This unannounced inspection took place on 20 and 22 February 2018.

Acorn Manor is a residential care home for nine people, including two flats for adults with autism, learning disabilities and challenging behaviour. At the time of our inspection there were seven people living at the home.

Acorn Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed 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 using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

Acorn Manor offered people a service which was highly personalised and took into account people's complex needs due to their autism. Staff were exceptionally skilled at working with people in the least restrictive way to promote their rights and empower them to live fulfilling lives.

The service ensured people led meaningful and fulfilled lives. This was because activities formed an extremely important part of people’s lives.

The service provided safe care to people. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service.

People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

There were effective staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development.

A number of methods were used to assess the quality and safety of the service people received and made continuous improvements in response to their findings.

At the time of our inspection there were seven people living at Acorn Manor. We spent time with four people and spoke five members of the care team, the registered manager and deputy. Everyone we communicated with indicated that they were happy at the home. People told us they ‘felt better’ and ‘felt safe’.

We observed how each person had a full and active schedule of activates every day. Activities had been risk assessed and appropriate staffing arranged so that individuals could fully participate. We saw that people were encouraged and supported to be as independent as possible with the support of staff.

We found there were high ratios of staffing at the home due to people's needs, and that staff worked closely with people throughout the day. We saw that people were respected and given choice. People knew the staff well and were relaxed in their company. Staff listened to what people said and gave them time to respond. People were observed to interact confidently with staff and were at ease in their company. We observed and listened to how staff worked with people at the home and found that staff were aware of the different ways that individuals expressed their feelings.

We examined the home's policies and procedures on safeguarding and recognising abuse. We saw that there were procedures in place if abuse were suspected. Records and care files were examined which we found were up to date and accurate.

We found that staff received training and support which enabled them to meet the needs of people who lived at the home. Staff told us they ’really enjoyed’ their job, and ‘loved working’ with the people. One person told us there were ‘fantastic training opportunities’ and another that they received ‘lots of support’.

The provider had quality assurance systems in place which ensured people were safe and changes could be made to improve the care provided. The complaints policy was displayed at various points throughout the home in symbol format. People were able to make clear who they would communicate with if they had any concern.

The home worked closely with other professionals which meant arrangements were in place for advice and guidance in meeting people's needs.

On the day of our visit we were told that there were seven people living at Acorn Manor. We spoke to four people living at the home, spent time observing the care people were receiving, spoke to four members of staff, which included the registered manager and looked at three people’s care files in detail.

Before people received any care or treatment they were asked for their consent and staff acted in accordance with their wishes. Throughout our visit we saw staff involving people in their care.

We spent time talking to people who lived at Acorn Manor and observing the interactions between them and staff. Comments included: “I like living at Acorn Manor”, “The staff are nice and I feel happy here”, “I go out shopping and for walks” and “I am going to the GP surgery this afternoon for a medication check up.” During our visit, we saw that people appeared relaxed and contented.

Medicines were safely administered. We saw the medication recording records which were appropriately signed by staff when administering a person’s medication.

People we spoke to said that staff were supportive and helpful. Staff knew how to respond to specific health and social care needs and were observed to be competent with such. Staff were able to speak confidently about the care practices they delivered and understood how they contributed to people’s health and wellbeing.

People were made aware of the complaints system. This was provided in a format that met their needs.

We carried out a review with an inspection to Acorn Manor on

20 December 2011 and we looked at the key outcomes 1, 4, 7, 13 and 16. The purpose of this review was to check compliance in these key outcome groups for people currently living in the home.

We looked at the records of two people in detail; and where possible we spoke to the individual and or their carer. Some people have communication difficulties, so we spent time observing how their needs are met. We also spoke to a professional about people’s experiences of care and support at Acorn Manor.

People were treated as individuals in a respectful way, for example we were told “this is the only place I’ve lived where I have choice”. Acorn Manor was well set up to help people with limited verbal skills to communicate in different ways through pictures and facial gestures for example.

People were supported to be actively involved in the community where they lived and lead busy lives.

Professionals said that Acorn Manor was a well run home, where people had a very good quality of life and their health had improved.

This unannounced inspection took place on 21 October 2015. We returned on 22 October 2015 as arranged with the registered manager to complete the inspection.

Acorn Manor is a nine bedded residential care home including two independent living flats for adults with autism, learning disabilities and challenging behaviour.

There was a registered manager in post. 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 felt safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. They were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were strong, caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

There were effective staff recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately. Staff spoke positively about communication and how the registered managers worked well with them, encouraged team working and an open culture.

A number of effective methods were used to assess the quality and safety of the service people received.