CQC report explained · a residential care home
What the CQC found at Acorn Hove
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were enough staff and people were supported safely, but recruitment checks were incomplete. Medicines and incident monitoring also needed improvement.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward, but that rating is not stated in this report.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward, but that rating is not stated in this report.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward, but that rating is not stated in this report.
- Well-led?
- Requires improvement
- Quality checks, records and provider oversight were not reliable enough. Some known problems were not followed up or fully resolved.
What inspectors found, April 2023
Acorn Hove is rated Requires Improvement; inspectors found kind, person-centred care but unsafe recruitment and weak oversight.
This was an unannounced, focused inspection on 15 February 2023. Inspectors looked mainly at Safe and Well-led, including infection control. They reviewed care, medicines, recruitment and management records, observed care, and spoke with people and staff.
People were generally happy and felt safe. There were enough staff, and staff knew people well. Care was tailored to people's wishes, and people were supported to make choices, stay independent and take part in activities.
However, some important safety and management systems were not reliable. Recruitment checks were missing, care plans and incident records were not always reviewed properly, and audits did not consistently lead to action. The overall rating fell from Good at the previous inspection to Requires Improvement.
Enough staff
Inspectors saw staff meeting people's needs promptly and without rushing. Staff also supported activities that mattered to people.
“There were enough staff to meet people's needs.” from the report
Personalised support
People received care suited to their wishes and were supported to make choices, remain independent and take positive risks.
“People were supported in the way they wished and received care tailored to them to enhance and enrich their lives.” from the report
People felt safe
People said they felt safe and were comfortable with staff. Staff knew people well and understood how to recognise possible abuse.
“I do feel safe here. I like the staff, they are nice.” from the report
Warm relationships
Inspectors saw warm, familiar interactions. People and staff described a positive culture and said the manager was approachable.
“There was a positive staff culture which achieved good outcomes for people and staff worked in partnership with others.” from the report
Recruitment checks
seriousSome staff files were missing references, parts of application forms and full employment histories. The report says this could mean unsuitable staff were employed.
“Staff recruitment processes were not always conducted safely, this included missing reference checks, gaps in applications forms and a lack of full employment history.” from the report
Weak quality oversight
seriousAudits did not always identify problems or make sure they were fixed. There was no registered manager, and provider oversight was lacking.
“The failure to operate effective systems to assess, monitor and improve the quality and safety of the services was a breach of Regulation 17” from the report
Care plans not kept current
needs fixingPeople had individual care plans, but some had not been reviewed for several months. Updates identified by the manager were still incomplete.
“People had their own individualised care plans in place, but they had not been reviewed for several months.” from the report
Incidents not fully reviewed
needs fixingAccidents and incidents were recorded, but there was not enough oversight to identify patterns or learning. This could mean missed opportunities to prevent problems happening again.
“The system to record, analyse and learn from incidents was not implemented effectively.” from the report
As-required medicines
needs fixingProtocols for as-required medicines were not detailed or personalised enough. Staff did not have clear guidance on when a person might need them.
“Medicines were not always safely managed. The protocols for as required medicines (PRNs) were not detailed or individualised to people.” from the report
- 01Have all staff recruitment files now got the required references, complete application forms and full employment histories?
- 02How often are each person's care plans reviewed, and how do you check that updates are completed?
- 03How are accidents and incidents now reviewed for patterns, and how are lessons recorded and acted on?
- 04What written guidance is now in place for each person's as-required medicines?
- 05Has a registered manager been appointed, and how does the provider now check that audits and action plans are completed?
This was a focused inspection of Safe and Well-led, including infection control; the other ratings were carried over from the previous inspection in 2018. This explanation was written from the published report of 6 April 2023 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, June 2018
Rated Good; inspectors found safe, kind and responsive care, with one recommendation about accessible information.
The CQC made a comprehensive, unannounced inspection visit on 24 April 2018. Inspectors observed care, spoke with people, a relative and staff, and checked care plans, staff files, training records and other documents.
The home was caring for 11 people and could accommodate up to 12. Inspectors found that people felt safe, staff treated them with kindness and respect, and their individual needs, choices, health care and activities were supported.
Medicines were managed safely at this inspection. This improved on the previous inspection, when there had been concerns about medicines. The home was rated Good in all five areas: safe, effective, caring, responsive and well-led.
The CQC recommended that the home improve its systems, training and procedures for the Accessible Information Standard. This was a recommendation rather than a breach of regulations.
Safe medicines
The home had improved its medicines systems since the previous inspection. Records, storage, administration and audits were found to be safe and appropriate.
“Medicines were managed safely and in accordance with current regulations and guidance.” from the report
Kind and respectful care
People described caring relationships with staff. Inspectors saw friendly, respectful interactions and support that protected dignity.
“People were supported with kindness and compassion.” from the report
Choice and independence
People could choose when to get up, go to bed, eat and spend their day. Staff encouraged people to do things for themselves where possible.
“People were empowered to make their own decisions.” from the report
Individual care
Care plans included people's routines, likes, dislikes, communication needs and support requirements. Staff showed that they knew people well.
“Care plans contained detailed information on the person's likes, dislikes and daily routine with clear guidance for staff on how best to support that individual.” from the report
Supportive management
Staff said managers were approachable and supportive. The home used audits, meetings and feedback to monitor the service.
“Staff said they felt well supported within their roles and described an 'open door' management approach.” from the report
Accessible information training
minorStaff were meeting people's communication needs in practice, but they did not know about the Accessible Information Standard. The provider was asked to put training, policies and procedures in place.
“However, none of the staff at the service were aware of the AIS and no policy, procedures or training around this had been implemented.” from the report
- 01What training have staff completed on the Accessible Information Standard?
- 02How do you record and review each person's communication needs?
- 03How do you check that medicines are given, recorded, stored and audited safely?
- 04How do you make sure staffing levels change when people's needs change?
- 05How are people and their families involved in care plan reviews and decisions about daily life?
This was a comprehensive inspection covering the premises and care provided, with all five ratings assessed. This explanation was written from the published report of 14 June 2018 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 Acorn Hove
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- April 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2018Goodstayed GoodSafe: GoodWell-led: Good
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 14 December 2010.
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.
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46 live-in carers within about an hour of Brighton and Hove
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 £1,020 to £1,280 a week. 37 can care for a couple. 10 years' experience on average.
“Lottie showed incredible patience and empathy, adapting her routine to fit in with Mum's moods. Most importantly, Lottie's cheerful manner helped Mum to get some enjoyment out of life.”
“He was infinitely patient with them and got on very well with us to the extent that we now regard him as a personal friend.”
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.