This was an unannounced inspection which took place on 20 February 2018.

Acorn House is a care home (without nursing) which is registered to provide a service for up to five people with learning disabilities. People had other associated difficulties such as being on the autistic spectrum.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Acorn House accommodates people in a purpose built domestic sized building. The service was run in line with the values that underpin the ‘’registering the right support’’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism can lead as ordinary a life as any citizen.

At the last inspection, on 5 January 2016, the service was rated as good in all domains. This meant that the service was rated as overall good. At this inspection we found the domain of responsive had improved to outstanding. Evidence in other domains continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

The service was exceptionally person centred and responded creatively to people’s diverse, individualised needs and aspirations. Activity programmes were designed to meet people’s individual preferences and choices. Care planning was highly individualised and regularly reviewed which ensured people’s current needs were met and their equality and diversity was respected.

People continued to be protected from all forms of abuse. Staff were trained in safeguarding people and knew what action to take if they identified any concerns. The service identified general health and safety and individual risks. Action was taken to reduce all risks, as much as possible. All aspects of safety were considered and actions were taken to assist people to remain as safe as possible.

People continued to be supported by adequate staffing ratios. Staff were able to meet people’s specific needs, including any relating to diversity, safely. Recruitment systems made sure, that as far as possible, staff recruited were safe and suitable to work with people. People were supported to take their medicines, at the right times and in the right amounts by trained and competent staff.

A well-trained and knowledgeable staff team remained able to offer people effective care. They met people’s diverse needs including their current and changing health and emotional well-being needs. The service worked very closely with health and other professionals to ensure they offered individuals the best care in the most effective and comfortable way.

People continued to be supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The caring, committed and enthusiastic staff team continued to meet people’s needs with kindness and respect. They ensured they promoted people’s privacy and dignity and communicated with them effectively.

The registered manager was experienced, respected and highly thought of. She and the management team ensured the service continued to be well-led. The registered manager and the staff team were committed to ensuring they offered people exceptionally person-centred and responsive care. They continually checked there was no discrimination relating to staff or people in the service. The quality of care the service provided was constantly assessed, reviewed and improved, as necessary.

Further information is in the detailed findi

This was an unannounced inspection which took place on 05 January 2016.

Acorn House is one of eight separate residential care homes within Purley Park Trust Estate. Acorn House is registered to provide care and support for up to five people who have learning disabilities and associated conditions, such as autistic spectrum disorders and behavioural difficulties. There were five people living in the service on the day of the visit. The house is built over two floors. Everyone who lives in the home is able to negotiate stairs safely.

There is a registered manager running the service. 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.

People who live in and visit the service were kept as safe, from harm, as possible. Staff knew how to identify abuse and how to deal with any concerns about people’s safety. Staff understood health and safety matters and followed the relevant policies and procedures which were supplied by the service. The service made sure that risks were identified and action was taken to minimise them, as far as possible. There were enough staff to look after people safely. There was a robust recruitment procedure to ensure, that as far as possible, staff were suitable to work with the people who live in the home. Medicines were given safely by properly qualified staff.

People’s health and well-being needs were met by an efficient and responsive staff team. The service sought advice from and worked with health and other professionals. This ensured people were kept as mentally and physically well as possible, so that they could enjoy their lives.

Peoples’ human and civil rights were understood, and upheld by the staff and registered manager of the service. The service understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who may not have capacity to do so. People were supported to make as many decisions and have as much control over their lives as they were able to.

People’s care was provided by kind, caring and committed staff who knew people and their needs well. People’s needs were met by an attentive, knowledgeable staff team who were very responsive to changes in people’s requirements and wishes. Individualised care planning ensured people’s equality and diversity was respected. People were provided with a variety of activities, according to their needs, abilities and preferences.

People’s care was effectively overseen by a registered manager and management team who listened and responded to them and others. The culture of the home was described as open and positive. The registered manager was highly thought of. The quality of care the service provided was continually improved.

We were welcomed into the house. We met and spoke with all five of the people living in Acorn House. We also spoke with four members of staff.

People were offered choices and encouraged to make decisions. They appeared happy and relaxed and we saw that they were spoken to with respect.

The care and support that we observed reflected the guidance in the support plans. People told us that they “really liked the staff” and that “they look after me well.” One person told us how much they had enjoyed their shopping trip and lunch out with a member of staff. We saw that staff members knew the people living in Acorn House well.

The care plans gave staff guidance on how to support people in each aspect of their life. Staff told us they found them clear and concise. We were also told how they were enjoying working with the new format care plan.

People were protected from the risk of inadequate nutrition. They were involved in choosing their meals and drinks. Staff supported them to make healthy choices.

Medications were ordered, handled and stored appropriately. There were processes in place to ensure they were safely administered.

Records were accurate. They were held securely and destroyed in line with policy.

We met with all four of the people living in Acorn House. They welcomed us into their house and spent some time talking with us. The house had a friendly relaxed atmosphere. We spoke with two people who told us they enjoyed living there. They said that they shared a house with their friends and that the staff were nice.

We saw that staff members involved people living in the house in the decisions that were made. They were also offered opportunities to get involved in activities within the house or to go out if they preferred. We saw that staff respected the decisions that people made.

Staff were aware of the issues of abuse and knew what to do if they suspected that abuse was taking place.

There was a complaints policy, in an appropriate format available to everyone who used the service. People’s comments and concerns were recorded and acted upon.

People told us that they were treated with respect by staff. They told us they were involved in the decisions made about their care and that they had no concerns or worries about the care they received. People said that they were kept fully informed about their care and could approach staff if they were worried or concerned.