Amber House Residential 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 requires improvement. The provider was in breach of legal regulation in relation to consent to care. Enough improvement was found and the provider was no longer in breach of this legal regulation. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider and management team had effective pre‑assessment processes in place, which enabled them to build detailed care plans that captured people’s wishes, needs and preferences. This meant staff had a good foundation from which to understand people and develop well‑rounded records of care which reflected them as individuals.

Staff had received additional training on the electronic documentation system, giving them a clearer understanding of how and where to record important information. This improved the quality and consistency of documentation and supported staff to meet people’s needs more effectively. By having clearer and more detailed documentation, professionals were able to use this information to support people more effectively.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff were able to support people more effectively because they were reviewing care plans more often and updating records when people’s needs changed. The service felt calmer and more organised, which helped staff understand people better and used this knowledge to provide care which was safe, appropriate and based on what worked well for each person.
 

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.

Leaders and staff had made considerable progress in strengthening multidisciplinary working, engaging proactively with other teams and external services to support ongoing improvements at Amber House. Enhanced processes ensured people’s needs, preferences were accurately documented, enabling all professionals involved to access reliable information and deliver well‑coordinated, person‑centred care.
 

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.

People were better supported to live healthier lives due to the wider improvements made across the service. With a stronger focus on listening and responding to people, staff had a clearer understanding of people’s needs, wishes and preferences. This meant people were offered more choice and control, and staff were able to support them in ways which promoted their wellbeing. Where needed, staff helped people access health services to ensure they remained healthy and well.

There had been some occasions where people’s oral health was not as well supported as it should have been. While the provider explained that some people had refused oral care, there was a greater need for this to be recorded thoroughly. The leadership team agreed to be referred to an oral health initiative to raise standards and ensure all staff understood the importance of good oral health.
 

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and
consistent, or that they met both clinical expectations and the expectations of people themselves.

Some aspects of record‑keeping audits were not sufficiently thorough, which meant certain issues were not identified in a timely way and this process still required improvement. For example, staff had not consistently recorded when people refused support with oral health. As a result, concerns about mouth care were not identified or acted upon promptly, and people were not given further encouragement or follow‑up support. Because refusals were not recorded, there was no mechanism to trigger review or oversight, limiting the provider’s ability to monitor outcomes effectively. We brought this to the attention of the leadership team, who agreed to follow this up with staff and take further learning themselves.
 

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. This can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service.

We found mental capacity assessments were in place, and the provider was meeting their legal responsibilities. However, these assessments often lacked sufficient detail, and further work was needed to ensure people who were unable to make decisions for themselves were assessed thoroughly and in line with the principles of the law. The care support manager was aware of this shortfall, and staff had recently completed additional training to improve their understanding and knowledge, with the aim of strengthening practice in this area.