Amethyst Care Home

Updated 29 December 2022

The inspection

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

The inspection was carried out by 2 inspectors.

Service and service type

Park Lodge 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. Park Lodge 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 not a registered manager in post. A new manager had been in post since August 2022. They told us they intended to submit an application to register.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). 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. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people using the service and 2 relatives. We observed interactions between people and staff to help us understand the experience of people who could not talk with us. We spoke with the manager, a senior staff member and 2 care support workers. We reviewed a range of records. This included 2 people's care records, records relating to medicines management, staff files, staff training and supervision information and other records relating to the management of the service.

Updated 29 December 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Park Lodge is a residential care home providing personal care to 7 people at the time of the inspection. The service can support up to 8 people.

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

Right Support:

The provider was not working within the principles of the Mental Capacity Act. They could not demonstrate that people’s consent to care and support was lawfully obtained or that proper legal authorisations were in place to deprive people of their liberty where appropriate. This meant people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service at the time of this inspection did not support this practice.

The service gave people care and support in a clean, well equipped, furnished and mostly well maintained environment. The provider was making improvements to the living environment at the time of this inspection to make this safer and more comfortable for people. People were able to personalise their rooms. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff enabled people to access specialist health and social care support in the community. Staff supported people to make day to decisions about their care and support. They communicated with people in ways that met their needs. Staff supported people with their medicines and to play an active role in maintaining their own health and wellbeing.

Right Care:

Not all people’s care plans were up to date which meant they did not fully reflect their current needs and preferences in relation to their care and support. There was a risk people could receive unsafe or inappropriate care and support. The provider was aware of this concern and was reviewing and updating care plans at the time of this inspection.

Staff promoted equality and diversity in their support for people. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. The service had enough staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right Culture:

People’s quality of life was not always enhanced by the provider’s oversight of the service and governance processes. These had not always been effective in taking action to keep people safe, protect people’s rights and provide good quality care and support.

Notwithstanding the issues we found, people received good care and support because staff could meet their needs and wishes. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, were involved in planning their care. The provider was improving the way people, and those important to them, worked with staff to develop the service. The provider was committed to continuous improvement at the service which helped to enhance the quality of people’s lives.

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 (published 23 October 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the change in management and leadership of the service. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.

Enforcement

We have identified breaches in relation to the need for consent, safeguarding service users from abuse and improper treatment and good governance 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.