Amberley 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 requires improvement. At this assessment the rating has remained the same. This meant people’s needs were not always met.

The service was in breach of 1 legal regulation in relation to the lack of consistent person-centred care.

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

Records did not always provide staff with detailed guidance about people’s individual needs and preferences. Where people’s needs had changed care plans and risks assessments were not updated to reflect this. For example, in relation to incidents where people had fallen. There was limited evidence to support the provider worked in partnership with people and their relatives to decide how to respond to these changes in people’s needs.

People’s care records lacked detail about their social history, routines and their likes and dislikes in relation to food and drink. This meant staff lacked clear guidance to meet people’s individualised wishes.

The environment had not been adapted to meet the needs of the people. For example, the environment was not conducive to supporting or promoting the independence of people living with dementia. Signage was poor to help people navigate the service and locate key areas such as lounges and dining rooms. Menus and meal choices were not pictorial to enable people who required support with alternative communication methods, to make choices about what to eat.

The provider did not ensure people, or their relatives were involved in developing or updating person-centred care plans. Relatives and people’s friends did tell us they were kept informed if something had happened to their loved one. One relative told us, “The staff call me or tell me when I visit about how [person] is. If it’s serious they call me straight away.”

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

Records did not always provide staff with detailed guidance about people’s individual needs and preferences. Where people’s needs had changed care plans and risks assessments were not updated to reflect this. For example, in relation to incidents where people had fallen. There was limited evidence to support the provider worked in partnership with people and their relatives to decide how to respond to these changes in people’s needs.

People’s care records lacked detail about their social history, routines and their likes and dislikes in relation to food and drink. This meant staff lacked clear guidance to meet people’s individualised wishes.

The environment had not been adapted to meet the needs of the people. For example, the environment was not conducive to supporting or promoting the independence of people living with dementia. Signage was poor to help people navigate the service and locate key areas such as lounges and dining rooms. Menus and meal choices were not pictorial to enable people who required support with alternative communication methods, to make choices about what to eat.

The provider did not ensure people, or their relatives were involved in developing or updating person-centred care plans. Relatives and people’s friends did tell us they were kept informed if something had happened to their loved one. One relative told us, “The staff call me or tell me when I visit about how [person] is. If it’s serious they call me straight away.”

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

The provider had some understanding of the accessible information standard (AIS) for meeting the information and communication needs of people with a disability, or sensory loss.Whilst communication needs were recorded in care plans, this did not consistently translate to information being communicated to people in an accessible way. There was a lack of pictorial, easy read, and large text information to enable people to understand information, or to make informed choices. The communication needs of people who lived with dementia had not been considered to see if alternative formats would benefit them, this included information such as the planned menu. We saw some procedures such as the complaint procedure was provided in easy read.

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.

People and relatives all told us they knew how to raise concerns, and we saw a procedure was in place. One person told us, “I would speak to the boss if I wasn’t happy, but I am fine no complaints.” A relative said, “The manager is pleasant and I feel I could approach them if I had any concerns. Everyone is approachable.” The team leader told us the home had not received any complaints.

There was limited evidence shared with us to show people, and their relatives were routinely asked to provide feedback either through meetings or surveys. A relative told us, “I can’t really remember the last time I completed a survey or was formally asked for feedback. I do thank the staff for all that they do.”

We saw the home had received many compliments praising the staff and the care they provided. Comments include, ‘Fantastic staff team and care provided to [person]. This is a home from home and I know [person] is well looked after. Excellent care and communication.’ and ‘The staff genuinely care and are so loving thank you for all that you do.’

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People and their relative’s confirmed people were supported to access healthcare professionals and appointments or with emergency healthcare as needed. This included, dentists, opticians, chiropodists, dieticians and other supporting professionals.

There was a GP linked to the service who carried out weekly contact with home either through virtual consultation or visits to the service. The staff on duty were required to prepare a list of people prior to the discussions with the GP practice of whom they felt needed to be reviewed that week. The senior staff were responsible for sharing information or referring anyone requiring a check-up or review to prevent any delays in care and treatment. Staff also shared any updates on anyone whose health or condition had deteriorated and required further referrals to other health professionals.

Staff and leaders did not always actively listened 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 failed to recognise the inequalities people they supported may face. This meant people’s care was not tailored in response to this. The provider had failed to recognise and take steps to minimise barriers to inclusion and promote positive experiences and outcomes for people using the service. The provider had not considered the quality of care for people at each stage of their dementia care pathway. The nature and severity of symptoms are likely to change over time. People with dementia were likely to experience poorer care at the latter stages of their care pathway.

The provider had not developed the service in a way which valued and empowered people. There was a lack of understanding on how to deliver good, personalised dementia care in practice. There was a poor culture where there were low expectations and a lack of purposefulness to a person’s day. For example, people were not given opportunities to meet their social and emotional needs to reduce the risk of loneliness, isolation and frustration. The environment was not tailored to meet people’s various needs. Aspects of the building were not in line with guidance on dementia friendly environments. The garden although accessible had not been developed for people to enjoy and for the specific needs for those with dementia.

People were not always 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.

At the time of the inspection the provider told us they were not supporting anyone on an end-of-life pathway. There were many people living at the home who were at different stages of this journey and some people were described by staff as ‘fragile’ and were being supported in their bedrooms. We found there was brief information in people’s care records about their end-of-life wishes. For most people this consisted of information about their wishes to not be resuscitated or treated in hospital if they were on the end-of-life pathway. Some people had information recorded about their preferred funeral directors.

Where people or their relatives were not ready to discuss planning for their future care, this was not clearly documented and there was no system in place to ensure this was revisited at suitable intervals.

We received positive feedback from relatives about the care provided to their loved ones when they had not been well. One relative said, “The staff are very good and they have looked after [person] very well.” Another relative said, “They will sit by [person] bed and hold their hand and have a chat.”