This inspection took place on 28 September 2016 and 3 October 2016. The service had last been inspected in 2014 and was compliant in all areas at that time.

Acacia Lodge Care Home (Acacia Lodge) is a 60-bedded residential care home. The home provides care and support across three floors, with one floor supporting people living with dementia and the other two floors providing residential care. All rooms were single occupancy and contained en-suite bathroom facilities. The care home is located in New Moston, Manchester and is close to the motorway network and local amenities. Acacia Lodge is owned by Avery Healthcare Group, a national provider of residential, respite and nursing home care.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Everyone we spoke with told us they felt safe living at Acacia Lodge. All the relatives felt their loved ones were safe living there. Staff knew how to keep people safe and were aware of how and to whom they could report any safeguarding concerns. This meant that staff were aware of how to protect people from risk of harm.

Staff sought consent from people before providing care or support. The ability of people to make decisions was always assessed in line with legal requirements to ensure their liberty was not restricted unlawfully. Decisions were always taken in the best interests of people when necessary and applications were made for Deprivation of Liberty Safeguards appropriately.

Risk assessments were up to date. Care plans were written in consultation with the person or their families. People had been supported to be involved in identifying their support needs. Assessments included people’s likes and preferences and staff knew the people well.

People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the needs of the people and had received appropriate training in order for them to meet people’s needs. The recruitment process was robust and all required checks were in place prior to staff commencing work. People living at Acacia Lodge were involved in the recruitment process which showed the service was taking their view into consideration.

People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the needs of the people and had received appropriate training in order for them to meet people’s needs. The recruitment process was robust and all required checks were in place prior to staff commencing work. People living at Acacia Lodge were involved in the recruitment process which showed the service was taking their view into consideration.

Medicines were administered, stored and disposed of safely and in line with the required guidelines. There were appropriate guidance and protocols for staff when people needed ‘as required’ medicine.

Staff were observed as being kind and caring, and treated people with dignity and respect. There was an open, trusting relationship between the people and staff.

We saw people were fully supported to attend activities within the home. People had access to lots of different activities and were able to make choices about how they spent their time and where they went each day.

We saw people and their relatives had been asked for feedback about the service they received. There was a record of what actions had been taken to address any identified concerns. Staff worked well as a team; we saw them communicating with each other in a respectful and calm manner. There was an open and transparent culture which was promoted amongst the staff team.

Everyone knew who the registered manager was and felt the service was

People living in Acacia Lodge told us what it was like to live there and some of their comments included,, “I decide what time I get up, go to bed and how I spend my day. All the staff respect this and encourage me to make these choices.” Another person told us, “My health has greatly improved since I came to live here.”

We observed how people were cared for and saw that they were looked after in accordance with their care plans.

We found that people felt safe living in the home.

We found that enough skilled and experienced staff were being employed to meet the assessed needs of those people using the service.

Records, including care plans and risk assessments were found to be up to date and were being reviewed on a regular basis.

At the last inspection visit it was judged that the home was not meeting the requirements of the regulations in relation to consent arrangements and record keeping. At this visit to the service we found the home was meeting the regulations in relation to consent arrangements, care and welfare, safeguarding, supporting staff and record keeping.

We used a number of different methods to help us understand the experiences of people using the service, including observing care and speaking to those people who could give their views on the home. We spoke with several people who lived in the home about their care and treatment. We also spoke with two sets of relatives of people who lived at the home. All the people we spoke with were very positive about the care they received. One person who used the service told us: This is the cleanest place you can find and I’ve never heard staff turn anybody down". Another said of staff that work in the home: "They’re there if I need help". A third person said: "I can’t fault it. We’re absolutely delighted with it... I didn’t think it would be like this. There is lots of things to do" .

We found that the home was meeting the essential standards and people were well cared for.

We completed this compliance review in response to concerns raised by our partner agencies including the local authority following safeguarding allegations concerning the home. The issues which arose from these allegations led us to look at specific outcomes and whether the home had made changes in light of the issues raised.

We spoke with several people who lived in the home and one relative of a person who lived at the home about the care provided. All the people we spoke with were very positive about the care they or their relatives received. One person who used the service told us: "We do different things every day". Another said:“They’d have a job to better it” and a third person said: “I don’t know anyone that comes here and doesn’t like it”. One relative stated: "We’ve been really pleased…They do quite pleasant things [referring to activities] …I’ve never had to complain". People confirmed that the home sought the views of people in the home and their relatives.

We found that the home was meeting the regulations in relation to care and welfare, nutrition, safeguarding, staffing and quality assurance. We judged that they were not meeting the requirements of the regulations in relation to consent arrangements and record keeping. We judged that this had (or may have had) a moderate impact on people using the service. Due to the action that the provider had already taken and previous evidence of action to make improvements, we have set compliance actions.