CQC report explained · a residential care home
What the CQC found at 8 Acres
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2022
8 Acres is rated Requires Improvement; inspectors found progress since an Inadequate rating, but medicines, health risks and management oversight remained unsafe.
This was an unannounced follow-up inspection in November 2021. Three inspectors visited for one day, including a medicines inspector. They spoke with people, relatives, staff and professionals, observed care, checked the home and reviewed records.
The rating improved from Inadequate to Requires Improvement. The home was no longer in Special Measures. However, all five areas were rated Requires Improvement, meaning inspectors found some improvements but could not yet be assured that care was consistently safe, effective, kind, responsive or well managed.
Inspectors found repeated medicines errors and problems managing health risks, including epilepsy, weight loss and delayed medical attention. Staffing continuity, activities, communication and records were also not reliable. The home had improved its buildings, safeguarding arrangements and some management systems, but changes were not yet firmly established.
Improved accommodation
Inspectors found major improvements to people's accommodation and the wider site. Refurbishment and redevelopment work was well underway.
“Vast improvement had been made in terms of people's accommodation and the site in general which was being refurbished and remodelled.” from the report
Safeguarding systems
The home had improved how it identified, reported and reviewed safeguarding concerns. Staff understood safeguarding and knew how to raise concerns.
“We were confident this had improved, and the service reported and reviewed safeguarding concerns.” from the report
Mental capacity work
Inspectors found improvements in mental capacity assessments and the tracking of authorisations. Assessments were linked to individual decisions and kept under review.
“Mental capacity assessments had been developed for each decision and were kept under review to ensure people were consulted and consent was sought as appropriate.” from the report
New staff support
New staff said their induction was good. Basic training was completed before their first shift, and new staff were supervised and given a mentor.
“Basic training was completed before the first shift and new staff were supervised and allocated a mentor as a point of contact.” from the report
Medicines safety
seriousMedicines were not always stored, prepared or given safely. Inspectors found repeated errors and missing or unclear information, creating a risk of harm.
“People did not always receive their medicines safety or as prescribed which place them at risk of harm.” from the report
Health risks and epilepsy
seriousRecords and actions relating to weight, fluids and epilepsy were not reliable. Inspectors described incidents where people did not receive prompt or appropriate help.
“These incidents put people at risk of avoidable harm.” from the report
Staff continuity
needs fixingVacancies and agency use meant people were not always supported by staff who knew their needs, communication methods or preferences. Some people did not know who would support them until the day began.
“High staff vacancy rates and high use of agency staff meant people did not always receive continuity of support” from the report
Activities and independence
needs fixingPeople did not always have enough meaningful activities or support to develop life skills. Activities depended on staffing, transport and commissioned hours, with limited evidence of their benefit.
“People were not fully supported to develop important life skills.” from the report
Weak oversight and records
seriousManagement oversight had improved but was not dependable. Records, handovers, night audits and learning from medicines errors were still incomplete or inconsistent.
“Governance and oversight of the service had improved but we were concerned that changes were not firmly embedded, and communication was not effective.” from the report
- 01What changes have been made to prevent medicines errors, including errors involving epilepsy medicines and rescue medication?
- 02How will you make sure staff know each person's communication methods, health risks, preferences and required level of supervision?
- 03How do you now monitor weights, fluid intake, nutrition and requests for medical help?
- 04How are you providing regular meaningful activities and support with life skills when staffing or transport is limited?
- 05What evidence can you show that night audits, handovers, care records and management checks are now completed reliably?
This was an unannounced one-day follow-up inspection covering all five key questions, with particular follow-up of earlier concerns and infection prevention and control. This explanation was written from the published report of 2 March 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2020
Rated Requires Improvement; inspectors found serious weaknesses in safety, staffing, personalised care and management after the service changed from Good.
This was an unannounced inspection on 20 and 24 February 2020. Inspectors looked around the site, spoke with staff, people who used the service, relatives and health professionals, observed care, and reviewed care plans and other records.
The home had been rated Good in September 2017. Since then, there had been changes to the company and several managers, staff turnover, vacancies, sickness and increased use of agency staff. Inspectors found that these changes had caused instability and had not been communicated or managed well.
All five areas were rated Requires Improvement. Inspectors found risks that were not always managed properly, gaps in medicines checks, late or unsuitable staffing, poor follow-through on professional advice, restrictions that were not always lawful or least restrictive, and care that was not consistently personalised.
The new area manager had taken immediate action after concerns were raised and had produced a detailed action plan. However, the report identified breaches of regulation and said CQC would continue to monitor the home until a re-inspection.
Some staff knew people well
Regular staff were described as caring and reliable. A core team appeared to support people with complex health needs effectively.
“A team of regular care staff supported people with complex health care needs, and this appeared to be working well.” from the report
Support with health care
Most people were supported to access the health services they needed. Relatives said regular staff noticed when people were unwell and helped with appointments and hospital stays.
“Relatives said regular staff knew their family members well and were quick to identify when they were unwell and supported them with hospital stays and health care appointments.” from the report
Community activities
People went out regularly and were supported to attend activities, community events and maintain family contact.
“People were out a lot and attended lots of different activities, community events and supported to maintain contact with family.” from the report
Immediate management response
The area manager acted immediately after inspectors raised concerns and later provided a detailed action plan.
“They have subsequently provided us with a robust action plan.” from the report
Risks and emergency planning
seriousInspectors found potholes, flooding, poor lighting and weak emergency arrangements. Senior staff could not identify the fire marshals or first aiders for the day.
“The environment was an open site and there were a number of hazards, potholes, flooding, poor lighting and poor contingency planning should there be an emergency.” from the report
Medicines safety
seriousNot all staff had current medicines training or annual competency checks. Records also had stock and storage gaps, and there was not enough oversight of medicines used for anxiety.
“We found however not all staff had up to date training and their medicines competency had not been checked annually.” from the report
Staffing and training
seriousStaff vacancies, sickness and agency use affected continuity. Some agency staff did not have the training needed for epilepsy or behaviours that could challenge.
“Agency staff were being used to cover staff vacancies and staff sickness.” from the report
Consent and restrictions
seriousMental capacity assessments were not decision-specific or regularly reviewed. Some locked doors and other restrictions were not shown to be necessary or least restrictive.
“The environment and practices around access were not always the least restrictive.” from the report
Personalised care and communication
needs fixingPeople did not always have enough choice about their support or daily routines. Information from professional guidance was not always included in communication plans or followed in practice.
“The care and support was not always sufficiently personalised.” from the report
Weak oversight and incident reporting
seriousSafeguarding concerns and other incidents were not always reported promptly or investigated thoroughly. Records did not consistently show what action had been taken or what had been learned.
“There had been insufficient oversight of incidents and a lack of reporting meant other agencies had not had the opportunity to investigate.” from the report
- 01How many permanent staff now support each person, and how often are agency staff used?
- 02Have all staff who give medicines had their training and competency checked within the required timescale?
- 03What has been done about the potholes, flooding, lighting and emergency arrangements identified by inspectors?
- 04How are mental capacity assessments, Deprivation of Liberty Safeguards and locked doors reviewed to ensure restrictions are lawful and least restrictive?
- 05What specific goals are now recorded for each person’s independence, communication, daily choices and progress?
This was an unannounced planned inspection covering all five key questions and both the premises and care; the previous Good rating from 2017 had deteriorated to Requires Improvement in every area. This explanation was written from the published report of 26 March 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 8 Acres
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- March 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- May 2012
Registered with the Care Quality Commission on 21 May 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
13 live-in carers within about an hour of Norfolk
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.