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Archived: Amber Banks Care Home

Overall: Inadequate read more about inspection ratings

53-55 Clifton Drive, Blackpool, Lancashire, FY4 1NT (01253) 341450

Provided and run by:
Amberbanks Care Home Ltd

Important: The provider of this service changed. See old profile

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Background to this inspection

Updated 10 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We undertook an unannounced comprehensive inspection of Amber Banks on 05 and 09 May 2016. This inspection was undertaken because we received information of concern about people’s welfare and safety. We inspected the service against the five questions we ask about services: is it safe, effective, caring, responsive and well-led. This was because we wanted to check people’s safety and wellbeing whilst they lived at Amber Banks.

On the first day of our inspection, the inspection team consisted of two adult social care inspectors and an inspection manager. On day two, an adult social care inspector carried out the inspection.

Prior to our unannounced inspection on 05 and 09 May 2016, we reviewed the information we held about Amber Banks. This included notifications about incidents that affect the health, safety and welfare of people who lived at the home. We checked safeguarding alerts, comments and concerns received about the home. At the time of our inspection, there were a number of safeguarding concerns being investigated by the local authority.

We spoke with a range of people about this service. They included four members of the management team, seven staff, five people who lived at the home and two relatives. We also spoke with a visiting healthcare professional. We discussed the service with the commissioning department at the local authority. They told us they had multiple ongoing concerns about Amber Banks and had suspended the home to new admissions. We did this to gain an overview of what people experienced whilst living at the home.

We also spent time observing staff interactions with people who lived at the home and looked at records. We checked documents in relation to six people who lived at Amber Banks and ten staff files. We reviewed records about staff training and support, as well as those related to the management and safety of the home.

Overall inspection

Inadequate

Updated 10 August 2016

At the last inspection on 07 July 2015, we found the provider was meeting all the requirements of the regulations. We rated the service as Good overall and in all five key areas.

We carried out an unannounced comprehensive inspection of Amber Banks Care Home on 05 and 09 May 2016 because we received information of concern about people’s welfare and safety. We undertook a comprehensive inspection to assess if people who lived at the home were safe. We also checked if staff were caring, effective and responsive in meeting people’s needs. Additionally, we evaluated the leadership and organisation of the home.

Amber Banks provides care and support for a maximum of 46 older people who may live with a physical disability. At the time of our inspection there were 29 people living at the home. Amber Banks is situated in a residential area of Blackpool close to the promenade. All bedrooms offer single room accommodation with en suite facilities. There are communal lounges, dining areas and a back yard, which had a seating and smoking area.

A registered manager was not in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The previous registered manager left two years ago and there have been seven managers in post since then. The new manager, who started in December 2015, told us they had sent an application to register with CQC in February 2016. However, our systems show we have not received this and the provider had no evidence to demonstrate the new manager had applied to register.

During this inspection, we reviewed staffing levels and skill mixes and found these were insufficient to meet people’s requirements. One person told us there were not enough staff and as a result, “The activities co-ordinator is not happening. The show and cinema doesn’t happen.” We observed there were not enough staff to meet people’s needs with a timely approach. Staff added there were not enough staff to ensure people received safe care and treatment. This included agency staff cover for short notice sickness, which meant staffing was not always adequate to monitor and support people continuously.

The management team had not continuously followed safe recruitment processes to ensure suitable staff were employed. They failed to check people’s full employment histories, criminal records and references at all times. Although the provider had a training programme in place, not all staff received training and supervision to support them in their roles. Their monitoring system and associated records were poorly organised.

We discussed safeguarding individuals from abuse or harm and found staff were knowledgeable about related principles. However, we saw multiple concerns with people’s environmental safety. We identified problems with health and safety, fire and infection control. The management team did not have effective risk assessment processes to protect individuals from potential hazards. The provider failed to have clear oversight of environmental safety and had not maintained living conditions that promoted people’s welfare and security.

We observed the provider failed to ensure people were protected from the unsafe management of their medicines. Staff were not enabled to focus on dispensing medicines without being distracted and medication was not always stored securely. The provider did not have scrutiny of related processes and had not checked these continued to be safe and efficient. Not all staff had medicines training provision, where required, following their employment at Amber Banks.

The provider failed to monitor people effectively against the risks of malnutrition and dehydration. For example, there were no associated risk assessments and there were gaps in records to assess people’s food and fluid intake. Individuals who lived at the home told us the food was poor.

One person said, “I don’t like [the catering system in place]. I get ‘[the catering system] stomach’ [trapped wind] and there’s too much additives.”

Staff demonstrated a good understanding of the Mental Capacity Act (MCA) and associated Deprivation of Liberty Safeguards (DoLS). However, there was no recorded consent to people’s overall and decision-specific care. There was no documentation of best interest processes, decision specific care planning or review of mental capacity. The provider had not protected people against the risks of inappropriate or unsafe care.

Staff referred people to other healthcare services when they developed further health needs. Nevertheless, the provider failed to update care records in order to meet their changing requirements. For instance, important hospital appointments were cancelled without any recorded follow-up. Care plans were not always revised after healthcare reviews to ensure support continued to meet the individual’s needs

We found care planning was poor and did not always guide staff to be responsive to each person’s needs. For example, actions to support people were brief and the frequency of support and how this should be done was unclear. We found gaps in records, which failed to ensure people were adequately assessed and monitored. Additionally, the provider failed to respond to people’s needs with a collaborative approach to ensure support was appropriate and met their requirements. For instance, they responded to two people’s complex needs in an unsuitable way, which was not responsive to their needs

Staff were kind, caring and encouraged relatives to visit Amber Banks. However, we noted consistency of staff who understood each individual’s care requirements was not always in place. One person told us there had been a, “Mass exodus of staff.” We observed staff spent minimal time engaging with people and did not always maintain their dignity. There was no evidence people were involved in their care to ensure this was personalised to their needs. Accurate and up-to-date records were not consistently maintained or securely stored to maintain people’s confidentiality.

The provider did not have a clear oversight of the quality and safety of Amber Banks. They failed to ensure premises and equipment were monitored to maintain people’s welfare. For example, there were no environmental safety checks and audits. The provider did not monitor other systems within the home, such as medication, infection control and care planning.

The environment and ethos of the home did not promote people’s welfare. We saw there was a lack of clear leadership and cohesion within the management and staff team. For instance, service organisation, filing systems and communication processes were poor.

There were limited arrangements to assess, monitor and improve quality assurance. For example, the management team had not sought or acted upon feedback from people about their experience of living at Amber Banks. Additionally, the provider failed to follow up on staff concerns or suggestions to improve the home.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.