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Amber Lodge Nursing Home Requires improvement

We are carrying out a review of quality at Amber Lodge Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 20 December 2018

At the last inspection in May 2018 we found that there were breaches in providing person centred care, dignity, adequate infection control, medicines, safeguarding people from abuse and governance in that effective systems were not in place to assess and monitor the quality of care.

This inspection took place on 1 and 4 November 2018, the both days were unannounced.

Amber Lodge Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Amber Lodge Nursing Home provides accommodation for up to 40 people in one adapted building. The service specialises in caring for people with physical disabilities and older people including those living with dementia. At the time of our inspection 34 people were in residence.

A registered manager was 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. We will continue to monitor this.

We found there had been improvements with the infection control where cleaning schedules and practices had been improved and upgrades to the fabric of the building were ongoing. The provider had improved the depth and frequency of audits and quality monitoring checks. These are supported by the consultant managers and home’s staff and are now recorded and overseen to ensure shortfalls are picked up and improvements made. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service and their relatives by questionnaires.

Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staff understood their role in caring for people with limited or no capacity under the Mental Capacity Act 2005.

People were provided with a choice of meals that met their dietary needs. Staff were aware of people’s dietary requirements and any restrictions on what food people could be offered. People’s opinions were sought about the menu choices in order to meet their individual dietary needs and preferences. Most people were offered fluids that supported their wellbeing. However, some people did not have free access to drinks and some of the recording in the daily records was not accurate.

Activities were now planned well in advance and there were personalised to people’s individual needs and capabilities. Staff had access to care plan information and a good understanding of people’s care needs. However, inconsistencies in some care plans and recording of information by staff detracted from the overall improvement in care provision. People were able to maintain contact with family and friends and visitors were welcome without undue restrictions.

People who used the service and their relatives gave us positive comments about the changes since our last inspection and the care offered to them. Some people were involved in the review of their care plan, and when appropriate their relatives were included. Staff had access to people’s care plans and most received regular updates about people’s care needs. Care plans included changes to peoples care and treatment and people were offered and attended routine health checks.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse.

Inspection areas

Safe

Requires improvement

Updated 20 December 2018

The service was not consistently safe.

There had been improvements in infection control procedures and administration of medicines, however, some issue have yet to be dealt with in these areas to make the provider fully compliant. Recording in daily records was variable with some entries being missed.

Staff were employed in sufficient numbers to protect people and understood their responsibility to report any observed or suspected abuse. Concerns about people’s safety and lifestyle choices were discussed to ensure their views were supported.

Effective

Requires improvement

Updated 20 December 2018

The service was not consistently effective.

Staff training and dietary knowledge had improved and met people’s needs. People were offered a balanced diet that met their nutritional needs, but the availability of drinks was variable. Staffs knowledge of people’s dietary needs was good. Staff supervision is still irregular for some staff.

People received regular access to health care services and staff understood the requirements of the Mental Capacity Act 2005 and sought people’s consent to care before it was provided.

Caring

Good

Updated 20 December 2018

The service was caring.

People were cared for by caring and kind staff. People had been involved in planning their care. People were treated with dignity and respect, and staff ensured their privacy was maintained.

Responsive

Requires improvement

Updated 20 December 2018

The service was not consistently responsive.

People’s care records were more person centred however the accuracy of some records was still inconsistent. Activities were now person centred and recorded on a regular and individual basis. Staff recorded people’s preferences, likes and dislikes and how they wanted to spend their time in a newly developing recording system.

People were confident to raise concerns or make a formal complaint where necessary.

Well-led

Requires improvement

Updated 20 December 2018

The service was not consistently well led.

The provider has developed effective systems of audits and governance which was now required to be embedded in the day to day running of the home.

There was a registered manager in post. People using the service, their relatives and staff had opportunities to share their views and influence the development of the service.