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Inspection Summary


Overall summary & rating

Good

Updated 8 March 2017

This inspection took place on 7 January 2017 and was unannounced.

Ambleside nursing home is registered to provide accommodation and nursing or personal care for up to 20 people. There were 18 people living at the service at the time of inspection. The home is situated in Weston Super Mare and offers accommodation split over four floors. There is a communal lounge on the ground floor and a separate dining area on the basement floor. There is lift access to each of the floors and the service was in the process of having a wet room installed with an accessible shower.

There was not a registered manager in post. 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. The current manager had applied to CQC to become the registered manager and this application was being considered at the time of inspection.

Staff were recruited safely because the provider undertook a variety of checks prior to staff starting work.

Assessments were made in line with the Mental Capacity Act(MCA), however best interests decisions did not include evidence about the options considered or whether decisions made were the least restrictive for the person.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns. Staff were also aware of how to whistle blow if they needed to and reported that they would be confident to do so.

Staff were aware of the risks people faced and understood their role in reducing these. People had individual risk assessments which identified risks and actions required by staff to ensure that people were supported safely.

There were enough staff available and people did not have to wait for support. People had support and care from staff who were familiar to them and knew them well. Staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet these needs.

People received their medicines on time. We saw that people were supported by staff who had received appropriate training to administer medicines and that they followed safe procedures when giving people their medicines.

Staff had the necessary skills and knowledge to support people and had received training which was relevant for their role. Some training offered was considered essential by the home and other training was offered based on the needs of people living at the home and the development needs of staff.

People spoke positively about the food and had choices about what they ate and drank. The kitchen were aware about people’s dietary needs and where people required a special diet or assistance to be able to eat and drink safely this was in place.

Staff knew people well and interactions were relaxed and caring. People were comfortable with staff and we observed people being supported in a respectful way. People were encouraged to make choices about their support and staff were able to communicate with people in ways which were meaningful to them.

People had care plans which were person centred and included details about their likes and dislikes and how they wished to be supported. Staff were able to confidently tell us about people’s preferences and care plans were regularly reviewed with people and their loved ones where appropriate.

People were able to engage with a range of activities including one to one time with staff. People told us that they had enough to do at the home and although there were planned activities, staff were also encouraged to spend unplanned time engaging people in activities.

Relatives spoke positively about the staff and management of the home. They told us that they were always welcomed and visited when then chose. Both relatives and people told us that they would be confident to complain if they needed to.

Staff felt supported by the manager at the home and were confident in their roles. The manager had undertaken some improvements since starting in the role and these were in place and working well. There were further developments planned which the manager was confidently able to explain to us. Staff were encouraged to have input into the development of the home and communication between staff and the manager was effective.

Feedback was gathered both formally and informally and used to drive improvements at the home. Quality assurance measures were regular and also used to identify gaps and trends which were then used to plan actions to drive high quality care.

Inspection areas

Safe

Good

Updated 8 March 2017

The service was safe.

The provider undertook a variety of checks prior to staff starting work.

Individual risk assessments were completed to ensure that people were looked after safely and staff understood their role in managing identified risks.

People were protected from the risks of abuse because staff knew how to recognise and report concerns and were confident to do so.

People received their medicines as prescribed and they were administered and stored safely.

Effective

Good

Updated 8 March 2017

The service was effective.

Staff were knowledgeable about the people they were supporting and received relevant training for their role.

People who were able to consent to their care had done so and staff provided care in people’s best interests when they could not consent.

People enjoyed a choice of food and were supported to eat and drink safely.

People were supported to access healthcare professionals appropriately.

Caring

Good

Updated 8 March 2017

The service was caring

People had a good rapport with staff and we observed that people were relaxed in the company of staff.

Staff knew how people liked to be supported and offered them appropriate choices.

People were supported to maintain their privacy and dignity.

People were encouraged to be as independent as possible.

Responsive

Good

Updated 8 March 2017

The service was responsive.

People had individual care records which were person centred and gave details about people’s history, what was important to them and identified support they required from staff

People enjoyed a range of activities and staff spent one to one time with people.

People and relatives knew how to raise any concerns and told us that they would feel confident to do so.

Well-led

Good

Updated 8 March 2017

The service was well led.

People, relatives and staff felt that the manager was approachable and had confidence in the management of the service.

Feedback was used to highlight areas of good practice or where development was needed. Information was used to plan actions and make improvements.

Quality assurance measures provided a clear picture of trends or gaps in practice and actions required were identified and acted upon.