Amberley House - London

Updated 6 January 2024

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 2 inspectors.

Service and service type

Amberley House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Amberley House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 1 November 2023 and ended on 11 December 2023. We visited Amberley House on 1 November 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. Following the last inspection, the provider also completed an action plan around the regulation 18 breach for staffing to explain how they would improve. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. At this home, the nominated individual was also the owner of the home.

We also spoke with 2 people living at Amberley House, 1 relative and 4 care staff. We used observations to help us understand the experience of people who were unable to speak with us. We reviewed a range of records related to 3 people’s care and support. This included people’s care plans, risk assessments and medicines records. We reviewed 3 staff files in relation to recruitment, training and supervision. We also reviewed records related to the management of the service, which included quality assurance records and rota systems.

Updated 6 January 2024

About the service

Amberley House is a residential care home providing accommodation and personal care for up to 30 people aged 65 and over, some of whom may be living with dementia. At the time of the inspection there were 3 people living at the home. The home is a large adapted detached house. There is a large garden to the rear of the property.

In December 2022 the local authority identified concerns around the quality of care being provided at Amberley House. On 9 December 2022 the local authority placed an embargo on Amberley House not allowing them to accept any new referrals until the quality of care had been improved. The embargo was still in place at the time of this inspection. Since the last inspection people had been supported by the local authority to move to alternative homes if they wished to.

People’s experience of using this service and what we found

At this inspection we found there had been an improvement in the quality of care and the provider had addressed some of the concerns raised during the last inspection. However, we found breaches of regulation around staff training, assessing risk and governance of the home.

We have also made a recommendation around care planning and the use of language when discussing people living with dementia.

People and their relatives told us people were safe living at Amberley House. Whilst we found not all staff had received training in safeguarding, staff were able to explain safeguarding and how they would report any concerns. People received their medicines safely and on time. Staff were recruited safely, and relevant background checks done before staff started work. There had been a lot of work on the premises around decorating and replacing furniture which was on-going. Staff had received training in infection control and understood how to keep people safe. There were no restrictions on visiting.

People were supported to eat and drink, and staff were aware of their likes and dislikes. People were referred to appropriate healthcare in a timely way. Staff knew people well and understood when they became unwell. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff were supported in their role through regular supervision and appraisal.

Activities for people had improved within the home and people’s interests and what they enjoyed were documented and acted on by staff. Care plans were person centred and contained information that was important to maintain people’s health and wellbeing. There was a complaints process in place. People and relatives knew how to make a complaint.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 26 April 2023) and there were breaches of regulation.

This service has been in Special Measures since 26 April 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

The provider completed an action plan around regulation 18 (staffing) after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made. However, we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Amberley House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to staff training, assessing risk and good governance of the home.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.