Enter and view: Acacia Lodge Care Home

Healthwatch Barnet carried out a safeguarding-focused Enter and View visit to Acacia Lodge Care Home on 12 April 2019. The home accommodated 26 residents at the time of the visit, most of whom were living with dementia, including some people with challenging behaviour. The visit involved discussions with management, staff, residents and relatives about safeguarding, care quality and residents’ experiences. 

Overall, the report found Acacia Lodge to be a safe, caring and person-centred care home with a warm and homely atmosphere. Residents and relatives consistently described the home positively, praising the kindness of staff, the quality of care and the respectful approach taken towards residents. Healthwatch concluded that the home provided a safe and welcoming environment where residents were able to maintain choice and individuality. 

The home had a strong focus on safeguarding. Staff received safeguarding training, understood how to identify and report concerns, and were familiar with local safeguarding procedures. Healthwatch observed a safeguarding reporting flowchart displayed within the home and found that staff demonstrated a good understanding of their responsibilities. The manager was confident that appropriate safeguarding systems and risk assessments were in place to protect residents. 

Staffing levels were generally stable, with low turnover and a number of long-serving employees. Recruitment processes included references, identity checks, Disclosure and Barring Service (DBS) checks, induction training and probationary periods. Staff spoke positively about teamwork and described the home as a pleasant place to work. However, some staff expressed a wish for more time to spend individually with residents.

Care planning was found to be thorough and regularly reviewed, with detailed assessments, risk management plans and daily monitoring records in place. Relatives were invited to contribute to care plans and reviews. However, Healthwatch noted that responsibility for assessments and care plans rested almost entirely with the manager and suggested that this workload could be shared with senior care staff. The report also recommended exploring electronic care records to improve accessibility and efficiency. 

The management of residents’ finances was described as robust. Financial records were carefully maintained, funds were securely stored, and regular audits were conducted. No concerns about financial management were raised by residents or relatives.

Residents had access to a variety of activities including seated exercise, netball, films, music sessions, garden events, concerts and community outings. Religious support was available for those who wanted it. Staff encouraged participation while respecting residents’ right to choose whether or not to join activities. However, Healthwatch felt that some more able residents appeared bored by the current activities programme and suggested developing a broader range of opportunities, including greater use of volunteers and consideration of a sensory room for residents with advanced dementia. 

Healthwatch found that communication within the home was generally effective. The diverse language skills of staff helped support residents whose first language was not English, and the home made efforts to accommodate individual communication needs. Residents and relatives reported that staff communicated respectfully and appropriately. 

The manager reported only one recent safeguarding referral, which related to suspected financial abuse by a family member. Although the case was ultimately resolved, concerns were raised about delays in receiving responses from local authority safeguarding teams and difficulties contacting the appropriate council staff. The home also highlighted occasional delays in receiving residents’ financial allowances from local authorities. 

Residents and relatives were very positive about life at the home. Residents said they felt safe, supported and able to make choices about their daily lives. Relatives described the home as caring, observant and responsive, with one noting that it was the ideal environment for their family member. Feedback on food was also positive, with relatives reporting that residents’ preferences were taken into account

Healthwatch concluded that Acacia Lodge operated in a way that promoted safety, dignity and wellbeing. Recommendations included sharing responsibility for care planning more widely among senior staff, considering a move to electronic records, creating a sensory room, increasing opportunities for one-to-one engagement through volunteers, and developing a wider range of activities for more independent residents.

In response, the manager accepted the recommendations and explained that staff training on care planning was underway. The home also confirmed it would consider introducing a sensory room, explore opportunities for volunteer involvement, and continue enhancing activities and one-to-one support for residents.