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Amberley Court Care Home Requires improvement

We are carrying out checks at Amberley Court Care Home using our new way of inspecting services. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 23 September 2016

We visited the service on 19 August 2016. This inspection was unannounced.

Ranelagh Grange Care Home is registered to provide accommodation for persons who require personal care. The service accommodates up to 39 people and bedrooms are located on the ground and first floor of the building. There were 16 people using the service at the time of this inspection.

A registered manager was not in post at the time of the inspection visit. However the manager had applied to become the registered manager with the Care Quality Commission and her registration was confirmed following this inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The last inspection of the service took place in May 2016. During that inspection we found improvements were needed in relation to the management of people’s medicines and the monitoring people’s fluid intake. After the inspection, we issued a requirement action in relation to the breach of the Health and Social Care Act 2008 which we identified.

Following the inspection the registered provider sent us an action plan stating that they had met the relevant legal requirement. During this inspection we found that the registered provider had made improvements in relation to the legal requirement, however we found other concerns in relation to the management of people’s medicines.

Improvements continue to be needed in the management of people’s medicines. Although we found that people’s medicines were safer, improvements were still required to ensure that all medicines were managed safely. This is a continued breach of Regulation 12(1) (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

We have made a recommendation in relation to checks on people's medication. During this and previous inspections carried out at the service we found on going concerns with the management of people's medication, which were not identified during audits (checks) carried out at the service. Whilst improvements had been made we need to be assured that those improvements are sustained.

At the last inspection in May 2016 improvements were noted in the way people’s fluid intake was being recorded, however some charts were not always completed correctly. We made a recommendation that the service reviews the systems in place to record and monitor people’s fluid intake to ensure that accurate information was available at all times. During this inspection we were unable to assess the improvements made. This was because at the time none of the people who used the service required a record of their fluid intake. However documentation for recording people’s fluid intake had been improved so that it captured all the relevant information to ensure an appropriate record was kept.

People told us they felt safe living at the service. The environment was kept clean and free from hazards. Equipment and hazardous substances were safely stored and used appropriately. Staff received training in relation to keeping people safe and they were confident about the action they needed to take if they had any concerns about people’s safety, including safeguarding concerns.

People received the care and support they needed with their healthcare needs. They attended appointments as required with their GP and other health care professionals involved in their care. Prompt referrals were made for people to other professionals when concerns about their health and wellbeing were noted.

Risk assessments had been carried out when planning people’s care and appropriate risk management plans were put in place instructing staff on how to provide people with safe care and support.

People’s dietary needs were understood and met. People told us they liked the food they were offered and that they were given plenty to eat and drink. Mealtimes were a positive experience for people and they had a choice of food and drink and where they ate their meals.

Staff received training and support which they needed to meet people’s needs. Training was provided to staff on an ongoing basis and their competency was checked to make sure they understood and benefited from the training undertaken. Regular staff meetings and one to one supervision sessions enabled staff to explore their training needs and discuss any additional support they needed to carry out their roles effectively.

Care plans included information about people’s abilities to make decisions and where required applications had been made to the local authority for Deprivation of Liberty Safeguards (DoLS) authorisations in respect of people. Staff obtained people’s consent prior to delivering care and support and they respected people’s decisions.

People’s privacy, dignity and confidentiality were respected. Staff had a good understanding of people’s needs, including their preferred gender of carer, routines, wishes, likes and dislikes. Staff approached people in a kind, caring and patient manner. Information about the service including planned changes to the environment and up and coming events was shared with people and their family members in a timely way.

People, family members, staff and external health and social care professionals were complementary about the way the service was managed. People commented on many positive changes made to the service over recent months. They described the management team as approachable and supportive and they had confidence in them. They said there was an open door policy operated at the service which enabled them to speak openly and in confidence with the management team.

Inspection areas

Safe

Requires improvement

Updated 23 September 2016

The service was not always safe.

People’s medicines were not always managed safely.

Risks people faced were planned for and managed safely.

People were protected from abuse and the risk of abuse.

Recruitment of new staff was thorough and safe.

Effective

Good

Updated 23 September 2016

The service was effective.

People’s nutritional and hydration need were assessed and planned for.

People received care and support from staff that were appropriately trained and supervised.

People’s rights were protected in line with the Mental Capacity Act 2005.

Caring

Good

Updated 23 September 2016

The service was caring.

People’s privacy and dignity was respected.

People’s personal information was securely stored and accessed only by authorised staff.

People were updated with information about the service.

Responsive

Good

Updated 23 September 2016

The service was responsive.

Care plans which were reviewed regularly described people’s needs and how they were to be met.

People enjoyed a variety of activities made available to them.

People had information about how to complain and they were confident about raising a concern or complaint.

Well-led

Requires improvement

Updated 23 September 2016

The service was well-led.

Systems for checking on medication need to be more robust and improvements made need to be sustained.

There was no registered manager in post at the time of the inspection visit; however the manager has since been registered by CQC.

People had confidence in the management team and the way they managed the service.