on the 7 February 2017.

Acorn House provides accommodation and support for up to six persons who have learning disabilities and other associated needs. There is safe access to a communal garden and homely communal rooms are situated on the ground floor.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good. The service people received was in accordance with fundamental standards of care.

The service was safe. Staff demonstrated good knowledge of how to keep people safe. Management responded to and appropriately managed safeguarding concerns. Recruitment procedures were robust to ensure staff suitability for their role and appropriate checks were completed. A recruitment drive was underway to ensure staffing levels remained sufficient to meet people’s needs within the service and out in the community. People’s individual needs were assessed, risks were identified and minimised with effective support plans in place. Medicines were stored, administered and managed safely.

The service was effective. Management had identified the need to ensure formal supervisions were undertaken regularly and staff refresher training was completed periodically. Plans had been initiated to rectify these matters immediately. The home manager and staff understood the Mental Capacity Act 2005 and how to support people’s independence and to have maximum choice and control of their lives. People were supported to eat and drink enough and maintained balanced lifestyles to meet their preferences. Health care professionals were liaised with in order to manage people’s changes in physical and mental health needs.

The service was caring. Positive relationships had been created within Acorn House. Staff were kind and patient towards people. Support workers understood people well and knew their personal preferences. People told us and we saw that privacy and dignity was respected.

The service was responsive. People and relatives were regularly involved in the planning of support for continued wellbeing. People chose what activities they wished to be supported with to enhance health, wellbeing, independence and social skills. Complaints procedures were in place and made readily available to people.

The service was well led. The service remained well led despite a period of disruption due to changes in management. The home manager felt supported by the provider to strive for improvements for people and staff, which displayed good leadership. The home manager and provider had a visible presence within the service and people, relatives and staff used the open door policy effectively. Quality monitoring systems for the service were in place and the home manager and provider were working together to develop systems to work more effectively within the service. Views of the quality of the service were sought from people, relative’s and health professionals.

Further information is in the detailed findings below.

The unannounced inspection took place on the 14 December 2015.

Acorn House provides accommodation and support for up to six persons who have learning disabilities and other associated needs.

The service is required to and did have 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.

Staff had good knowledge of their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Management applied such measures appropriately.

Effective support was delivered by staff. People’s safety was ensured whilst independence and wellbeing was promoted by the staff providing the care. As part of a robust recruitment process staff were recruited and employed upon completion of appropriate checks. There were sufficient staff to meet people’s individual needs. People’s medicines were managed safely by trained staff.

People had enough to eat and drink and staff understood and met their nutritional needs. Staff and managers ensured access to healthcare services were readily available to people and worked with a range of health professionals to maintain good health of the people.

Privacy and dignity was valued by staff and were observed to be respectful and compassionate towards people. Staff understood their roles in relation to encouraging people’s independence whilst mitigating potential risks. People were provided support in a person centred way by staff who clearly displayed good knowledge of the people they supported. People were helped to identify their own interests and pursue them with the assistance of staff. These person centred activities took place within the service as well as in the community.

The service was well led and ran effectively using quality monitoring audits which the manager and deputy manager carried out to identify any improvements needed. A complaints procedure was in place and had been used appropriately by management. Systems were in place to make sure that people’s views were gathered.

People told us that they had received good information about the care that would be provided for them. They said that the staff treated them well. One person said, “I like the staff, they make me happy." People’s needs had been fully assessed. The care plans were detailed and informative. They included risk assessments and management plans for all areas of identified risks. People told us that they were very happy with the care they received at Acorn House.

People told us that they felt safe. They said that the manager and the staff were very friendly, caring and kind. Staff interaction throughout our inspection visit was good. Staff had been given information and training on safeguarding adults and they showed a good awareness of the procedures.

The provider had good quality assurance processes. Regular audits of the service’s systems and practices had taken place. People received safe, effective and compassionate care from a well-led service that responded quickly to their changing needs.

Each person was noted to have a support plan in place detailing their specific care needs and how they were to be supported by staff. Records showed that people who use the service were supported to maintain their healthcare needs. We saw that staff arranged for people to be seen by their doctor when they became unwell or their medical or mental health condition required a review.

The atmosphere within the service was calm and relaxed and staff interactions with people who live there were noted to be positive. Staff were able to demonstrate a good understanding of people’s care and support needs. We spoke with two people who used the service. They told us that they were happy living at Acorn House and found the care and support to be appropriate and to meet their needs.

Records showed that the provider had an effective recruitment and selection process in place and this involved all relevant checks being carried out prior to the member of staff commencing employment at Acorn House.

One person spoken with who used the service, told us that they felt confident to raise issues with the manager and/or staff and that any concerns would be listened to and acted upon.

Most of the information about people’s experiences was gathered through our observations, during our inspection, of the care provided. Two people we spoke with told us that they were treated well by staff. One person told us that their privacy and dignity was always maintained.

During our visit we were able to hold a conversation with two people and they were able to make comments about specific issues, such as the quality of the meals, whether or not they liked their room, how they spent their day and if they liked staff.

People told us they were happy and liked where they were living. People also told us that the care and support they received was good and that they liked the staff working within the service. People told us that they felt safe and that, if they had any concerns or worries, they would discuss them with a member of staff. One person we spoke with told us that they received the right medication and this was administered in a timely manner.