The inspection was unannounced and took place on 8 December 2016.

Acorn Lodge is registered to provide accommodation and personal care for a maximum of 60 older people, some of whom had a diagnosis of dementia. There were 53 people living at the home on the day of our inspection visit. The home was a purpose built building and comprised of two floors which were accessible by a lift. The first floor was called the “Memory Floor” and supported people with a diagnoses of dementia. On this floor dementia friendly signage was used to help people to access the toilets or their rooms.

The registered manager had recently left their employment at the home following a period of not being at work. During their absence the deputy manager had acted as home manager. Following the registered manager’s resignation, the deputy manager had successfully gained the permanent role of home manager and was in the process of applying to be the 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.

People told us they felt safe and well cared for and staff were able to demonstrate they had sufficient knowledge and skills to carry out their roles effectively and to ensure people who used the service were safe. People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people's safety and shared information so that people's safety needs were met.

People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. There were guidelines in place for people prescribed ‘as required’ medicines to ensure they were given safely and consistently.

There were enough staff to meet people’s needs. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who lived in the home.

The assessment of people's capacity to consent had been completed. People's rights and freedom were respected by staff. Staff understood people's individual care needs and had received training so they would be able to care for people effectively. However, risk assessments did not always contain detailed information about people’s care. There were good links with health and social care professionals and staff sought and acted upon advice received, so people's needs were met.

People and relatives were positive in their feedback about the home. People told us they enjoyed meal times and were positive about the choice of food they received. People said their privacy and dignity was maintained and our observations supported this.

People received care that met their individual needs. People were encouraged to express their views and give feedback about the service. People said staff listened to them and they felt confident they could raise any issues should the need arise. People were positive about the care and support they received and the service as a whole.

Staff spoke highly of the management team and of the teamwork within the service. Staff were supported through supervisions, team meetings and training to provide care and support in line with people’s needs and wishes.

The quality of service provision and care was continually monitored by the manager and the provider and actions taken where required.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by Care Quality Commission (CQC) which looks at the overall quality of the service. This inspection was unannounced.

Acorn Lodge is a residential care home which provides care to people who are older and to people who have dementia. The home offers care to a maximum of 60 people. The building is two storeys. People living with dementia are supported on the second floor of the building.

At the time of our inspection a registered manager was employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People who lived at Acorn Lodge and the staff who supported them, thought people who lived at the home were safe. There were systems and processes in place to protect people from the risk of harm. These included robust recruitment practices, staff training, environmental checks, equipment checks, and building checks.

People told us staff were kind and respectful to them. We observed staff were caring to people throughout the time we inspected the home. We saw staff respected people’s dignity and privacy when providing care. We were satisfied there were sufficient staff on duty to meet people’s needs.

We saw people participated in a well-planned activity programme which included reminiscence sessions. People were supported to undertake individual interests such as crosswords.

We saw staff understood they needed to respect people’s decisions if they had the capacity to make those decisions. Assessments had been made and reviewed about people’s capacity. Where people did not have capacity, decisions were taken in their ‘best interest’. This meant the service was adhering to the Mental Capacity Act 2005.

The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). There was no one living at Acorn Lodge who had been assessed as requiring a DoLS, but we were aware the provider had referred a person to the local authority for their assessment.

We saw people’s health and social care needs were appropriately assessed. Care plans provided accurate and up to date information for staff to help them care for people effectively. Risks associated with people’s care needs were assessed and plans were in place to minimise the risk as far as possible to help keep people safe.

There were effective management systems to monitor and improve the quality of service provided.

During our inspection visit we spoke with six people who lived at Acorn Lodge about the service they received. We also spoke with three visiting family members.

Some people had complex care needs, which meant they might have had difficulty telling us what it was like to live at Acorn Lodge. We therefore also gathered evidence of people's experience of the service by observing the care they received from staff.

People told us they were well cared for and satisfied with the care received. One person said, “I’m very happy. The manager and staff are always asking me if everything is ok.” A visiting family member told us, “The care is outstanding.”

People had a range of assessments and care plans in place that detailed the care and treatment they needed. Records showed people’s health and care needs were monitored and reviewed regularly.

The home was well maintained and decorated to a high standard. One person said, “I love my room, it’s very comfortable.” A visiting family member told us they “couldn’t have asked for a nicer room for their relative.”

Sufficient staff were available with appropriate experience and skills to meet the needs of people who used the service.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager for the service on our register at the time.

We spoke with seven people who used the service, four visiting relatives, a healthcare professional, the manager and six staff.

People told us they liked living at the home. One person said, “It’s very nice here, I would definitely recommend it to anyone.” A visiting family member told us, “I am more than happy with the care. As far as I can tell, everyone is well looked after.”

We saw staff respected people’s privacy and dignity and promoted their independence. Staff gave people reassurance and talked through any care tasks that they were carrying out with the person they were supporting.

We looked at records which stated how people liked and needed to be cared for. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The care staff we spoke with demonstrated an understanding of people's needs.

People told us they felt safe and able to report any concerns they may have. One person told us, “I have nothing to complain about.”

Staff spoken with told us that they were happy working at Acorn Lodge. They said that they had regular meetings with management to monitor their care practices and had access to training which kept their skills up to date.