Amelia House Residential Home

Amelia House is a residential care home that provides personal care for up to 19 people aged 65 and over. There were 16 people living there at the time of the inspection; some of whom were living with dementia.

People’s experience of using this service and what we found

People were relaxed with one another and the staff group. They looked relaxed in their surroundings, chatting together in one of the lounges or spending time in their room. People told us they were pleased with their choice of home and they had no plans to move. Visitors were equally pleased how well their relative had settled in, for example one commented, “A very caring home, my mum is happy here.” People living, visiting and working at the home said they had or would recommend the home to others.

The registered manager, the day to day manager and the staff team worked with a shared purpose to keep people safe and to support their well-being. A relative told us, “I cannot praise the staff enough for her care, they are amazing and I would certainly recommend this home to others.”

Despite national staffing shortages, the management team had worked hard to ensure they recruited new staff. Recruitment checks helped ensure staff were suitable to support people.

People were complimentary about the staff group. For example, one person told us the staff were “marvellous” because they took good care of them, and then said, “Yes, I’m very happy that I will be staying here.” A relative wrote, “All the staff I’ve been in contact with are amazing.”

People looked well cared for; visitors said they were reassured by their relative's appearance and contentment. The service provided safe care to people. People looked at ease and comfortable in the company of staff. For example, they said the staff were “so good” and “marvellous.” People's views mattered; staff listened to them, respected their choices but also took time to explain their suggestions.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Health and social care professionals were regularly involved in people's care to ensure they received the care and treatment which was right for them.

Staff followed current hygiene practice to reduce the risk of infections. People praised the cleanliness of the home. Health and safety checks of the premises and equipment were carried out at regular intervals. People received their medicines in the way prescribed for them.

Before people moved to Amelia House an assessment was completed to identify the level of support they needed. This assessment included risks to their health and well-being. People’s care needs were regularly reviewed and updated.

A number of relatives commented on the positive friendly feeling when they visited. They praised the manager’s approachability and availability. For example, they said, “Yes, we know (the manager), she is very approachable we often have a chat when we visit and if we need to ring her to ask questions, she is always available to answer them.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 4 April 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Amelia House Residential Home provides care and accommodation for up to 19 people. On the day of our inspection there were 17 people living at the service. The home provides residential care for the elderly and people living with dementia.

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.

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. One of the providers is also the registered manager.

At the last inspection on the 29 October 2015, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good:

We met and spoke with all the people living in the service during our visit. However, some people were not able to fully verbalise their views, so staff used other methods of communication, for example by providing visual prompts. Others were able to tell us about the care and support they received. Due to people’s needs we spent time observing people with the staff supporting them.

People who were able to said they felt safe living in Amelia House. One person said; “Yes I feel safe here.” Staff said; “We keep people safe because we have all worked here a long time and know everyone well.” A relative said; “Absolutely mum is safe here.”

People remained safe at the service. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. People, relatives and staff agreed there were sufficient staff to keep people safe. Staff said they were able to meet people’s needs and support them with activities and trips out.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to enable people to retain as much independence as possible. People received their medicines safely by suitably trained staff.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff had completed safeguarding training. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). Staff said the Care Certificate training looked at and discussed the Equality and Diversity and Human Rights policy of the company.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s end of life wishes were documented. People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals.

People’s care and support was based on legislation and best practice guidelines, helping to ensure the best outcomes for people. People’s legal rights were upheld and consent to care was sought. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people preferences and wishes. Information held included people’s previous history and any cultural, religious and spiritual needs.

People were observed to be treated with kindness and compassion by the staff who valued them. The staff, most who had worked at the service for a number of years, had built strong relationships with people. Staff respected people’s privacy. People or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People’s equality and diversity was respected and people were supported in the way they wanted to be. People who required assistance with their communication needs had these individually assessed and met. People were able to make choices about their day to day lives. The provider had a complaints policy in place and records showed all complaints had been fully investigated and responded to.

The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. People, relatives and staff said the providers were approachable.

The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider’s to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service.

There were 14 people living in the home at the time of our inspection. We talked with six people who lived at the home, five staff including the manager and two visiting professionals. We looked at the care records of four people living in the home including records relating to their community nursing support.

The people we spoke with and the professionals were complimentary about the home and people told us they had been consulted about their care, treatment and support. One person told us, 'I'm happy living here, there's nothing they could improve for me'; whilst another person told us, 'I get everything I want'. We saw how people's care and welfare was provided with dignity and respect in line with their care needs.

The home was clean and tidy and recent building work and refurbishments had been completed. Hygiene and infection control practices had been improved and people living in the home told us the home was kept clean.

Staff had access to further training and were able to work towards diploma type courses in care. They received regular support from the manager and provider and a new computer records system had been introduced which alerted management when retraining was required.

We saw audits and checks were in place for services such as fire and equipment testing and maintenance and improvements had been identified or completed. Cleaning logs were in place and improvements were seen in care reviews and policy monitoring.

People we spoke with were happy with their care and with the home. They told us 'It's nice living here', 'The meals are alright, better than I can make' and 'I like to go out in the garden'; some people said they would 'like more things to do'. However, we found that people's views and experiences were not always taken into account in the way the service was provided and delivered.

People told us they liked the staff and felt supported by them. We saw there were enough qualified, skilled and experienced staff to meet the needs of people's currently in the home. However, people could not be sure they would experience appropriate support that met their needs with insufficient written information being available about their needs and how to meet them.

One person said staff did not clean their room often. We found people were not fully protected from identifiable risks of infection because effective systems were not always in place to reduce such risks.

The provider did not have effective systems to assess and monitor the quality of service that people received. There were gaps of over three months in some records, and audits were not always evident, for example.