Archived: Ambleside - Luton

Below is a summary of what we found. The summary is based on discussions with people who used the service, the staff who supported them and from looking at records.

We found that the home had not met the minimum standards required in all areas.

If you wish to see the evidence supporting our summary please read the full report.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found.

Is the service safe?

The provider had not always indicated the correct number of staff needed to assist with the care and support of people within their care plans. We saw that staff were aware of the needs that people had but that the information within the care plans was not always accurate. We found that staff were supported and trained in order to provide a good level of care to people. Staff we spoke with told us that the training they received was 'good'.

We found that the home did not have an effective infection control and cleaning system in place. Although the home did have a cleaner employed and staff were tasked to carry out some general cleaning tasks. The cleanliness of the home was not meeting the standards required.

Is the service effective?

When we spoke with people who used the service we were told that the staff were 'pretty good'. We were told that although staff were busy if they needed them they would always come. People had no complaints about the service. We saw from the care plans that although they had been reviewed by the provider not all had been updated to reflect what had been identified within the monthly reviews. Therefore the information held within them was not always correct or accurate. This meant that people could be at risk of receiving inappropriate care.

Is the service caring?

People were supported by kind and caring staff. We observed staff interacting with people. We saw that staff took the time to sit with people and talk with them about their interests. We observed one staff member sitting with a person and discussing the book that they were reading. We saw that the member of staff did not rush the conversation and took interest. We later asked the person about the staff member and they told us that they were 'very nice' and 'approachable'. We were told that staff were 'gentle' when providing personal care and did not 'rush'.

Staff told us that they had enough time to spend with people and enjoyed talking with them. We observed on the day of our inspection that staff were seen to be sitting with people and talking to them.

Is the service responsive?

Although care plans were regularly reviewed we saw that the updates to some were not consistent with the reviews that had been undertaken. We also noted that there were no risk assessments in place for people. We did note however, that some risks were identified within the care plans, but that there were no control measures or guidance in place for staff to follow in order to limit the risk to the person. Each care document provided staff with clear information about the person and the care they required although for some people this needed to be updated. Staff however, were aware of people's needs and preferences and acted in accordance with their wishes.

Is the service well-led?

People we spoke with told us that the manager was 'nice' and that they always acted on any issues within the home. Staff told us that the manager was good and approachable. We did however note that the manager appeared over stretched as in addition to managing the home they also provided care and cooked for people at the service. We noted from their recent supervision record that they had identified themselves as being over stretched in their role. We could see that due to this multi-tasking, other areas such as auditing the services provided and the updating of care plans was not up to the standards required.

We observed staff offering people choices and trying to reassure people who were confused, in a gentle and unhurried manner.

Arrangements were also in place to ensure people had their comments and complaints listened to and acted on effectively.

During our inspection we used a number of different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not always able to talk to us about their experiences. We spoke with, or observed the care provided to nine of the 11 people living in the home, and spoke with four members of staff including the provider/manager.

We found that staffing levels had been increased to reflect an increase in the number of people living in the home, and to meet their assessed needs. Staff spoke positively about their roles and demonstrated that they worked well together as a team.

Significant improvements had been made to people's care records since our last inspection in January 2013, and there was evidence that their health and wellbeing had improved as a result.

Appropriate arrangements were also in place to keep people safe and to address their social needs. One person living in the home told us that they had noticed improvements in the running of the home and that things were changing for the better.

We used a number of different methods such as observation, reviewing records and speaking with people, to help us understand the experiences of people living in the home.

We found that the arrangements for ensuring that new staff had the right skills and knowledge to care and support people living in the home were not adequate. However, we observed some positive interactions between staff and people. Staff demonstrated through actions and conversation that they were familiar with the people they were supporting and understood their needs, but they did not have enough time to spend with people. We observed that people's basic needs were being met, but the majority of people were not engaged in meaningful activities. Staff we spoke with said they were just managing, but thought it was easier for those who had worked in the home for longer and knew the people living there better.

Records showed that people's care needs were being monitored but when people's needs changed, actions were not always taken in a timely manner to ensure their well being and safety.