Archived: Amber House - Great Yarmouth

Amber House is registered to provide accommodation, care and support for up to 22 people with learning disabilities. At the time of our inspection 14 people were living in the home, one of whom was receiving respite care.

There was 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.

Processes were in place to ensure that only those suitable to work in health and social care were employed. Staff received an induction and on-going training. Staff were supported and received regular supervision and annual appraisals.

The service encouraged a respectful, friendly and welcoming culture that was mutually supportive. Staff demonstrated professionalism, patience and compassion when interacting with those they supported. Staff, and the people living in the home, were aware of professional boundaries. People had privacy and staff demonstrated that they promoted dignity, choice and independence.

Staff understood the types of abuse people could experience and knew how to report any concerns they may have. The service had processes in place to manage any safeguarding issues and contact details for the local safeguarding team were on display.

People received their medicines as prescribed and the service managed, stored and audited medicines appropriately.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service demonstrated that they worked within the principles of the MCA. Staff had received training in this and could give us basic information on how this was applied. People who used the service had support and encouragement to make their own decisions. There were DoLS authorisations in place and the service understood the principles of the safeguards.

People and, where appropriate, their relatives, had been involved in planning the support they required. Support plans were in place that were detailed and individual to each person and staff demonstrated that they knew the life histories, support needs, likes, dislikes and preferences of those they supported. People told us their needs were met and the relatives we spoke with agreed.

People were supported and encouraged to participate in activities in the home and in the community. Many of the people accessed day services in the community and some had part time employment locally.

People’s nutritional needs were met and the service monitored people’s food and drink intake where necessary to ensure their wellbeing. People had access to healthcare professionals as required and staff supported people to attend appointments. Robust recording was in place regarding this that identified the treatment each person had received, any actions required and any follow up treatment needed.

The manager had robust and effective systems in place to monitor the effectiveness of the service and the safety of the premises. The manager was visible in the service was valued and respected by people living in the home and the staff.

We carried out this inspection to see whether changes the provider told us they would make to address concerns found at our inspection of 9 July 2013 had been made.

We found that satisfactory progress had been made, but the registered manager admitted that they had been over-ambitious regarding the timescales. A revised action plan noting progress to date and proposing slight amendments to the dates for completion had recently been produced. This was given to us when we arrived to carry out the inspection. We discussed the revised dates with the registered manager. We agreed that these were reasonable and more realistic and we accepted the revised action plan.

The service had introduced a comprehensive, monitored training programme to ensure that staff received the necessary training. There were plans to ensure that this would be updated as needed.

The service was taking a cost-effective and efficient approach to ensuring robust monitoring of the quality of different aspects of the service by using tried and tested tools from elsewhere.

Satisfactory progress was being made towards ensuring that the records kept were accurate and appropriate, to help ensure that people were protected from the risks of unsafe or inappropriate care and treatment.

Satisfactory progress was being made in securing the training that would help the registered manager to more effectively fulfil their management role and improve outcomes for people using the service.

The people using the service and their relatives told us that they were happy with the care received. One person stated they were,'Happy here' and that the staff were caring. A relative told us, 'You can't fault the care.' The service had a complaints policy. The registered manager informed us that no complaints had been received within the last 12 months.

We observed that staff were kind, caring and treated the people who used the service with respect. Before people received any care or treatment they were asked for their consent and their wishes were met. People's needs were assessed and they had access to other health care professionals when needed.

Records were stored confidentially. However, some records were not kept up to date and were sometimes inaccurate.

There were recruitment checks in place to ensure that staff were of good character. Staff received appropriate supervision and appraisal. However, we did not see evidence of a comprehensive and well monitored training programme to show that staff and the registered manager had received the necessary training and that this was up to date.