Archived: Ambassador Care Home

Updated 25 December 2021

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 Care Act 2014. 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, an inspection manager and a medicines inspector.

Service and service type

Ambassador Care Home 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 service had a manager registered with the Care Quality Commission at the time of the inspection. This means that they, when registered, and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was not available during the inspection, the deputy manager was managing the home in the registered manager’s absence.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Lancashire Safeguarding Authority. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service. We spoke with eight members of staff including the deputy manager, the provider, four staff who delivered direct care, a housekeeper and the cook. We reviewed a range of records. This included five people's care records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including environmental information were also reviewed. We looked at medicines and records about medicines for 16 people. We spoke with one senior carer who had responsibility for administering medicines on the day of the inspection and the deputy manager.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at environmental records, policies, training records and care records. We wrote to the provider and took action to ensure immediate improvements were made. We shared information with the local authority, commissioners and other relevant stakeholders to support their decision making.

Updated 25 December 2021

Ambassador Care Home is a residential care home providing personal care to 31 people who may be living with dementia. The service can support up to 31 people in one adapted building. At the time of the inspection 24 people were receiving support.

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

Medicines were not managed safely which placed people at risk of harm. Records did not consistently reflect the help people needed or were not always accessible so staff could not always learn about the help people needed.

Recruitment procedures were not consistently followed to ensure staff were suitable to work with people who may be vulnerable. People were not always supported by staff who knew the help they needed, and people’s dignity was not always maintained. Some areas and equipment within the home required cleaning to minimise the risk and spread of infection. Governance systems were ineffective at ensuring people received safe and high-quality care.

People said they were happy at the home and they liked the staff.

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 16 July 2021) and there was a breach of regulation. At this inspection we found improvements had not been consistently made and the provider was still in breach of regulations.

Why we inspected

We received concerns in relation to the management of medicines, infection prevention and control, nutrition, risk and staffing. We also received concerns on how people were supported to maintain their dignity. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.

We carried out a focused inspection of this service in March 2021. 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 in the areas of good governance. We undertook this focused inspection on 14 October 2021 to check they had followed their action plan and to confirm whether they now met legal requirements. This report only covers our findings in relation to the key questions safe, caring and well-led which contain those requirements.

We have found evidence that the provider needs to make improvements and that people were at risk of avoidable harm. Please see the safe, caring and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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 the service can respond to coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for this service is inadequate. This is based on the findings at this inspection.

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

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has remains inadequate. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified breaches in relation to the safe management of medicines, record keeping and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up information

We took urgent action under Section 31 of the Health and Social Care Act 2008, to impose conditions on the providers registration. The provider has since applied to deregister with the Care Quality Commission.