Acorn Park Lodge

Updated 1 July 2023

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

Two inspectors and one expert by experience completed the inspection.

Service and service type

Acorn Park Lodge 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. Acorn Park Lodge 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager was in post and was planning to submit an application to register.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 20 January 2023 and we visited the service on this date. Inspection activity ended on 2 February 2023. Following feedback to the service on 9 February 2023, the provider requested the opportunity to submit further evidence, which was also reviewed by the inspectors.

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. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

Most people living at the service were not able to share their views verbally, so we observed how they spent their time and how they interacted with staff. We spoke with 3 people, 7 staff members including the manager and deputy manager, and a healthcare professional. We reviewed 3 people’s care records, 2 people’s medicines records and a range of records related to the management of the service, such as meeting minutes and audits. We spoke with 6 relatives by phone.

Updated 1 July 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

About the service

Acorn Park Lodge is a residential care home providing personal care to up to 9 people. The service provides support to people with a learning disability and / autism. At the time of our inspection there were 8 people using the service.

Right Support:

The model of care did not maximise people’s choice, control and independence. The care model did not consistently focus on people’s strengths or promote what they could do. This meant people did not have fulfilling and meaningful everyday lives. Limited information was available about people’s aspirations and goals and how staff could support them to achieve these. Staff did not ensure people received an interactive and stimulating service.

The environment appeared to be clean but there were limited records to evidence when the service was cleaned. Maintenance tasks had not been undertaken in a timely way.

Medicines were not always administered as prescribed or recorded accurately. Actions to improve medicines safety had not stopped medicines errors occurring.

People were not consistently supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support good practice.

People could access specialist health and social care support according to their needs but healthcare professionals raised concerns about accuracy of records, availability of equipment and consistency of staff available.

Right Care:

Staff had received safeguarding training but had not always raised concerns promptly.

Staff were caring but did not always treat people with dignity or respect.

Individualised communication tools had not been used to empower people to have control over their service.

People’s care plans reflected their range of interests, but these were not always provided for. This limited their wellbeing and enjoyment of life.

Staff training was not all up to date. Systems to ensure there were always staff available with the correct training and skills to keep people safe, had not been used effectively. Relatives did not think there were always enough staff available.

People’s records contained information about how they liked to spend their time. We were told that people were supported to do more but records and our observations showed people were not supported on a daily basis to undertake activities or pursue interests that were tailored to them.

People’s care plans and risk assessments did not include information about all risks relating to people’s needs. Information about people’s needs was not always shared across all documents.

Right Culture:

The service did not reflect best practice. Not all areas for improvement had been identified. When areas requiring improvement had been identified, action had not always been taken. When action had been taken, this had not always been embedded into practice.

People did not lead confident, inclusive and empowered lives. Staff were not always proactive in supporting people to live a quality life of their choosing and did not consistently follow best practice.

The lack of permanent staff at the service affected the quality of care people received.

Relatives and staff raised concerns about the lack of support from senior managers.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 May 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. The service is now rated inadequate. This service has been rated below good for the last 3 consecutive inspections.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 20 May 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and the governance of the service.

We planned to undertake a focused inspection of the service covering the Key Questions Safe, Effective and Well-led, to check they had followed their action plan and to confirm they now met legal requirements. As a result of information gathered during the inspection process, we decided to also inspect the Key Questions Caring and Responsive.

The overall rating for the service has changed to inadequate. 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 Acorn Park Lodge on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to person centred care, staffing, safe care and treatment and the governance of the service.

We required the service to report to us on a monthly basis detailing the improvements they are making to the service.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.