Archived: Six Acres Residential and Supported Accommodation Limited

Six Acres 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. Six Acres a small privately owned care home providing accommodation and support for up to six adults with learning disabilities. The home is a bungalow with six separate bedrooms, shared bathroom and toilet facilities and two communal lounge/dining areas. At the time of our inspection there were two people living at the home.

At our last inspection on 21 December 2016, we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

During the last inspection, although the home was rated as good overall, it was rated as requires improvement in the key question effective, as we identified one breach of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to good governance, specifically that neither nutritional screening nor pressure ulcer risk assessment tools were in place. At this inspection we found the provider had addressed the previous regulatory breach and was now meeting all regulatory requirements.

The service had 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.

People told us they felt safe living at Six Acres. The home had appropriate safeguarding policies and procedures in place. Staff were all trained in safeguarding vulnerable adults and had a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.

Staffing levels were based on the needs of people living at the home and their schedules. Rotas demonstrated enough staff had been deployed to meet people’s needs and accommodate outings or activities.

We saw the home was clean and had appropriate infection control processes in place. The staff carried out all cleaning tasks, following a daily and weekly cleaning rota. All cleaning equipment was stored safely and securely.

Care files contained detailed risk assessments, which were reviewed regularly to reflect changing needs. This helped ensure staff had the information they needed to support people to stay safe and well.

Medicines were stored safely. The home had effective systems in place to ensure medicines were ordered, stored, received and administered appropriately.

Staff received appropriate training, supervision and appraisal to support them in their role. Training completion was monitored via a matrix, to ensure staff remained up to date.

People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible, with the home’s policies and systems supporting this practice.

People were encouraged to make decisions and choices about their care and how they wanted to be supported. People had control over how they spent their time and what activities they completed. People's consent to care and treatment was sought prior to care being delivered.

Both the registered manager and staff we spoke with demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We saw the service was working within the principles of the MCA and had followed the correct procedures when making DoLS applications.

People’s nutrition and hydration needs were being met. Professional guidance for people requiring a modified or special diet was in place and had been followed. People were involved in choosing what meals they ate and when and where they ate them.

Throughout the inspection we observed positive and appropriate interactions between the staff and people who used the service. Staff were seen to be caring and treated people with kindness, dignity and respect.

Care plans contained detailed, personalised information about the people who lived at the home and how they wished to be cared for. Each file contained people’s aims and goals, which were regularly reviewed and updated, to ensure their needs had been met.

The home had a complaints procedure in place and whilst none had been received since the last inspection, people told us they knew how to do so, should they ever need to.

The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Action plans were drawn up, to ensure any issues had been addressed. Feedback of the home was sought from people, relatives and staff and used to drive continued improvement.

Six Acres is a small privately owned care home providing accommodation and support for up to six adults with learning disabilities. The home is a bungalow with six separate bedrooms, shared bathroom and toilet facilities and two communal lounge/dining areas. At the time of our inspection there were three people living at the home.

The home was last inspected on 07 September 2015, when we rated the service as ‘requires improvement’ overall. We identified four breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to medicines, premises and equipment, consent and good governance.

At this inspection we found the service had made improvements in regards to the management of medicines, premises and equipment and consent however identified one breach of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to good governance, specifically that neither nutritional screening nor pressure ulcer risk assessment tools were in place. You can see what actions we told the provider to take at the back of this report.

At the time of the inspection the home had 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.’

We saw that the home was clean and had appropriate infection control processes in place. The staff carried out all cleaning tasks, following a daily and weekly cleaning rota. All cleaning equipment was stored safely and securely.

People we spoke with told us they felt safe. The home had appropriate safeguarding policies and procedures in place. Staff were all trained in safeguarding vulnerable adults and had a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.

Both staff and people living at the home told us enough staff were employed to meet people’s needs. We saw that staffing levels were determined by both the needs and plans of the people using the service, with resources being used flexibly to accommodate outings or activities.

Robust recruitment procedures were in place to ensure staff working at the home met the required standards for working with vulnerable people. This involved everyone having a Disclosure and Baring Service (DBS) check, two references and full work history documented.

Staff reported that they received a good level of training to carry out their role and were encouraged and supported to attend more if required. We saw that all staff completed an induction training programme when they first started and that on-going training was provided to ensure skills and knowledge were up to date.

Staff also told us that they felt supported through completion of supervision meetings and appraisals. Team meetings were also held, which staff were encouraged to attend and contribute towards.

We saw that the home had systems in place for the safe storage, administration and recording of medicines. Medication was kept in a locked cupboard within the office. All necessary documentation was in place and was completed consistently. Staff responsible for administering medicines were trained and had their competency assessed.

We looked at three care plans and two service user files, which contained detailed information about the people who lived at the home and how they wished for staff to support them. The care plans also contained individual risk assessments, which helped to ensure their safety was maintained. We did not see evidence that either a nutritional screening tool such as the malnutrition universal screening tool (MUST) or pressure ulcer risk assessment, such as the Waterlow risk assessment were in place. Whilst no issues with either malnutrition or pressure care had occurred or been identified, due to two people having impaired mobility and one requiring a special diet, these tools would help to assess potential areas of concern and ensure the home was meeting NICE guidelines.

Both the registered manager and staff we spoke to demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We saw the service was working within the principles of the MCA and had followed the correct procedures when making DoLS applications.

Throughout the day we observed positive interactions between the staff and people who used the service. Staff were seen to treat people with kindness, dignity and respect. This was mirrored in the feedback we received from both people who used the service and relatives, who were very complimentary about the standard of care provided.

The home supported people to engage in social and leisure activities of their choice, both within the home and the wider community. Care files captured people’s wishes and interests and we observed these being met during the inspection.

Everyone we spoke to felt that the home was both well led and managed. The manager was reported to be approachable and supportive. Staff told us they enjoyed working at the home.

The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Audits were completed on differing timescales, depending on the area being assessed and covered a wide range of areas including medication, care files, infection control and building maintenance. All audits contained sections for action points.