Four Acres

The inspection was prompted in part by information of concern about the quality-of-care people received. The information shared with CQC indicated potential concerns about incidents and falls, infection control, staffing and management of the home. This inspection examined those potential risks. This was a comprehensive inspection and included a review of the ratings for all key questions.Since the last full rated Inspection in 2019, there had been multiple registered management changes. Staff told us those changes did not always provide a stable service. At this inspection, the manager had been in post since February 2026. The manager was not registered with us, but they had submitted their application to become registered with us. Staff feedback was the current manager had made positive improvements to the quality of care. Staff felt there was an improved culture at the home although further improvements were planned. Staff said they felt supported and confident to approach management if they needed help or guidance.

There were enough staff, who had been recruited safely, to support and meet people’s needs. The regional operations director and manager were confident staffing levels matched people’s needs. Staffing levels had been increased, and the manager was confident this had made a positive difference. Staff told us they received training that helped keep their practice updated and records showed staff training was completed and refreshed when needed. People received their medicines from staff who were trained and assessed as competent. Medicines were stored and administered safely.

Staff knew how to protect people from abusive practice and were confident to report and record those events. Staff understood the importance of seeking people’s consent, maintaining people’s privacy and dignity and providing care at people’s preferred pace. People’s records showed their mental capacity was considered and, in some cases, staff made decisions if people lacked capacity. We told the manager, some best interest decisions we saw required better documentation to evidence how those decisions had been reached.

Staff had time to support people to do things they enjoyed doing, such as supporting people to do word searches comfortably, and to chat to them, so people did not become isolated. People were empowered to prepare drinks for themselves and visitors on the ground floor. Meal choices and the mealtime experience for some needed improvement and consideration, especially to include more vegetarian options. When some people did not eat their meal, staff needed to investigate why this was, rather than take people’s meals away and not offer another choice.

There was a varied activities programme that enabled people to do the things they wanted, and staff supported people to do this. People were supported to go out of the home on planned trips or to spend time in the outdoor area. The manager told us they continued to improve the activities programme based on people’s feedback. To support activities, the provider had set themes for each month to meet people’s varied interests.

Infection control practices needed to be improved. Some areas of the environment required more intense cleaning to ensure it reduced any cross contamination. Some food items were not always dated or packed safely away to minimise any risks, especially for people who were on special diets.

The provider had a series of audits and checks which were completed regularly to provide oversight of the quality provided. Some of those audits required more oversight, especially when delegated to others. The manager took action to improve practices in the home, and they were open and honest about the challenges and areas they continued to identify for improvements.