About the service Amberley Court Care Home is a residential care home providing personal and nursing care to 47 people. The service supports younger and older people, some with a physical disability, brain injury or disorder. The service can support up to 62 people.
People’s experience of using this service and what we found
Systems in place to ensure people received their medicines as prescribed were not consistently followed, resulting in people being at risk of their medicines not being effective. Some medicines had not been stored at the correct temperature, resulting in them being destroyed.
The new manager had the support of a management team and a number of systems and processes were in place to assess, monitor and improve the quality and safety of the services provided. However, staff were not routinely following all of these processes and audits that were in place had failed to identify a number of areas for action. Systems were in place to record and act on accidents and incidents, but these were inconsistently recorded which meant opportunities could be lost to learn lessons from events.
People’s views of the service were not routinely sought and where people had raised concerns, although they felt listened to, they were not confident that action would be taken to address the concerns raised.
Staff did not always keep people’s confidentiality and privacy and dignity was not always maintained.
Staff had received training in how to recognise signs of abuse and where safeguarding issues had been raised they had been reported, investigated and acted on. Staff were aware of the risks to people, but not everyone spoken with felt safe in the home, particularly when supported by agency staff. Risk assessments did not always provide staff with the information they needed to manage risks to people.
There were several staff vacancies which were covered by agency staff. Recruitment was on-going, and a number of permanent appointments had recently been made. There was a dependency tool in place to assess staffing levels, but despite this, people did not always feel staff responded to their needs in a timely manner.
Staff felt well trained and supported in their role, particularly by the new manager and had recently undergone a period of refresher training. Staff had not received formal supervision for some time but were aware the new manager was making arrangements to rectify this and felt they could approach them to discuss any concerns they may have.
People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff obtained people’s consent prior to supporting them but were not aware of authorisations in place to lawfully deprive people of their liberty. Systems in place to monitor these applications were not effective and a number had expired and had to be reapplied for.
Concerns remained regarding staff respecting people’s privacy and dignity and maintaining confidentiality. People were supported to be involved in decisions regarding their day to day care but were not consistently involved in the planning of their care. People complained at the lack of activities made available to them. Efforts were being made to introduce a variety of activities that would be of interest to people. People told us they would like to access the community more often.
Staff were aware of people’s health care needs and people were supported to access a variety of healthcare services to help maintain good health. Overall, people enjoyed the food on offer and where appropriate, support was offered at mealtimes.
People were supported to make decisions about their care and encouraged to maintain their independence where possible.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection The last rating for this service was good (published 15 April 2019)
Why we inspected
The inspection was prompted in part due to concerns received about staffing, medicines, and management of care. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive 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 identified breaches in relation to Regulation 12 regarding the management and administration of medicines, Regulation 10 with regard to dignity and respect and Regulation 17 relating to the management and oversight of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.