Amberley Hall Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

The service was previously in breach to the legal regulation in relation to need for consent. On this inspection the service was no longer in breach of this regulation.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. We found people’s assessed needs were not always clear within their care plans. We found 1 person used the communal bathroom instead of their ensuite to meet their continence needs, however, their care plan did not refer to this. Some people’s care records referred to them as different people. Some people were at risk of dehydration and had fluid targets in place and had different targets recorded in their care plans.

We received mixed feedback from people about reviewing their care plans. A person told us, “I am not aware of a care plan.” Another person said, “I haven’t had a discussion about a care plan, so far they are doing everything I want.” The provider had a resident of the day scheme in place which involved speaking to people and their relatives in the service and entries evidenced them being asked if they are happy with all their care and support needs. However, this did not evidence people’s involvement in assessing and reviewing the care plans.

The provider did not always follow evidence based good-practice and standards. People that had a history of urinary tract infections (UTI’s) or were taking medications to prevent a bacterial infection were not having their fluid intake monitored. We signposted the service to the National Institute Care Excellence (NICE) guidance and they reviewed their current policies and procedures, created a lesson’s learnt and produced training material for staff and began to monitor this. However, for other people whose fluid intake was being monitored, there was evidence of regular entries and escalation between teams when targets weren’t achieved.

Staff could explain different clinical monitoring tools they used in the service and why. They could inform us of the specific dietary needs of people they supported. We observed at mealtimes that people’s dietary needs were met. A staff member told us, “We follow care plans for dietary needs like diabetes or swallowing difficulties.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff informed us there was generally a good team approach between the staff work force, a staff member said “yes, that is one of things I have realised is teamwork is highly regarded. Great team work there.” The service had effective working relationships with healthcare professionals. There were regular multidisciplinary meetings to discuss people’s needs and actions were clearly recorded in their care plans. The service was working in partnership with the ICB and local hospital to improve discharging processes and these appeared to be effective.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Records showed the staff ensured people had access to healthcare when needed. Care records evidenced there was regular communication with healthcare professionals, and their advice was incorporated into people’s care plans. All the people we spoke with informed us how they were supported to maximise their independence. 1 person told us, “I have told the staff that I would like to walk as much as possible and they have been very encouraging” and another person said, “They let me do as much as I possibly can. They don’t push their help onto me, and I am pleased with that.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. We reviewed care records of people that were supported to reposition due to the risk of their skin breaking down. For 1 person we were unable to identify how often they required to be repositioned, and another person was meant to be repositioned every 4 hours. On review of their care notes in a 5-day period, there were 7 entries of this not being achieved and some of the gaps covered a 14-hour period of not being repositioned. Speaking to the registered manager they confirmed there were issues with the current care planning software, and that was one of the main reasons they were moving to an alternative software that sends alerts to staff to monitor this more closely. All the staff we spoke with assured us how they monitor people in the service.

A staff member told us, “We weigh them and work out their Body Mass Index (BMI) and complete the Multi-Universal Screening Tool (MUST). Any risk identified, we weigh weekly to make sure they are gaining weight and try to identify what could be causing the persons weight loss.” MUST is an assessment tool to assess the risk of malnutrition.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff recorded consistently that they obtained people’s consent when supporting them with their care and support needs and we observed this when we were on site. People who lacked capacity into certain aspects of their care had thorough mental capacity assessments forms in place and best interest decisions detailing decisions made and ensuring they were least restrictive. People who had capacity had consent forms in place around their care and support needs. Staff informed us on the importance of obtaining consent before doing anything. A relative told us, “Oh yes, they always ask before they do anything.”