Amberley Care Home

Updated 26 May 2023

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 3 inspectors.

Service and service type

Amberley 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 Care Home is a care home without 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.

What we did before the inspection

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 sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 7 members of staff, including the registered manager, care staff and a cook. We reviewed a range of records, including 6 people's care records and 5 people's medication records. We looked at 2 staff files in relation to recruitment and staff competencies and a variety of records relating to the management of the service including policies and procedures.

Updated 26 May 2023

About the service

Amberley Care Home is a residential care home providing personal care to up to 25 people. The service provides support to people aged 18 and above, some of whom were living with dementia. At the time of our inspection there were 25 people using the service.

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

People's medicines were not always managed safely. There was a lack of information and guidance to guide staff on how and when to offer people’s ‘when required’ (PRN) medicines and how to apply their topical medicines.

Risks to people's health and safety had not always been identified and managed. People had not always received consistent support to reduce known risks.

The provider had failed to implement effective systems to assess, monitor and improve the service.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There were enough staff to meet people’s needs. Staff were recruited safely. People told us they felt safe.

Staff knew people well; however, records did not provide clear guidance for staff to follow when supporting people.

People were encouraged and supported to eat and drink. Staff worked with other professionals to ensure people received a joined-up approach to their care.

Relatives told us they were kept informed of accidents and incidents involving their loved ones. Staff meetings took place and staff said they found them useful.

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 27 January 2022) and there were breaches of regulation. At this inspection we found improvements had not been made and the provider remained in breach of regulations. The overall rating of the service has remained requires improvement.

Why we inspected

The inspection was prompted in part by information regarding an incident involving a person using the service who had died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the safeguarding of people who used the service. This inspection examined those risks.

We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective 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.

Enforcement

We have found breaches in relation to safe care and treatment and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.