Archived: Ambleside

There were two registered managers in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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.

One of the registered managers was the owner, and as a provider they had values and a clear vision that were person centred and focussed on people having the opportunity to be part of their local community and gain their independence. All staff and managers demonstrated passion and commitment to providing a service for people that met their individual needs.

People had beneficial relationships with staff. Relatives commented on the positive impact staff had made on people’s lives and how they had changed for the better. People’s lives had improved as a result of using the service; people were enabled to become more independent by gaining everyday life skills and understanding how to care for their health and well-being.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. People were empowered to make their own decisions and to take responsibility for them. Staff provided people with information to enable them to make an informed decision and encouraged people to make their own choices.

People received safe care and support. Staff understood their role in safeguarding people and they knew how to report concerns. There were enough staff with the right skills and attitudes to meet people’s needs. The provider included people in the in-depth recruitment and selection of new staff.

People benefited from staff that had received training that specifically met their needs. Staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. Staff were clear about their roles and responsibilities in caring for people and received regular support from the provider.

There was a person centred and flexible approach to each person’s nutritional needs and staff promoted healthy eating. Individuals were supported to realise the knowledge and understanding they needed to attain a healthy weight, plan and prepare meals.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures required to minimise any risks. Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals.

Staff protected people’s privacy and dignity. All interactions between staff and people were caring and respectful; staff were consistently patient, kind and compassionate. Staff demonstrated affection and warmth in their contact with people, which was clearly reciprocated.

Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. Staff and people were confident that if they had any concerns they would be listened to and any concerns would be addressed.

People were involved in monitoring the quality and safety of the service and staff regularly monitored the support people received. People and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement.

People told us that they were involved in planning the menus and they enjoyed cooking the food when it was their turn. Another person told us that they bought their own clothes and they went out to the park, pub, and gym and had takeaway meals which they enjoyed. They told us 'Staff help us when we need help and I have no complaints'.

We observed that staff spoke to people in a kind manner and worked at their pace. The records kept for people using the service had been updated and were located promptly when required.

People also told us that the staff knew the care they needed and how they wished to be supported. One person said 'I am very well looked after here' and another person said 'the staff are kind and I feel safe living here'.

One relative of a person who had just left, told us that 'Staff here are wonderful, we can't say enough'. Another relative told us that they knew all the names of most of the staff and found them very caring towards their family member and other people living at the home.

We observed the care staff talking to people in a dignified manner. However we saw that management did not always maintain people's privacy and dignity. The records kept in home for people using the service were also not always located promptly when required.

We examined the arrangements that were in place to obtain people's consent to their care and treatment. We looked at how care and support was provided to people to ensure their welfare, the arrangements that were in place to ensure medication was appropriately handled, the support and development that was offered to staff, and the records that were in place to support the running of the service. We found concerns with the support that was offered to people, the records that were maintained for people and the service, and the accessibility of staff records.