Amberley Lodge Care Home

Updated 15 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Amberley Lodge Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Amberley Lodge Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 26 September 2022 and ended on 3 October 2022. We visited the location’s service on 26 September 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection including the action plan submitted. We sought feedback from Healthwatch, Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we observed the care and support people received throughout the day. We spoke with three people who used the service about their experience of the care provided and five relatives of people who use the service. We spoke with two healthcare professionals who regularly visited the service. We spoke with eight members of staff including the registered manager, managing director, deputy manager, registered nurses, care staff and kitchen staff.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

Updated 15 October 2022

About the service

Amberley Lodge Care Home is a residential care home providing personal and nursing care to up to 17 people. The service provides support to older people living with dementia and age-related frailties. At the time of our inspection there were 16 people using the service.

People’s experience of using this service and what we found

People received their medicines by nurses who were trained and competent to administer them safely. Staff mostly practiced good infection control to help protect people from the COVID-19 pandemic, however, a nurse was seen not to wash their hands between administering medicines to people. The registered manager addressed this concern during the inspection.

Quality assurance processes were not always robust to ensure effective managerial oversight of monitoring systems. Audits of care records carried out by the management team had not always identified some inconsistencies in people’s care records. The registered manager rectified the discrepancies during the inspection and told us their plans to further monitor records. Other quality assurance processes were effective in identifying areas for improvement. The management team worked in partnership with professionals to continually learn and develop the service.

People’s health risks were assessed and managed safely. Where people required support with equipment to move and position, staff followed care plans to ensure they were assisted safely. Some people were at risk of choking, risk assessments and care plans detailed how staff should support them with their meals. Professional advice had been followed for people who were assessed to receive a modified diet, for example, pureed food. We observed people being served meals at the correct consistency and staff assisted them in line with their care plan.

People told us they felt safe, their relatives said they felt comfortable to speak with staff or management if they had any worries or concerns. One relative told us, “I feel [person] is safe. I have not had a concern.” Staff received safeguarding training and understood their duty on how to prevent and report potential abuse.

People and their relatives gave positive feedback about the staff. One relative said, “The girls make you feel comfortable, nothing is too much trouble.” One person told us, “They are nice people here, the staff are nice people.”

People’s relatives said they were involved in planning their loved one’s care including life histories for staff to learn about people. One relative told us, “They asked me to bring in photos and were interested in who's who in the family so they can chat to [person] about them. They were interested in finding out about their history. They have really tried to get to know my relative.”

People, their relatives and staff told us they felt comfortable to make suggestions or complain if needed, they were confident the management team would deal with any problems. Relatives told us staff and management kept them up to date with changes to their loved ones. One relative said, “I would thoroughly recommend it to any of my friends. I find it excellent. It’s a very good place to care for people with dementia.”

Staff and the management team worked closely with health and social care professionals to improve people’s care, safety and well-being. Professionals spoke highly of the service. Comments included, “They have lovely care workers there, in [registered manager’s] absence they will contact me too. They are cooperative.” And, “Staff are very caring, I have met everybody now, I have no concerns, nothing to raise a red flag for me.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 October 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 29 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve Safe care and treatment and Good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, responsive and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Amberley Lodge Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.