We carried out an unannounced comprehensive inspection on 26 June and 3 July 2018. Acacia Lodge is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Acacia Lodge is registered to provide accommodation for up to 32 people who require personal care. The home also provides a respite service. The service supports older people, many of whom have dementia. There were 28 people living at the home at the time of our inspection.

We last inspected this service on 11 July 2016 and the service was rated good. Since the last inspection there has been a change in the provider’s company name. This means the home has been registered as a new service but there is a clear link between the old location and provider and the one currently registered.

There was a registered manager at the service, who was on leave at the time of the inspection. The service manager was providing day to day management of the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People told us they felt safe and enjoyed living at the service and we saw staff were kind and caring.

We found a number of issues with fire safety including one fire exit door which had the key pad code changed but not all staff knew the new code to enable a quick exit. This issue was resolved subsequent to the inspection.

We found there were comprehensive care plans and risk assessments in place for people living at the service. People received good quality care.

The service was clean throughout, and staff used effective controls to minimise the spread of infection.

We could see quality audits took place on a regular basis. However, we found the service did not always ensure all building related matters were safely managed. We also found the service had recently moved people to different rooms without the necessary consultation and impact assessments taking place.

Staff knew how to recognise and report any concerns or allegations of abuse and described what action they would take to protect people against harm. The service was not always recording accidents and incidents thoroughly. The service have updated their processes subsequent to the inspection.

Whilst the majority of safety checks had taken place related to the building and facilities, for example, fire safety equipment and hoists. We found the gas cooker had not been serviced annually to ensure it was functioning safely since installation in 2016. Subsequent to the inspection this has now taken place.

All necessary checks took place prior to staff starting work; so staff were considered safe to work with vulnerable adults. We found staff were not rushed when providing care, but we have asked for staffing levels to be reviewed to accommodate all safety concerns around people who have behaviours that challenge, and the risk they pose to other people.

Medicines were safely stored and administered, and people told us they received medicines on time.

Staff undertook training in key areas and supervision and appraisal took place regularly. Staff told us they felt supported and enjoyed working as part of the team.

The service had been awarded five stars for food hygiene, and people told us they enjoyed the food.

We found a breach of the regulations related to safe care and treatment of people due to poor fire safety at the premises. We have made a recommendation in relation to staffing levels.