Amber House - Coventry

Amber House - Coventry is a residential care home providing personal care to up to 15 people. The service provides support to older people, some of whom live with dementia. Accommodation is provided on two floors accessed by stairs and a stair lift. People have their own rooms with shared bathroom facilities and access to communal areas. At the time of our inspection there were 13 people living at the service.

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

Systems in place to monitor environmental and infection risks to people were not robust and placed people at risk of harm. The service was not clean, staff did not always wear Personal Protective Equipment (PPE) correctly and people were at risk of sustaining burns from uncovered hot water pipes. The provider took immediate action to rectify the issues we identified.

Quality monitoring was in place and a full range of audits were being completed for all areas. Whilst the monitoring was being carried out it had not identified all of the shortfalls we found during the inspection. The provider and manager had not ensured CQC were notified of all events they have a regulatory responsibility to inform us of. Following our inspection, the provider reviewed their quality monitoring system and made changes to make it more robust.

People and their relatives told us they received a good service and felt safe. Accidents and incidents were recorded, and risk assessments were in place. Staff understood their responsibilities about safeguarding and had been appropriately trained. Arrangements were in place for the safe administration of medicines.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure and carried out relevant vetting checks when they employed staff.

People, relatives and staff were asked for feedback about the service and for ideas on how to make improvements. People, relatives and staff spoke positively about the manager and the culture of the home.

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.

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 good (published 17 January 2020)

Why we inspected

We undertook a targeted inspection to review the service’s infection prevention and control procedures.

We inspected and found there was a concern with relation to the cleanliness of the service and environmental risks, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Good 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 and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Following the first day of inspection the provider took action to mitigate the risk we identified. On the second day of inspection we found these actions had been effective to keep people safe.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safe care of people and the governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Amber House – Coventry is a residential care home providing personal care. The service can support up to 15 people aged 65 and over in one adapted building. At the time of the inspection the service was supporting 13 people, some of whom were living with dementia.

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

Systems and processes were in place to keep people safe and risks associated with people's care needs had been assessed. There were enough staff to meet people's needs and recruitment processes and procedures were robust which helped to ensure suitable people were employed. Medicines were managed safely. The service was clean and well maintained, and there were appropriate procedures to ensure any infection control risks were minimised.

Staff received training and supervision for them to perform their role. People's nutrition and health were supported and promoted. 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 knew people well and care plans were detailed and provided staff with clear guidance on how to meet people's needs. Staff respected people privacy and dignity and encouraged people to remain independent. People and relatives could express their views about the running of the home.

People received personalised care and support which met their needs and reflected their preferences. People benefited from a variety of activities, events and trips out that were available to reduce social isolation, give meaning and purpose and enhance their wellbeing.

The service was well led. The registered manager was mentoring a new manager to learn the role in preparation for when they retired, this was being done to ensure that people were not disrupted by the planned change. There was a positive culture throughout the service which focused on providing care that was personalised. The management team used a variety of methods to assess and monitor the quality of the service. They were aware of their regulatory responsibilities associated with their role.

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

Rating at last inspection

The last rating for this service was Good. (Report published 15 June 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was 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.

People’s safety was supported by care staff that knew and understood how to protect and reduce the risk of harm. People were happy that their home was safe and the care staff helped to keep them safe. We saw people had their needs met during our inspection from care staff who were available to offer guidance or care. People told us they received their medicines at the same time daily. If needed extra pain relief or other medicines were provided on request or as assessed by care staff.

Care staff were supported to look after people with training and were supported by the management team. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they enjoyed the meals and always had a choice of meals and drinks they enjoyed and kept them healthy. We saw that where people needed additional support from healthcare professionals the treatment was supported by the care staff who followed any advice and guidance.

People told us and we saw that their privacy and dignity was promoted and care staff were respectful and kind with people. People's choices and decisions were listened to and respected by care staff when providing care and support in the communal areas.

People’s care needs were assessed, including their views on how their care was planned and delivered to meet those needs. Where needed to aid planning, people’s relatives felt they were involved in the care and were asked for their opinions and input. People told us staff offered a variety of things to do and had entertainers visit which included music and exercise.

People were confident to approach the manager if they were not happy with the care. The provider had reviewed and responded to all concerns raised.

People’s views and opinions of the care they had received had been sought and reviewed to look at how improvements could be made. The management team ensured people and their relatives were kept informed of any changes or improvements planned. People and care staff told us the management team were easy to talk with and always available within the home which people and relatives liked.

Further information is in the detailed findings below2

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

Amber House is a small residential care home which provides care and support to a total of 15 people who live with dementia. At the time of our visit, 13 people were living at the home.

The service has a registered manager. 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.

A relative and staff told us people were safe living at the service.

Staff were trained in safeguarding adults and understood how to protect people from abuse.

Risks associated with the care provided to people who lived at Amber House at the time of our visit, had been assessed and action taken to minimise the risk.

Incidents and accidents had been documented in detail, and the provider had taken action to reduce the risks of identified incidents re-occurring in the future.

There were sufficient numbers of staff on duty both day and night to meet people’s needs.

People's care and support needs were being effectively managed. We observed staff supporting people with respect and patience.

Staff understood their obligations to report any observed or suspected abusive behaviour.

We were satisfied people were receiving their medicines when they needed them and in a safe way.

Staff spoke positively about the training they received. One staff member told us, 'They will always ask us if we think there is something we need to do.' Staff found the specialist dementia training they were undertaking supportive of their practice in the home.

Records we looked at showed the service had systems in place to monitor the care provided to people. We saw there was a process in place to audit records to make sure people were receiving the care as outlined in their care plans.

We also spoke with two visitors, and spoke with two relatives by phone. We spoke with the manager and the co-owner of the home and looked at a sample of three care plans. We also spoke with a contracts monitoring officer from the local authority.

We saw staff engaging with people at the home in a positive, respectful and supportive manner throughout. We spoke with two relatives by phone who were very positive about the home. One person told us they were 'Very, very happy with the home.' Another told us 'They are very good ' very approachable.' One relative who was visiting the home and took an active part in the care of their relative told us were not happy about the care and had complained about this.