Archived: Amberdene Lodge

Amberdene Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Amberdene Lodge is registered to provide care and accommodation for a maximum of 25 older people who may have dementia. It is close to the city centre and local amenities and facilities are within walking distance. It is also close to public transport routes. At the time of this inspection there were 15 people using the service.

The provider was required to have a registered manager in post. At the time of this inspection there was a manager that had been registered and in post for the last 16 years. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found that the premises were not sufficiently suitable for providing care to older people and measures had not been taken when developing the service to include features which ensured the environment was ‘friendly towards’ those living with dementia. We made a recommendation about following the NICE guidance on dementia friendly environments and general upkeep of the décor and furnishings.

People were protected from the risk of harm. The premises were safely maintained. Accidents and incidents were appropriately managed and risk assessed. Equipment was safely used. Recruitment policies, procedures and practices were robust. Staffing numbers were sufficient to meet people’s needs. The management of medicines was safe and practices were audited to protect people from harm. The risks of infection were reduced by good infection control management and practices. Systems showed that when things went wrong, lessons were learnt.

People’s mental capacity was appropriately assessed and their rights were protected. 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. Staff were qualified, competent, regularly supervised and received annual appraisals of their personal performance. Staff respected the diversity that people presented. People’s nutrition and hydration needs were met to support their health and wellbeing. The provider worked well with other health and social care professionals. They supported people well with health care.

People received compassionate care from kind staff that knew about their needs and preferences. People were involved in their care and exercised a right to express their views. Wellbeing, privacy, dignity and independence were monitored and respected.

Person-centred care plans reflected people’s needs and were regularly reviewed. People engaged in pastimes and activities and maintained family connections and support networks. Communication needs were assessed and met. An effective complaint procedure was in place and used successfully. People’s needs with regard to end of life preferences, wishes and care were sensitively managed.

Quality assurance systems were effective. Audits, satisfaction surveys, meetings and handovers ensured there was effective monitoring of service delivery. Culture was person-centred, friendly and caring. The registered manager understood their responsibilities with regard to good governance and practiced a management style that was open, inclusive and approachable. Engagement and involvement of people, public and staff was effective. The registered manager looked for continuous learning and updated their practice wherever possible. Good partnerships with other agencies and organisations was fostered.

Further information is in the detailed findings below.

'Daily routine' pages provided information to staff on what personal care was required and 'good days' and 'bad days' pages informed staff how best to support people. Communication charts detailed what people's actions meant and how to comfort the person when certain behaviours were displayed.

Appropriate arrangements were in place for the safe ordering, dispensing and disposal of medication. The home had a medication policy in place that outlined how to manage medicines effectively.

We asked the registered manager how staffing levels were determined and were told, 'An assessment of need is completed before anyone moves into the home, those assessments are used to work out the number of staff we need.'

Records were kept securely and could be located promptly when needed. The registered manager said, 'We have paper care plans, lots of our information is on paper so it can be accessed easily but everything is backed up on the computer.'

We found that staff had access to information about how to meet the needs of the people who used the service and this was updated as people's needs changed.

We found that people were protected from abuse and staff had received training about how to identify and report any issues they may witness or become aware of. People told us they felt safe at the home and were confident concerns would be supported by management. Comments included 'Staff are very nice here'; 'I would feel happy to tell staff if I had a problem' and 'I feel safe here.'

We found that staff had received training about how to care for the people who used the service and this was updated regularly.

We found that people who used the service could have a say about how the home was run. Other people who had an interest in the welfare of the people who used the service were asked for their views as well for example, relatives and visiting doctors and nurses.