The Acorns is a residential Care Home for up to five younger adults with learning disabilities. Care is provided in a house within a residential area. Some of the bedrooms are accessed by stairs and there is an enclosed garden.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People were supported to stay safe and understood safety measures in place, such as fire procedures. People were actively encouraged to manage their own risks and be independent in their care and support. Systems were clear for managing medicines in the home and staff supported people’s independence where they wished to manage their own medicines.

Staff had regular opportunities to update their skills and professional development. Staff demonstrated an understanding of the impact of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There was a friendly, welcoming atmosphere and people experienced good quality interactions from kind and caring staff who knew each person well.Staff were highly motivated and worked well as a team, with effective support from managers in the organisation.

Care records contained clear information covering all aspects of people’s individualised care and support.People were enabled and empowered to be as independent as possible and they felt able to complain if they were unhappy about any aspect of their care.

There was a clearly defined management structure so that all staff knew their responsibilities. There was an open and transparent culture in which staff felt able to approach managers.

Further information is in the detailed findings below.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found -

Is the service safe?

At this inspection we followed up a compliance action which had been set in relation to appropriate checks not being undertaken prior to staff commencing work. We checked a staff file of the most recently recruited member of staff and this contained all the information required by the Health and Social Care Act. This demonstrated that the staff employed to work at the home were suitable and had the skills and experience needed to support the people living in the home.

We also followed up a compliance action in relation to records not being kept securely and not always being kept up to date. We found significant improvements had been made. Staff understood the importance of confidentiality and ensuring people’s records were kept securely.

Is the service effective?

People told us they were happy with the care provided and said staff understood their needs. It was clear from speaking with staff that they had a good understanding of people’s care and support needs and they knew them well. Staff had received training to meet the needs of the people living at the home.

Is the service caring?

People told us they had things to do. One person said they had cleaned their room and were supported to do their laundry. We saw this person had personalised their room which reflected their tastes and interests and helped to make their room more homely. Another person said: "Staff listen to me.”

Is the service responsive?

People told us they knew who to speak to if they had any concerns. We saw evidence to show people met with their key workers to discuss what was important to them. People had care plans and risk assessments in place which covered their needs. We saw people had access to health services when required. For example, there was evidence people had access to a doctor, an optician and dentist.

Is the service well-led?

We saw evidence the registered manager carried out regular audits on areas such as: care records, staff records, fridge temperature checks, fire tests and cleanliness. The registered manager recorded where action was needed, by whom and when. However, we found where action had been identified as being required, the information recorded within the audits was very limited. This meant it was difficult to establish what led the registered manager to believe action was required.

Five people were living at the home at the time of our inspection. People were independent and able to communicate with us in a clear way. We spoke with three people who were all aware they had a care record and told us they could change things if they wanted. One person told us; “I talk about it [care record] with staff.”

We looked at a sample of two care records and saw overall each person had a care plan and risk assessment which covered their needs. We found there was a good level of detail within the care plans which gave a clear picture of what people’s needs were and how they should be met. However, we did note where one person had a specific need there was not a care plan in place. We also found there were no specific care plans in relation to people’s personal goals. We therefore found people’s personal records were not always accurate and fit for purpose.

We looked at the menu planning which showed choices and variety were offered to people. Staff had received training in nutrition which helped to ensure people were offered a healthy balanced diet. All three people we spoke with were happy with the quality of food and told us they had a choice of food. One person commented; “It’s home cooking.” Another person told us; “I can choose what I want.”

We looked at three staff files and found effective recruitment and selection processes were not in place. We found references from one member of staff’s last known employer had not been obtained. Another member of staff had started work without a Disclosure and Barring Service check, although the person had been working with other staff members. The provider did not carry out appropriate checks before staff began work.

All three people we spoke with knew who to speak with if they were unhappy with staff or their care. People named three members of the management team they could raise any concerns with. One person told us about a complaint they had made a long time ago. They said they had been listened to and their complaint had been resolved.

On the day of our inspection five people occupied the home. We spent time with three people and discussed their views and comments about their life at The Acorns. They told us they would like to be referred to as service users.

People who used the service were given appropriate information and support regarding their care or treatment. One service user said, “I am in charge of my care and the staff here help me where I need support.”

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We were informed by all three service users they were involved in all the decisions about their care and had given staff permission to support them in the way they liked.

People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements. Two people said they were supported by the staff and the house rules they had agreed to abide by helped them to be safe. One service user said, ”I always let the staff know what time I will be returning when I go out.”

The provider had an effective system to regularly assess and monitor the quality of service that people receive. Service users told us from time to time they attended meetings with staff and the manager at the house. They talked about what was good and anything they could change so that they were all able to continue enjoy living at The Acorns.

This inspection took place on 7 and 11 May 2015 and was unannounced.

There was no registered manager at the service. 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. The Acorns is registered to provide accommodation for 5 people.

The environment was very friendly, welcoming and homely.

People told us they felt safe. Staff demonstrated a clear understanding of people’s individual risks and how to maintain people’s safety. Risk assessments were clearly detailed in care plans and people were encouraged to understand their individual risks and how to stay safe.

People received their medications when they needed them.

Staff received training to help them support the people who lived at The Acorns. Staff understood legislation and worked within the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were involved in the running of their home, including helping to plan and prepare meals. People told us they enjoyed the food and had choices in what they ate.

Staff demonstrated a respectful and enabling approach to working with people, promoting their independence in all aspects of their care and support.

Activities were based upon people’s individual preferences and people chose how they wished to spend their time.

The registered provider sought feedback from people, their relatives, staff and visiting professionals in relation to the quality of the service.

You can see what action we told the provider to take at the back of the full version of the report.