Amberley Lodge - Purley

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People received safe care and support from staff trained to recognise signs of abuse and risk and they understood how to support people safely. People told us that they felt safe. Risks to people's safety were assessed and reviewed. Care plans were linked with individual risk assessments which guided staff in providing safe care. Staff were pro-active in supporting people, who had capacity, to make decisions about the risks they took in their day to day lives. Where people lacked capacity, the registered manager ensured people’s rights under the Mental Capacity Act were respected. People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible. The provider ensured that when things went wrong, accidents were recorded, and lessons were learned. There were enough staff to keep people safe. People received care and support in a personalised way. Staff rotas evidenced staffing levels were appropriate to meet people’s needs. Staff were recruited safely which had ensured that only suitable staff were employed to work at the service. Staff received training that was relevant to their roles and responsibilities and this included regular support through supervision and appraisal to continuously learn and improve their working practice. Managers made sure recruitment checks were undertaken on all staff to make sure only those that were deemed suitable and fit, would be employed to support people at the service. All areas of the home had been maintained to a high standard. An effective cleaning schedule was in place and has helped to ensure people were safe from infection. Staff received training in infection control and food hygiene. This has helped to prevent the spread of infection to people. Safe medicines practices were followed. There were enough staff to meet people's needs.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were processes to support staff in reporting concerns to the relevant safeguarding authority when required. This included having safeguarding and whistleblowing policies for staff to refer to. Staff received training in safeguarding adults to ensure they had the knowledge to keep people safe. The registered manager had submitted appropriate Deprivation of Liberty Safeguard applications for people. These were followed up and information was available in people’s individual care records. Staff understood the principles of the Mental Capacity Act and had received training to ensure they knew how to apply these in practice. The provider was working in line with The Mental Capacity Act 2005 (MCA).

Staff were aware of their responsibilities to safeguard people from abuse and any discrimination and knew of the signs of abuse and how to report safeguarding concerns. They were confident the management team would address any concerns regarding people’s safety and well-being and make the required referrals to the local authority. Comments from staff included, “We get safeguarding training and refresher training, it helps to keep me on the ball with any changes”, “The training we get is really good and interesting”, "If I witnessed abuse, I would report it to manager straight away”. Staff were aware of the different types of abuse and knew the process for reporting any concerns they might have.

People told us the staff team were well established and staff turnover was low. They said this meant good relationships with staff were established and staff knew them well. They told us they felt safe living at the service. Comments included “I feel safe living here”, “Staff ensure we are kept safe”, “If I didn’t feel safe I would talk to one of the managers.” Relatives told us, “My [family member] is very happy here and I'm confident that she is safe”, “Yes thanks, we have been happy with the care,” and “As a family we have been very happy with the care [family member] receives, they are certainly safe.” People told us they had access to information about how to raise any concerns they might have. Comments included,” I know how to complain, I’d talk to the manager. There are notices on the notice boards that explain what would need to be done,” and “I have a folder in my room and which says how to make a complaint.”

People and their relatives told us they were involved in care planning process and were consulted on their views. Care plans and risk assessments were available for people to view. Comments included, "We were involved with [family member’s] care plan, and it was reviewed with us quite recently” and “Yes, I was involved with my care plan.“

The provider used a computerised care plan and risk assessment system. Risks to people had been assessed on admission, reviewed monthly or more often if required and their safety and monitored. There were risk assessments in place for various aspects of people's care such as the risks of pressure damage to the skin and hazards such as the risk of choking. Staff reviewed these regularly and updated them as necessary. People had a personal emergency evacuation plan (PEEP) as a part of their risk assessments which detailed what support each person needed in the event of a fire or other evacuation of the premises. These were all up to date and reflective of people's current needs.

We observed that people were safe and treated well by staff.

Staff told us how they all benefited from having a stable staff team with most staff having working in the service for several years. Staff knew the people they supported well, and this enabled them to keep people safe and reduced the risk of harm. Staff told us how they encouraged and supported people to make choices to reduce risks and stay safe, whilst also respecting people's rights to make their own decisions within a risk assessment framework. Care plans and risk assessments were reviewed and updated regularly or as necessary and contained up to date information to support people safely and effectively. Staff were able to discuss peoples’ individual risks and demonstrated a good level of understanding when identifying new potential risks, managing the risks, and keeping these under review. Especially for those whose mobility was decreasing and were in need of further support or the use of moving and handling equipment. Staff told us people’s risk assessments contained up to date information to support people safely and effectively. Staff understood their responsibilities for reporting accidents, incidents, or concerns. Staff had identified when changes to peoples' health, both physical and mental could impact on their safety and, that of other people who lived in the service, staff, and visitors.

People told us they were happy with their rooms. People felt the environment was safe.

Staff told us they thought the environment in the home was good. They said all areas of the home were regularly audited and maintained as necessary including regular repainting of any areas in need.

Our tour of the premises demonstrated the environment was safe and well maintained to a high standard of care. All areas of the home were freshly decorated and there was an effective schedule in place to ensure maintenance was carried out as and when necessary. There were no unpleasant odours in any area of the home and we noted people’s rooms were personalised to meet their choices and preferences. Daily staff handover meetings were held. We observed these provided staff with the opportunity to discuss people's daily needs and any issues or concerns that had arisen including with the environment. Staff team meetings were held on a regular basis and provided staff with the opportunity to discuss issues relating to the management of the home.

There were audits and checks taking place to ensure the environment was safe. Fire drills were held so that staff were prepared to support people in the event of an emergency. Environmental audits took place to check for areas requiring improvement. People had personalised evacuation plans in place so that staff knew how they needed to be supported to safely evacuate the building. The provider ensured equipment was maintained, and regular maintenance of the premises was carried out. The registered manager recognised the importance of regularly monitoring the quality of all areas of the service to help drive improvements and keep people’s safety a high priority. There were effective processes in place to monitor the quality of the service and to make any improvements highlighted. Audits included areas such as medicines management, care plans, staff records, health and safety and the home environment. Where required, action plans were developed to address any issues or concerns identified. The registered manager ensured all the information from audits and surveys was shared and discussed with the relevant people so that they could contribute to and understand how improvements to the service were being driven.

During the inspection site visit we observed there were good staffing levels. We also saw good, trusting interactions between people and staff. It was evident that staff knew people well and were able to meet their needs and to keep them safe. People were well presented and attention had been paid to their personal wishes regarding personal care, such as hair and nails. Staff assisted those people who remained in bed due to their physical frailty regularly and we saw that they were comfortable, clean and were given regular drinks and meals throughout the visit.

Staff confirmed there were enough staff on duty to meet people’s needs. The registered manager ensured there was a suitable skill mix and experience during each shift. The registered manager told us they used minimal agency staff to ensure continuity of care. People were supported by staff who felt confident and competent to assist and care for people. The registered manager ensured staff were equipped with the necessary skills and knowledge to meet people’s physical and psychological needs. Staff confirmed the training they received was effective. Staff told us they felt supported by the registered manager, deputy and other colleagues. Additional support and supervision was provided on an individual basis. Supervision supported staff to discuss what was going well and where things could improve.

There was evidence of robust recruitment procedures. All potential staff were required to complete an application form and attend an interview, so their knowledge, skills and values could be assessed. The provider undertook checks on new staff before they started work. This included checking their identity, their eligibility to work in the UK, obtaining at least two references from previous employers and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable people. The registered manager used a dependency tool, reviewed monthly, to ensure adequate numbers of qualified, skilled and experienced staff were employed to meet people’s needs safely and appropriately.

People, their relatives and the health and social care professionals we spoke with told us there were enough suitably skilled and experienced staff to support people. They said the staff team worked well together. Comments included, “I visit my [family member] every other day, I also come on weekends and it’s always fully staffed”, “There are always good numbers of staff on duty”, “Staff here are really good. They know the residents very well. It has helped having such a stable staff group and such good managers.”

Our tour of the premises demonstrated the environment was safe and well maintained to a high standard of care. All areas of the home were freshly decorated and there was an effective schedule in place to ensure maintenance was carried out as and when necessary. We saw cleaners busy operating the cleaning schedules. There were no unpleasant odours in any area of the home and we noted people’s rooms were personalised to meet their choices and preferences.

Staff told us personal protective equipment was available to them and we saw staff accessed and disposed of this appropriately. Staff told us they received regular training in infection control and were able to tell us the correct and safe use of equipment. They said they also had received effective training in food hygiene and health and safety. All of this they said contributed to the high standards maintained with infection control in the home.

People and relatives told us they always found the home was clean and well kept. They said cleaning schedules were rigorously maintained by staff. Comments included, “There are always staff cleaning, sweeping and keeping the home up to a high standard”, “During the pandemic excellent standards were kept here and this really helped to keep people free from infection”.

Up to date policies and procedures in place demonstrated how the provider ensured infection control measures were in place. This has helped to promote safety in the home with regards to hygiene practices and infection control. This included making sure infection outbreaks were effectively prevented and managed.

People told us that staff supported them appropriately with their medicines.

Registered nursing staff told us they were responsible for administrating people’s medicines and were fully aware of the actions they were required to take when there were specific considerations such as with people's PRN medication. Staff told us they regularly liaised with health professionals for advice. Health professionals we spoke with confirmed this.

Appropriate policies and procedures were in place for staff to follow to ensure the safe administration of medicines to people. Staff received appropriate training. Regular medicines audits took place to identify any areas for improvement. We reviewed the most recent of these audits. Competency checks were completed for staff responsible for administering medicines.