Amber Court

Amber Court is registered as a care home with nursing and provides accommodation for people who require nursing or personal care. The home is in a residential area of Blackpool. It can accommodate a maximum of 33 people. Accommodation is over two floors with bedrooms and communal facilities on both floors with lift access. There is a car park at the front of the home.

At our last inspection in May 2016, we rated the service overall good. However safe was rated as required improvement. This was in relation to staffing. People who lived in the home, relatives and staff told us there were times when staffing was too low and staff were rushing about. We also observed this on that inspection. We made a recommendation about regularly reviewing staffing rotas to ensure safe and sufficient deployment of staff.

During this inspection visit on 10 January 2019 we found staffing was sufficient to meet the needs of people supported. We found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of the inspection 33 people lived at the home.

The inspection visit took place on 10 January 2019 and was unannounced.

There had been a change of registered manager since the last inspection. The new manager had been the registered manager for the home since July 2018. 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.

People told us they felt safe and cared for by staff. There were procedures in place to protect people from abuse and unsafe care and staff were aware of their responsibilities in keeping people safe. Risk assessments had been developed to minimise the potential risk of harm to people. Any safeguarding concerns, accidents and incidents were dealt with appropriately.

Medicines were managed safely. People received their medicines when needed and appropriate records had been completed.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs. Most people said there were sufficient staffing levels in place. One person said, “I only have to shout and they are here quickly.”

We saw and people told us staff provided care in a way that respected peoples’ dignity, privacy and independence. People told us they enjoyed a variety of social and leisure activities and staff were welcoming to their families and friends. People said this assisted their well-being.

We saw people had access to healthcare professionals. People told us staff cared for them in the way they wanted and met their care needs promptly. They referred them to healthcare professionals in a timely way.

People’s care and support had been planned with them and was person centred and informative. We saw they had consented to their care and treatment wherever possible. People had been supported to have maximum choice and control of their lives and were supported in the least restrictive way possible. The policies and systems in the service supported this practice. People had information about support from an external advocate should this be required.

Most people told us they enjoyed the food provided and had choice and variety. People received sufficient food and drink and the assistance they needed. The kitchen was clean, organised and stocked with a variety of provisions and staff were trained in food safety.

We looked around the building and found it was clean and hygienic, had been maintained and was a safe place for people to live. There were safe infection control procedures and practices and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when providing personal care to people so they did not risk causing cross infection. The design of the building and facilities in the home were appropriate for the care and support provided. We found equipment had been serviced and maintained as required.

People and staff were complimentary about the management support in the home. The management team sought people's views in a variety of ways. They assessed and monitored the quality of the service through audits, resident, relative and staff meetings and surveys. People felt able to complain if they were not satisfied with their care and said action would be taken. They told us the management team were supportive and approachable.

Further information is in the detailed findings below.

Amber Court Care Home is registered as a care home with nursing and provides accommodation for people who require nursing or personal care. The home can accommodate a maximum of 33 people. Amber Court is situated in its own grounds on the outskirts of Blackpool close to the motorway. The building is designed over two floors with lift access. All rooms are single occupancy and provide en-suite facilities. Communal lounges and dining areas are located on both floors. There is a passenger lift for ease of access and the home is wheelchair accessible. There are communal lounges and dining areas and a garden area at the rear of the home. Parking is available.

At the time of the inspection 31 people lived at the home.

At the last inspection in May 2014 the service was meeting the requirements of the regulations that were inspected at that time.

There was a registered manager in place. 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.

People told us they felt safe living at Amber Court and liked living there. Risks to people had been minimised because the registered provider had procedures in place to protect them from abuse and unsafe care.

We looked at how the home was staffed. We saw there were not always enough staff to provide safe care. People who lived in the home, relatives and staff told us there were times when staffing was too low and staff were rushing about. We also saw staffing was too low on part of the inspection. We raised this with the registered manager who promptly took steps to improve staff rotas to provide safer staffing levels.

We recommended the registered provider monitor staffing levels to ensure sufficient staff are on each shift.

Recruitment and selection was carried out safely with appropriate checks made before new staff started working in the home. This reduced the risk of employing unsuitable people.

Staff managed medicines safely. Medicines were given as prescribed and stored and disposed of correctly. People said they received their medicines when they needed them.

People told us they were offered a choice of healthy and nutritious meals. Drinks were available throughout the day and people’s dietary and fluid intake was sufficient for good nutrition. Almost everyone we spoke with were praising of the meals.

Staff had received training in caring safely which gave them the skills and knowledge to provide support to people.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). This enabled staff to work within the law to support people who may lack capacity to make their own decisions.

We saw staff were familiar with people’s care needs, likes, dislikes and wishes. People we spoke with told us staff were friendly, caring and respectful. They said staff supported them to remain as independent as they could be. They also assisted them in a timely way and made time to talk with them even when they were busy.

There was a transparent and open culture that encouraged people to express any ideas or concerns. People and their relatives felt their needs and wishes were listened to and acted on. They said staff were easy to talk to and encouraged people to raise questions at any time.

There were procedures in place to monitor the quality of the service. The registered manager sought people’s views in a variety of ways and dealt with any issues of quality quickly and appropriately. Staff told us she supported them and communicated well.

As part of the inspection visit we looked at how people were being cared for and supported. How the service worked with other professionals for the benefit of people who live at the home. We looked at the environment to make sure it was a safe and suitable place for people to live. We looked at how the service recruited staff to ensure they were safe and suitable to meet the needs of people living at Amber Court. We also looked at quality assurance systems to see how the service developed the services it provided to people.

On 13th January 2014 we served a fixed penalty notice to Countrywide Care Homes (2) Limited for failing to have a registered manager in place at Amber Court. A fine of '4,000 was paid. A manager application has been received and is currently being assessed.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, staff supporting them, relatives and by looking at records. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Amber Court.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. One person told us, 'When I leave here I know my relative is well care for. That gives me piece of mind'. Another said, 'The staff are excellent and I feel safe and secure. I feel settled here'.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns and whistleblowing investigations. This reduced the risks to people and helped the service to continually improve.

Staff we spoke with had knowledge and understanding of individual personal care plans and risk management plans for people they were supporting. One staff member told us, 'The plans we use are clear and easy to follow'.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant people would be safeguarded as required.

The homes environment was designed to meet the needs of people using the service. Maintenance service certificates were in place and up to date to ensure systems in the home were safe.

Is the service effective?

People's health and nursing care needs were assessed with them and they were involved in developing their plans of care where possible. Relatives views were also sought to ensure people received the right care to meet their needs. Specialist dietary, mobility and equipment needs had been identified in care plans where required. There was also an ongoing review process to ensure people's needs were continuously monitored and changes made when needed.

Personal history profiles were in place providing an individual picture of each person which staff said had been a useful tool to understand peoples backgrounds, their likes and dislikes.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People we spoke with told us, 'I think the staff are all very good with my relative, it's nice to see the same faces'. Another told us, 'My family are pleased with the level of care my relatives receive here. They have really settled and all the staff are very respectful'.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

The service employed an activities person to support people to undertake chosen interests and activities, however they were on leave on the day of inspection. One member of staff said, 'She is off today but the residents love here she is very good.' A resident we spoke with said, 'There are things going on if you want to join in but it's up to you whether or not you choose to'. Another person who lived at the home said, 'I don't join in much but I have to say she is always trying to put things on for people.'

People using the home, their relatives, friends and other professionals involved with the service completed annual satisfaction surveys. The results were used to inform the development and quality of the service. Any issues highlighted were looked at and responded to in order to ensure the home was meeting quality standards.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities. Staff had an understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure people received a good quality service at all times.

There were a range of audits and systems put in place in by the manager and provider to monitor the quality of the service being provided.

We saw people were supported to make choices with their meals and there was choice of food being provided. We noted that the catering team showed a good knowledge of people's individual needs and preferences. There were several variations of the main meal provided in order to cater for people's preferences.

Some of the people we met were unable to tell us there experience of living in the home. However we observed that people appeared to be happy with the care and support they received. It was a busy day when we inspected, and we saw staff working conscientiously and in good humour. We saw people were treated with care and respect.

The manager had a range of audits and systems in place to monitor the quality of the service being provided.

We saw that people were smartly dressed, well groomed and wearing clean and comfortable clothing.

People we spoke with told us, 'They are looking after me well. I couldn't wish for better carers.'

Family and visitors we spoke with told us, 'I find the place excellent, they look after my wife very well. '

Another comment made to us was, 'When I leave here I don't worry.'