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Inspection Summary


Overall summary & rating

Good

Updated 21 June 2018

Amber House is registered with the Care Quality Commission (CQC) to provide accommodation and personal care for up to a maximum of 13 people who may have learning disabilities or autistic spectrum disorder. It is situated in the village of Broughton, close to local amenities. The service also provides support to one person living in their own home in the community, supporting them with activities and promoting their independent living skills.

Accommodation is provided over two floors, in single bedrooms with en suite facilities. There are a range of separate lounges and a large dining area situated on the ground floor. Enclosed gardens to the side and rear of the service are easily accessible.

This comprehensive inspection took place on 25 April and the 8 May 2018 and was unannounced. At the last inspection on 17 and 18 August 2017 the service was found to be non-compliant with regulations; 9, person –centred care, 11, consent, 12, safe care and treatment, 15, premises and equipment, 17, good governance and 18, staffing of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because care plans were insufficiently detailed to enable staff to meet people's needs, there were restrictions in people's lives that had not been agreed as in their best interest and people did not always have risks to their safety mitigated. It was also because elements of the environment were unsafe, quality assurance systems and oversight of people's needs were ineffective and staffing recruitment checks were insufficiently robust.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and the timescales this would be achieved to improve the key questions, is the service safe, effective, responsive and well-led? We received a comprehensive action plan and regular updates, which demonstrated the progress made with the improvement programme. At this inspection we looked at the previous breaches of regulations and the action plan to check that improvements had been made and sustained over a period of time. We found significant improvements had been made in all areas.

The care service has been developed and designed in line with the values that underpin the 'Registering the Right Support' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

In our last report of 17 and 18 of August 2017 we reported that a management company had been contracted by the provider to support the necessary changes required. The management company purchased the service since then and became the nominated individual.

The new provider, registered manager and staff had worked hard to make improvements. People, relatives, staff and professionals provided only positive feedback about the service and the improvements made. The leadership and management had improved, with both working alongside staff and taking an active role in the running of the service. Everyone spoke highly of the management team and said they were approachable and supportive.

Quality assurance systems had been fully implemented and maintained since the last inspection and we saw action had been taken when issues had been identified. The provider had worked hard at implementing many positive changes and was committed to ensuring improvements were sustained and developed further, to ensure people received high quality care.

A robust recruitment process was in place, which ensured staff had the necessary skills and experience and were suitable to work with people who used the service. Staff received the training and support they needed to carry out their roles and meet people’s needs. The provider monitored staffing levels regularly, to ensure staffing levels were sufficient and staff deployment was effective.

Staff knew how to safeguard people from the risk of harm a

Inspection areas

Safe

Good

Updated 21 June 2018

The service was safe.

Improvements had been made in staffing numbers and they were sufficiently deployed to meet people�s needs safely. Staff received safeguarding training and knew how to protect people from abuse and avoidable harm. Staff were recruited safely.

Systems were in place for the safe management of medicines. People's medicines were securely maintained and staff had completed relevant training. Audits on medicines and records were carried out.

Risks to people�s health, safety and welfare were assessed and mitigated. Environmental checks took place regularly and equipment was well maintained. Infection control and prevention was effectively managed.

Effective

Good

Updated 21 June 2018

The service was effective.

There had been improvements in staff�s understanding and implementation of mental capacity legislation. When people lacked capacity to consent to care, best interest�s decisions were made in consultation with relevant people.

Staff had access to a range of training, supervision and support to ensure they had the necessary skills and were confident when caring for people and meeting their needs.

Improvements had been made to the environment to ensure it was safe and met people�s needs. Health care and nutritional needs were met.

Caring

Good

Updated 21 June 2018

The service was caring.

Staff maintained confidentiality and personal records were stored securely.

Staff were observed speaking with people in a kind and patient way and treated them with dignity and respect. People were provided with information and explanations, so they could make choices and decisions about aspects of their lives.

Responsive

Good

Updated 21 June 2018

The service was responsive.

Personalised care and support was delivered by staff and relevant professional to help maintain people�s health and well-being.

There was a complaints procedure on display and people felt able to raise issues, which were appropriately addressed.

Well-led

Good

Updated 21 June 2018

The service was well-led.

Previous regulatory breaches had been met. There had been improvements in the quality monitoring of the service delivered to people. Quality assurance systems highlighted shortfalls and appropriate action taken.

The new nominated individual provided strong leadership and effective management of the service. People, relatives, staff and professionals told us the service was well managed and the culture within the service had improved.