Amberley Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were supported safely by a consistent and caring staff team. People were safeguarded against the risk of abuse and staff received training in safeguarding vulnerable people. Staff felt confident to raise any concerning information and were aware of the whistleblowing policy which supported them to raise concerns without fear of reprisals. Risks to people were assessed and mitigated. Staff were aware of risks people faced and how they should keep people safe. Staff were recruited safety and received training to support their role. Staffing levels were sufficient, and people told us staff were visible within the home. The home was clean and tidy and infection control was well managed. Medication was safely managed, and people received their medicines as prescribed. There was an ethos of learning from events across the home to reduce repeat occurrences.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their families told us, they felt listened to and were comfortable to raise any concerns they may have directly with the registered manager or the staff team. A relative told us, they were always contacted, for example, if their relation had fallen or had become unwell.

Staff told us they felt empowered to report any concerns they may have in relation to risks, accidents and incidents. A staff member we spoke with, told us, “Staff are given feedback about incidents, complaints or events which we may need to learn from. For example, if someone is repeatedly falling, we learn what we can do to prevent further falls or injury.”

The provider was proactive in ensuring there was a culture of safety. There were robust processes in place to identify and reduce risk. Accidents and incident records were detailed, and action was taken to reduce repeat occurrences. The provider used a ‘Critical reflection’ tool as a discussion with staff to assist in identifying what they may do differently following an incident or when a concern had been raised. Complaints were appropriately investigated.

People and relatives told us their transition into the care home had been positive. A relative told us, they and their relation had been fully included and listened to when planning the move.

Staff were made aware of a new person moving into the home in advance. Staff told us, they were able to review care records and spend time with the individual and their family to understand their needs and preferences.

Partners spoke positively about the home, the registered manager and the staff team and the support they provided to ensure a move into the care home was safe.

The provider had robust processes in place to ensure safety was paramount when a person transitioned into the care home. Processes to ensure people were registered with a GP, had immediate access to their prescribed medication as well ensuring timely referrals were made to other professionals were completed as part of the initial assessment process.

People and their relatives understood safeguarding and what they should do to report any concerns they may have. People told us they felt comfortable being supported by the staff team.

Staff understood the importance of safeguarding vulnerable people and each staff member we spoke with, could describe what action they would take to report any concerning information. Staff told us, there was a whistle blowing policy which supported them to raise concerns without fear of reprisals and all staff told us they felt fully confident to raise any concerning information with the registered manager or a senior staff member. Staff received training in safeguarding vulnerable people as well as training in the Deprivation of Liberty Safeguards and mental capacity.

We observed people were supported safely by the staff team. We observed staff speaking kindly to people and with dignity. Staff always explained any interventions they were supporting a person, and we observed staff supporting people effectively when they became distressed.

The provider had processes in place to ensure any safeguarding concerns were identified and reported immediately. The registered manager was committed to ensuring appropriate action was taken following any concerns being raised and we saw evidence concerns had been addressed promptly. The registered manager had met with people and their families to ensure, they were aware of what action should be taken if they had a concern or didn’t feel safe. The provider had processes in place where a person lacked capacity to make a particular decision, and a referral was made to deprive them of their liberty and in their best interests.

People and their relatives told us they were involved in managing risk. A relative told us, they had been fully involved in planning the care for their relation and had been able to contribute to the care plan.

Staff were aware of the risks people may present. One staff member described to us in detail how they supported an individual who may become distressed. Another staff member explained whom was at risk of choking and how they reduced the risk such as ensuring the person received a modified diet or used a prescribed fluid thickener. Staff told us all information pertaining to the risks people presented was in the electronic care plan which they had immediate access to, within the electronic device they carried with them, at all times.

We observed staff supporting and managing risk safely. We observed staff using equipment to support people to safely move around the home and we observed staff supporting people to use strategies to reduce their distress. People appeared to be at ease with the staff. Staff spoke to people to support them to understand the risk and the care interventions they were providing.

Risk assessments clearly identified the risk each person presented. Care records evidenced people’s involvement, for example, one person wanted to continue to administer their own medicines, and the risk assessment recorded what staff should do to promote independence to keep the individual safe. Staff were continually updated with any changes to people’s care and support needs. Care records were regularly reviewed with people, their families and staff to ensure they remained accurate.

People felt the home was safe and secure. Relatives told us, the security across the home gave them peace of mind, knowing their relation, could not leave without supervision.

Staff told us they were responsible for checking equipment in the home was safe to use. Staff told us, they checked moving and handling equipment was safe and checked assistance call points were working in bedrooms.

We observed the home was well maintained. The registered manager, staff and the maintenance team completed regular walks of the building checking fixtures and fittings were safe. Equipment such as hoists were safely stored. We saw people had their own moving and handling slings and tilted chairs. The building was specifically designed to support people with varying needs to live in a spacious and adaptive environment.

There were processes in place to ensure the external and internal safety of the home was safe. External contractors regularly completed a programme of maintenance on fire fighting equipment, moving and handling equipment including passenger lifts, gas and electrical safety and water safety. There was a maintenance team employed by the provider who ensured internal checks were completed regularly which included ensuring regular fire drills were undertaken.

People and relatives told us staff were visible and attentive. One person told us they sometimes had to wait for staff, but it didn’t impact on their care. Another person told us, “I feel very safe. I have no concerns. There is always someone about.”

Staff told us they received an induction when they commenced employment with the provider. They also told us they received regular supervision and appraisal and were able to complete additional qualifications to aid their knowledge. A staff member told us, they had received training to support people living with dementia and following completing this training, they had researched further information from the internet to ensure they were always following best practice. Staff told us the training enabled them to understand their role and nursing staff were able to access training to enhance their clinical skills.

We observed staffing levels to be sufficient. Staff had the time to speak with people and get to know them. It was evident, staff knew people well. We observed friendly interactions, and some people referred to staff as their wider family.

Staff were recruited safely. Pre-employment checks were completed to ensure staff were suitable to support vulnerable people. Staff received an induction and training when they commenced employment and training was regularly updated. Staff received regular supervision from leaders, and we saw where staff performance wasn’t meeting expectations, action was taken promptly. Staffing rotas reflected a consistent staff team, regularly worked across the home.

People and their relatives told us, the home was always clean and tidy. They told us, there were always housekeeping staff on duty and care staff also ensured any cleaning was kept on top of if required.

Staff told us they had completed training in infection, prevention and control. They also told us personal protective equipment (PPE) such as gloves and aprons were available in plentiful supply. They told us and we saw, staff changed PPE following supporting each individual and disposed of it appropriately.

The environment was decorated to a high standard and very clean and tidy. We observed staff were continually monitoring for any spillages or incidents and taking prompt action to ensure the environment remained clean and free from any malodours. Hand washing facilities were available in every bedroom and across communal parts of the home. Alcohol gel was safely accessible for staff and visitors to use, and PPE was available for use when required.

Polices and procedures were in place to guide staff in managing infection, prevention and control effectively. Guidance was in place for managing outbreaks of infection and the provider was supported by the community infection, prevention and control team. Cleaning schedules were in place and followed. The providers oversight of monitoring of infection, prevention and control was robust.

People told us their medicines were safely managed and they received their medicines when they were due. For medicines to be administered ‘when required’ (PRN), person centred protocols where in place. These provided staff enough information to administer these medicines appropriately. People were supported to self-administer their medicines where they wanted to do so, and staff had assessed the risks with them to do this. One person told us, they had been suffering with a headache and was given paracetamol to ease their symptoms.

Staff were trained and competent to administer medicines. Staff understood policies and procedures to ensure people had their medicines reconciled when they moved between services.

Medicines were stored securely, and use of medicines was recorded appropriately Allergies were recorded on people’s medicine administration records (MAR’s); however, some related paperwork did not always contain the correct information. Staff were not always recording when thickened fluids were being given to people at risk of choking and aspiration. The time a medicine was administered was documented for time sensitive medicines, staff could be assured that the safe 4-hour time interval between paracetamol doses had been observed. Covert medicines (medicines that are hidden in a person’s food or drink) were managed well and had the appropriate people involved in decisions. The service ensured that they had instructions from a pharmacist so staff could administer medicines in a safe way.