17 May 2023
During an inspection looking at part of the service
Ampersand is a residential care home providing accommodation for persons who require nursing or personal care to up to 43 people. The service provides support to older people, some of who lived with dementia. At the time of our inspection there were 35 people using the service, 1 of whom was in hospital during the inspection.
People’s experience of using this service and what we found
The service was not always well led. Records were not always robust and accurate. The provider’s audits and checks had failed to identify issues relating to risk assessments, medicines management, infection control and safe recruitment practice. Their quality monitoring processes had not identified issues with records that we found on inspection.
Risks to people's safety had not always been identified. Risk assessments did not have all the information staff needed to keep people safe. Medicines management was poor. The provider could not be assured that people had received their medicines as prescribed. Some areas of the service were not clean.
People could not be assured new staff were adequately checked to ensure they were suitable to work with people to keep them safe. We found no evidence that people had been harmed. However, systems were not robust enough to demonstrate staff recruitment was effectively managed. We were not fully assured that staff were deployed effectively across the service. We have made a recommendation about this.
Despite the feedback above, people and relatives told us staff were kind, caring and friendly. Comments included, “They are all very nice and very respectful. They always call me by my name”; “They are excellent, very friendly and kind. They will get me anything” and “I have been here a long time and am used to it. I am happy here. The staff make me feel safe here.”
Staff understood their responsibilities to protect people from abuse. Staff described what abuse meant and told us how they would respond and report if they witnessed anything untoward.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 26 October 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last 4 consecutive inspections.
Why we inspected
We carried out an inspection of this service on 21 August 2019. A breach of legal requirements was found. This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ampersand on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to risk management, infection control, medicines management, safe recruitment practice and good governance at this inspection. We have made a recommendation about staff deployment.
Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.