During this inspection visit by one inspector, we spoke with twelve people using the service, four visiting family members or friends, eight members of staff and two managers. We looked at five people's care plans as well as other records held by the provider including those kept for staff training, supervision and quality assurance.Following our last inspection visit in February 2014, we asked the provider to take action to make improvements around staffing and record keeping. We found this action had been completed.
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.
Is the service safe?
People told us that they liked living at the home and said they felt safe there. Comments included 'I think it's quite nice', 'Fantastic', 'Never known it to be so good' and 'It's handy, as good as anywhere."
We saw the home environment was safe, clean and well maintained. Further work could take place to make the home more 'dementia friendly' with improved opportunities for engagement and occupation.
Is the service effective?
We saw people's changing care needs were being identified and discussed by care staff through their key worker responsibilities, care plan reviews, handovers, team meetings and supervision sessions with their line manager. New systems had been put in place to ensure that an effective management structure was in place on each floor. Staff were initially worried about the changes taking place with some individuals moving to different floors however positive feedback was received during our second visit to the home. Comments included 'I love the change' and 'I like the results'.
We saw that staff now had access to the training and supervision that helped them do their jobs well.
Is the service caring?
People using the service told us that staff treated them with respect and said they were happy living at the home. Feedback included 'I love it here', 'The staff are quite friendly', 'They're very kind' and 'Very nice."
Staff understood the importance of treating people with dignity and respect and they gave us examples of how they upheld these values. A small number of instances were however noted where people were moved without being properly informed beforehand. This should be seen as a priority for on-going work by the dignity champions appointed on each floor of the home.
Is the service responsive?
We had some mixed feedback from people using the service and their family members or friends about the activities provided within the service or out in the community. Some people were very positive about the activities but others would welcome more things to do particularly outside of the home environment. The service does not currently benefit from having its own vehicle to enable more regular or spontaneous trips out.
People said they knew how to make a complaint and felt able to approach the manager or other senior staff. Family members or friends told us 'they have listened to me' and 'I can go and they do something about it'.
Is the service well-led?
The service had a new manager in post. The turnover of managers at Amberley Lodge Purley has been highlighted in previous inspection reports and remains a key risk for this service.
Family members or friends of people using the service told us 'Issues have fallen between different managers' and 'I think we have had seven or eight managers come and go'. Some individuals reported that they had stopped going to the relatives meetings saying 'There is no point in attending...there is always a new manager and in the end what we suggest is forgotten and is not acted upon."
Staff members spoke about the impact this had on their work saying 'It's not easy to keep changing manager' and 'Very unnerving.' They were however positive about the leadership, support and training now being provided which helped them to meet people's needs. One staff member said 'They're on top of it now' and another said 'fingers crossed, we've been through a lot here."
The home clearly needs to benefit from having a consistent management team in post for a prolonged period of time.