Two Acres Care Home

Updated 3 July 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of three adult social care inspectors, a pharmacist

inspector, a nurse specialist advisor, and two experts-by-experience. An expert-by-experience is a

person who has personal experience of using or caring for someone who uses this type of service.

Service and service type:

Two Acres Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Two Acres Care Home Care accommodates up to 115 people across four separate buildings. At the time of our site visit a registered manager was not in post. The current manager had taken up the post in November 2018 and had submitted an application to register with CQC. They become registered shortly after our inspection visit. It is important for a manager to be registered with CQC so they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced on the first day. The provider and manager were informed we were to return on 17 April 2019.

What we did:

We reviewed information we had received about the service since they were registered. This included details about incidents the provider must notify us about, such as abuse. We sought feedback from the local authority and other professionals who work with the service. We assessed the information we require providers to send us at least once annually 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 we spoke with seven people and six relatives to ask about their experiences of the care provided. Not all people in the service were able to provide detailed verbal feedback. We also observed the support staff provided. We spoke with 14 members of care staff. This included; two care assistants, one senior care assistant, two team leaders, one apprentice, two nurses, two clinical leads, a unit manager, the training co-ordinator, the manager, the company secretary, and the director. We also spoke with two professionals visiting the service.

We reviewed a range of records. This included 13 people's care records and 18 people’s medicine records. We also looked at three staff files, records relating to training and supervision of staff, and records relating to the management of the service.

Following our site visit we reviewed additional information we had requested the registered manager send to us.

Updated 3 July 2019

About the service: Two Acres Care Home is a residential home that provides personal and nursing care for up to 115 people aged 65 and over. Accommodation is provided in four separate buildings on the site. At the time of our inspection 61 people were living there and one of the four units was closed.

People’s experience of using this service:

This service has been in special measures. Services that are in special measures are kept under review and inspected again within six months. We expect services to make significant improvements within this time frame. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of special measures.

Some improvements were still required to records, quality monitoring systems and health and safety checks, however overall, we found significant improvements to the quality of the care provided.

The provider had implemented a number of wide-ranging changes across the service which had improved the quality of the care provided. These included changes to the management team, the introduction of an electronic care management system, an increase in staffing levels, a reduction in the use of agency staff, and changes to the quality monitoring processes in the home.

People using the service were safe. Risks to people were monitored and responded to. Systems to safeguard people were in place and concerns were reported appropriately.

Staffing levels in the home had been increased and people were supported by staff who knew them well.

Regular audits of medicines were made and improvements had been made regarding their management and administration.

Improvements in how people were supported at meal times had been made. People had choices in relation to the meals on offer and were more involved in discussions regarding food options.

Staff sought people’s consent regarding the care provided and their ability to make individual decisions was assessed and recorded.

Positive outcomes were achieved for people through staff working effectively with others.

There was good training and support for staff to help them understand and meet the individual needs of people using the service. This included regular competency checks and observations of staff practice.

The provider had implemented a programme of refurbishment across the home. Environmental improvements had been made. The design and decoration of the building met people’s needs.

Staff were kind, caring, and supported people’s dignity and independence.

Systems had been improved to ensure people and relatives were engaged and involved regarding decisions about their care and support.

Improvements had been made to people’s care plans and their involvement in them. The care provided met people’s individual preferences and needs, this included in relation to the provision of activities.

Positive comments were received regarding the manager, their openness, and their proactive approach. Improvements had been made to the involvement of people, relatives, and staff in the running of the service. People and relatives felt listened to and staff morale had improved.

Rating at last inspection: Inadequate; published 22 November 2018.

Why we inspected: This was a planned inspection based on the rating of the service at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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