Amber House

Updated 13 May 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.

This was a targeted inspection to follow up on a specific concern we had about assessment and management of risks. We were concerned guidance to minimise risk was not being followed by staff and that systems and processes were not robust enough to mitigate risks to people.

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

This inspection was undertaken by one inspector.

Service and service type

Amber House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period of notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us. Due to the on-going pandemic, we also needed to know about the provider's infection control procedures to make sure we followed their visiting procedures.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. 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 used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and one relative about the experience of the care provided. We spoke with four members of staff including the registered manager, a senior care worker and care workers.

We reviewed a range of records. This included three people’s care records and risk assessments. We also looked at a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke to two more relatives. We also sought feedback from two medical professionals who have regular contact with the service.

Updated 13 May 2021

About the service:

Amber House accommodates seven people in one adapted building supporting people with Prader-Willi Syndrome (PWS). PSW causes low muscle tone with consequent motor developmental delays, a mild to moderate learning difficulty, incomplete sexual development, and emotional and social immaturity, leading to behaviours that can challenge. During childhood, an overwhelming and insatiable chronic appetite usually develops which, without rigorous food management and exercise regimes, leads to food seeking, stealing and life threatening obesity. Instead of the main characteristics of this syndrome is, learning disabilities ranging from severe to borderline and people experience an excessive appetite.

The home is situated in St Leonards-By-Sea and on the day of inspection there were six people living at there. Amber House is located over five floors which are accessible via stairs. The home had two large communal areas and a garden at the rear of the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

Systems supported people to stay safe and reduce the risks to them, ensuring they were cared for in a person-centred way. People and relatives told us they felt the home was a safe place to be and felt comfortable to raise concerns with staff. A relative told us, “I feel very confident that my son is safe at Amber House and the staff are very good.” Staff had a good understanding of how to identify and respond to any suspicion or allegation of abuse.

Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to live as independently as possible and told us that their needs were met. Activities took place on a daily basis and people were encouraged to participate if they wanted to. One person told us, “I choose what I want to do.” Relatives and visitors were welcomed and given the privacy to talk to their loved one.

People's needs were effectively met because staff had the training and skills they needed to do so. Specialist training was provided to ensure people's needs could be met and refresher courses were booked when due. This included in depth training on PWS, which is a genetic disorder where people are constantly hungry. One person told us, “Staff are trained well and have good understanding of my condition.”

People and relatives told us that staff treated them with kindness and we observed friendly interactions throughout the day. People were supported to ensure their health needs were responded to and health needs were reviewed on a regular basis. People had their privacy and dignity protected.

People were happy with the food and said they were given a choice of home cooked meals. 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.

The provider had quality assurance systems in place to monitor the standard of care and drive improvement. People, relatives and staff spoke positively about the culture of the home and said it was well managed. One relative told us, “I really do I think the management is very good and they have everything just about right.”

More information is in Detailed Findings below.

Rating at last inspection: This was the first inspection of Amber House since it was registered by the Care Quality Commission (CQC) on 3 May 2018. New services are assessed to check they are likely to be safe, effective, caring, responsive and well-led when registering.

Why we inspected: This was a scheduled inspection

Follow up: We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our re-inspection schedule for those services rated Good.

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