Four Acres

Updated 30 June 2022

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 Health and Social Care Act 2008.

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

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Four Acres is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Four Acres is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service such as Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

The provider was in the process of completing their provider information return (PIR) at the time of our inspection visit. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We spoke with 10 members of staff including the registered manager, the deputy manager, two care team leaders, four care assistants, the chef and a member of the housekeeping team. We spoke with one visiting professional, seven people and nine relatives to gather their experiences of the care provided. We carried out observations of care to understand the experiences of people who could not talk with us.

We reviewed four people's care records and eight people's medicines records. We looked at a sample of records relating to management of the service including health and safety checks, accident and incident records and two staff files relating to recruitment.

Updated 30 June 2022

About the service

Four Acres is a purpose-built residential home registered to provide accommodation and personal care for up to 67 people, including people living with dementia. At the time of our inspection visit there were 55 people living at the home. Care is provided across two floors. Communal lounge and dining areas were located on both floors. People’s bedrooms were en-suite and there were further communal bathroom facilities located on each floor.

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

Improvements had been made to ensure staff had the guidance they needed to minimise people's identified risks and support them at times of anxiety or distress. Information was shared with staff, so they understood the support people required to keep them safe. Staff understood their responsibility to report any concerns about people’s health and well-being.

On the day of our inspection there were enough staff available to maintain people’s safety and respond to their requests for support. Staff received regular training and support and told us managers were available to give guidance when needed.

Staff worked with other professionals to ensure people's health needs were met effectively and in a timely manner and supported people to maintain a healthy diet. Medicines were stored, managed and administered in line with good practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Improvements had been made in governance systems. The registered manager’s approach to governance ensured people’s experience of living in the home was central to assuring the quality of care provided. Learning from incidents was shared with staff to prevent reoccurrence and generate improvements within the home.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 28 June 2021).

At our last inspection we found a breach of the regulations in relation to good governance of the service. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was now meeting this regulation.

Why we inspected

We carried out an unannounced focused inspection of this service on 25 May 2021. A breach of legal requirements was found in relation to Good Governance. This inspection was prompted by a review of the information we held about this service and to check if the provider had made improvements and were now meeting the legal requirements.

This report only covers our findings in relation to the key questions Safe, Effective and Well-led. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Four Acres on our website at www.cqc.org.uk.

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 that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect