This inspection was unannounced and took place on the 3, 4 and 7 December 2018. This was the first comprehensive inspection at this home under a new registration.

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 home is registered to accommodate up to 40 people. At the time of the inspection there were 15 people living at the home.

The home is required to have 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. At the time of this inspection, the home did not have a registered manager. The home had an interim manager in place that would not be registering with the Care Quality Commission. A new manager had been appointed and a start date was awaited.

At this inspection we found breaches of Regulation 12, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Fire safety systems were not followed and a fire risk assessment was not in place. Staff were not recruited safely and had not received training and support in line with best practice guidelines. The registered provider had not identified areas of concern for development and improvement. You can see what action we told the provider to take at the back of the full version of the report.

We made a recommendation that all care plans and risk assessments were reviewed to ensure all information about people and guidance for staff remained up to date.

Staff recruitment systems were not robust and staff files did not always hold up to date references and a DBS. The DBS carry out a criminal record and barring check on individuals who intend to work with children and vulnerable adults, to help employers make safer recruitment decisions. Staff had not all undertaken an induction or completed essential training required for their role. Staff had not consistently received supervision and support. This meant people were supported by staff that may not have the right skills and knowledge for the role.

The registered providers’ policies and procedures had not been written in accordance with best practice guidelines and held out of date information. This meant staff did not have access to up-to-date guidance to successfully support people.

Quality audit systems had not been consistently completed which meant areas for development and improvement had not always been identified and actioned.

Fire safety procedures had not been regularly undertaken to ensure staff were competent in the event of an emergency. Fire safety refresher training had not been completed.

Staff felt confident and knew what they needed to do if they had any safeguarding concerns at the home. They were able to describe what abuse may look like and described the actions they would promptly take.

People's needs were assessed before they moved into the home and this information was used to create individual care plans and risk assessments. Guidance was in place for staff to follow to meet people's individual needs. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. Care plans needed to be reviewed and updated at the time of our inspection.

Medicines were managed safely in accordance with best practice guidelines. The registered providers medicines policies had not been written in line with National Institute for Health and Care Excellence (NICE) guidelines as required. NICE use the best available evidence to develop recommendations that guide decisions i