Amberley House Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.This meant people’s needs were not always met.

The service was in breach of legal regulations in relation to person-centred care and governance.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Healthcare professionals raised concerns that people’s, “basic care needs [were] not being met”. Systems and processes were not effective in ensuring robust monitoring of people’s health or wellbeing. People’s needs were not always accurately assessed, and they did not consistently have choice and control over their care. Some people’s personal hygiene records indicated people may not have received personal care every day. This had not been recognised by the provider or staff. This meant the provider could not be assured care and treatment was always person-centred and tailored to meet individual’s needs.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

As care plans and risk assessments were not always up to date and advice from healthcare professionals was not followed, the provider could not be assured people received consistent care. The provider’s systems and processes to monitor and review care were not always effective.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Healthcare professionals had advised the service to provide pictures of meal choices to 1 person to support their decision making. During the assessment, we found not all meals had associated pictures, this meant the person may not have been able to choose what they wanted.

The provider told us information was available to people in different formats if they required this. We saw there were references to how people communicated in their care plans. Staff confirmed to us they were aware of how people communicated.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

There were systems and processes to obtain feedback. For example, people had taken part in a residents meeting. We reviewed the meeting minutes and saw feedback regarding the choice of meals waslargely negative, ‘sick to death of sponge and custard nearly every day’, ‘more of a variety would be nice, it appears to be the same old thing’,‘toomuch sponge and custardfor lunch and supper mostdays.’ There was no evidence action had been taken in response to the feedback provided and during the inspection weobservedpeople were served sponge and custard. Comments received from people during the assessment included, “the food is sometimes cold”.

There were systems for managing complaints. People and relatives knew how to raise a complaint if they needed to.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People mostly had access to health professionals and services when they needed it. For example, district nurses, specialist teams and the GP. However, where staff had continued concerns after a healthcare professional had reviewed people, further referrals were not always requested.

Healthcare professional’s advice once sought was not always followed to ensure treatment was provided as required, this included guidance provided in relation to repositioning to reduce skin damage and dietary requirements.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. The provider did not ensure staff with knowledge of people’s needs was effectively deployed to ensure people received safe support. Risk assessments and care plans were inaccurate, contradictory and failed to reflect people’s full care needs. Staff had not been provided with clear guidance on how to respond to people’s individual needs.

People who lacked capacity and people who received care in their bedroom did not receive care which promoted their physical wellbeing, as they did not have the same opportunities as others to take part in activities. The time staff spent with people was task led with little focus on people’s wellbeing and reducing social isolation.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. The service did not consider the risk of isolation when people were admitted to the service.

The service provided end of life care for people. Care plans contained information relating to people’s next of kin and funeral plans. During our assessment we heard staff speaking with a person’s relative in a kind manner, providing information on the person’s condition and offering support.

One person had been admitted during the assessment to receive end of life care. Their room was in the newer part of the home away from general communal areas and at the end of a corridor. This meant staff and visitors did not pass their room on their way to other areas of the home. Although staff checked the person at regular intervals, they were at risk of isolation and staff might not be aware if their needs suddenly changed.