Amber House Residential Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. The provider was in breach of legal regulation in relation to good governance. Enough improvement was found and the provider was no longer in breach of this legal regulation. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.
 

This service scored 62 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Since the last inspection, there had been significant change, improvement and learning across the service. This progress was underpinned by a shared understanding that change was necessary and there was a need for a collective drive to improve. Leaders acknowledged previous standards had not been sufficient and recognised the need for support to move the service forward. The care support manager said, “We were not in a good place at the last inspection, but we took on board the advice and got the help we needed, and now we are in a much better place. There is still lots to do, but we will get there.”

With a renewed sense of teamwork and shared purpose, leaders and staff had begun to make meaningful progress. Improvements were becoming increasingly evident, and there was a clear sense of momentum as the service continued to develop a more positive and cohesive culture.
 

Leaders did not always have a full understanding of the context in which care, treatment and support was delivered. They were beginning to more consistently reflect the culture and values of their workforce and organisation and were building on the skills, knowledge, experience and credibility to lead effectively.

This remained a work in progress, and although many learning opportunities had been acted on and new systems introduced, there were still aspects which required further development to ensure the service could consistently deliver a sustainable and good standard of care.

Leaders were building their skills, knowledge, experience and credibility, and were making progress in leading with greater integrity, openness and honesty. While further development was still needed, they were taking steps in the right direction and continuing to strengthen their approach to leadership.
 

The provider fostered a positive culture where staff and people felt they could speak up and their voice would be heard.

People and staff we spoke with told us they felt listened to and that their views were valued. They described being more comfortable raising ideas, concerns or suggestions and felt these were taken seriously by the leadership team. This represented a clear shift from our previous inspection, when people and staff reported feeling unable to discuss matters with the provider because they believed nothing would change. The improvement in how people and staff were heard contributed to a more open and supportive culture within the service.

Comments we received included, “Yes, the managers are open to ideas and we are listened to”, “Yes, there is a positive culture of collaboration. Staff are encouraged to share ideas in team meetings, supervisions, and handovers. Communication is open, and feedback is taken seriously. This helps us learn from each other and continuously improve the quality of care” and “Yes, the service is well led. We have the freedom to speak up if there are any issues, the manager is approachable and supportive.”
 

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us they worked in an inclusive environment where individual differences were respected.

Staff were supported through training in equality, diversity and inclusion, helping them understand how to contribute to a fair and inclusive workplace. The provider also took account of individual circumstances and put reasonable adjustments in place when needed, including for staff with health‑related conditions. This approach helped staff stay in work and continue performing their roles safely and effectively.
 

The provider did not have always have clear systems of accountability and good governance. They could not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Although many improvements had been made, the governance and oversight arrangements still required further strengthening to ensure they were consistently robust. Leadership had begun to shape a more positive working culture; however, some areas continued to lack the level of governance needed to fully embed and sustain new working practices.

For example, not all audits were completed in line with best practice. Some were carried out collectively, with limited detail about what had been reviewed or who had been included. Where actions were identified, the lack of clarity about the audit process meant these actions could not always be followed up in a timely or effective way.

In other cases, audits highlighted the need for improvements, but no individual had been assigned responsibility for completing the actions or setting timescales. This approach reduced the service’s ability to track progress and ensure improvements were delivered.

As a result, some shortfalls identified during the inspection, such as errors in medicine records, had not been recognised through the provider’s own governance processes.
 

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The whole staff team worked collaboratively with a range of organisations to strengthen the quality of care. This included close partnership working with integrated healthcare trusts, local authorities and the fire service. By adopting this approach, systems and processes were becoming more coordinated and effective, leading to improved outcomes for people using the service.

Feedback received by partner agencies was reflective of the improvements we found and observed during our inspection.
 

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

People and relatives we spoke with told us they had seen the improvements taking place and felt more assured about the overall care provided at the service.
The provider and the whole team had been on a significant journey of improvement since the last inspection. They sought advice and guidance from other professionals and organisations to better understand what was required and used this learning to introduce new practices and processes. As a result, people experienced a noticeably improved standard of care, and staff felt more empowered to deliver it. Staff described feeling more confident in their roles and having a stronger sense of accountability and responsibility.