Amberley Lodge - Purley

Updated 30 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 17 March 2021 and was announced.

Updated 30 March 2021

This inspection took place on 11 and 12 October 2018 and our first day of inspection was unannounced. At our previous inspection in February 2016 we found the provider was meeting the fundamental standards. We rated the service Good overall and Outstanding in the key question ‘Is the service Well-led?’ At this inspection we found the service had improved significantly and we rated it Outstanding overall.

Amberley Lodge - Purley is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Amberley Lodge – Purley provides nursing care. CQC regulates both the premises and the care provided and both were looked at during this inspection. The care home specialises in dementia care and end of life care. The service provides care for up to 59 older people requiring residential or nursing care. There were 49 people using the service at the time of our inspection.

The home had a registered manager in post. 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 service was outstandingly caring. Staff were exceptionally kind and caring and demonstrated a real empathy and understanding of people with dementia. Staff knew people well and staff helped people reflect on their past creatively. People received compassionate care in line with best practice for people with dementia. The service had a strong, visible person-centred culture and the registered manager set up a successful ‘wish tree’ project to fulfil people’s wishes, despite their advancing age, dementia and medical conditions. People were supported to maintain relationships and social contacts. People were given the privacy and dignity they needed.

The service was outstandingly responsive and the service was innovative in relation to end of life care. Staff were encouraged to talk about death and dying openly and sensitively with people and the service helped people plan the end of their lives with dignity. Staff had an excellent understanding of the best ways to deliver end of life care following best practice guidelines including ‘Namaste’ care for people with advanced dementia. Staff also followed the personal wishes of people and their relatives when people were at the end of their lives. The service responded rapidly to people’s changing care needs so people experienced a comfortable, dignified and pain-free death. Staff were very able to meet people and relative’s emotional and practical needs when people reached the end of their lives.

Arrangements for social activities showed innovation with a weekly fruit market for people at the home. Activities met people’s needs and helped them lead a full life. Relatives and professionals agreed the service was excellent at providing person-centred care.

The service was outstandingly well-led by the registered manager and management team. Managers developed their leadership skills and those of others and the registered manager created a positive atmosphere to work where staff felt well supported. Staff were motivated by and proud of the service with award systems in place to recognise their achievements. Staff had high levels of satisfaction levels relating to equality and inclusion at work. The registered manager and other managers kept their knowledge current attending forums and completing specialist training in leading services for people with dementia. The registered manager developed the values of the service through involving people and staff and the values placed people centrally. Governance was well-embedded in the service with a strong framework of performance monitoring and the service was involved in an internal ‘good to great’ scheme to achieve excellent standards. There was an emphasis on continuous improvement and the views of people, relatives and staff were pivotal to this.

People felt safe with the staff who supported them and staff knew how to safeguard people from abuse and neglect. People received care from the right numbers of staff. Risks relating to people’s care, including those relating to their medical conditions such as diabetes, dementia, mobility and risk of falls, were well managed by staff. Staff understood people’s needs well. People received care from staff who were suitable as the provider carried out the right recruitment checks. People received their medicines safely and the provider was implementing an electronic medication administration recording system with the aim of improving safety. The premises were clean and free from malodours and staff followed appropriate infection control procedures. People lived in premises which were maintained safely and were secure.

People received the support they needed relating to eating and drinking including any specialist support to reduce their risk of malnutrition. Staff took care to ensure mealtimes were a pleasant, unhurried experience for people. The chef had a good knowledge of people’s needs and preferences and followed guidance from professionals such as dietitians and speech and language professionals in preparing food.

People were supported with their day to day health and nurses worked with other healthcare professionals to ensure people’s medical needs were met.

The premises were adapted to people living with dementia based on current research including the use of colour to help people recognise doors and entrances.

Staff received the training and support they needed to understand their roles and responsibilities and staff told us the training was good quality.

People received care in line with the Mental Capacity Act (MCA) and their choices were respected by staff. The provider followed the Deprivation of Liberty Safeguards (DoLS) in lawfully depriving some people of their liberty as part of keeping them safe.

Processes were in place to respond to concerns or complaints and the provider’s complaints policy was shared with people and their relatives so they knew how to raise a concern.