CQC report explained · a residential care home
What the CQC found at Amber Court Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2023
Wellesley House Nursing Home Limited was rated Requires Improvement; people felt safe, but staffing plans, medicines guidance and management checks were not reliable enough.
This was an unannounced focused inspection on 21 March 2023. Inspectors looked only at Safe and Well-led because concerns had been raised about safety and leadership. They spoke with people, a relative and staff, and checked care records, medicines records, audits and recruitment checks.
People said they felt safe and received their medicines. Inspectors found that risks were assessed and reviewed, infection control was followed, and staff had the required recruitment checks. However, there was no clear system for calculating staffing levels from people's individual needs. Some 'as required' medicines did not have the written guidance staff needed.
Management checks were not completed consistently and did not always identify problems or show what had been done to fix them. The home was still in breach of Regulation 17 about good governance. The overall rating and the ratings for Safe and Well-led remained Requires Improvement.
Risk assessments
Inspectors found that risks were assessed, monitored and reviewed. Care plans gave staff detailed guidance about areas such as diabetes, pressure relief and moving and handling.
“Risks to people were now assessed, monitored and reviewed and when needed individual care plans were in place.” from the report
People felt safe
People told inspectors they felt safe and received support when they needed it. Relatives raised no concerns about people's safety.
“I like it here, I am happy and feel well protected, the doors are secure” from the report
Safe medicines administration
People received their regular medicines as prescribed. Staff who administered medicines had completed training and competency checks.
“Staff administering medicines had completed training and a competency check to ensure they were safe to administer medicines.” from the report
Infection control
Inspectors were assured that infection prevention measures, including the use of protective equipment and hygiene practices, were in place.
“We were assured that the provider was using PPE effectively and safely.” from the report
Weak management checks
seriousAudits and checks were not completed consistently. They did not always identify problems, record actions taken or show how learning was used to improve the home.
“The systems in place were not effective in identifying areas of improvement.” from the report
No clear staffing calculation
needs fixingAlthough people were supported without reported delays, there was no system showing that staffing levels were based on individual dependency and needs.
“It was unclear how staffing levels were calculated within the home.” from the report
Missing guidance for some medicines
needs fixingSome 'as required' medicines did not have protocols explaining when and how staff should give them. Inspectors said this created a risk that people might not receive them when needed.
“This placed people at risk of not receiving these medicines when needed.” from the report
Task-led care
minorInspectors saw limited interaction between staff and people. Care was sometimes organised around completing tasks and set routines rather than working with each person.
“Some improvements were needed to ensure people always received care in a person-centred way.” from the report
- 01How are staffing levels now calculated using each person's dependency and care needs?
- 02Does every person who has 'as required' medicine have a current protocol explaining when and how it should be given?
- 03What checks are now completed each week or month, and how are actions recorded and followed through?
- 04How are incidents reviewed so the home can show what went wrong and what was learned?
- 05How is feedback from residents and relatives used to make changes, and when will those changes be reported back?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were not inspected and the previous ratings were used to calculate the overall rating. This explanation was written from the published report of 18 April 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2020
Wellesley House Nursing Home Limited was rated Requires Improvement; inspectors found kind care but safety, staffing and management needed improvement.
This was an unannounced inspection on 28 and 29 January 2020. One inspector and an Expert by Experience spoke with people, relatives, staff and a health professional. They also observed care and checked care records, medicines records, staff files and management records.
The home was not consistently safe. Some risks were not properly assessed or recorded, people sometimes waited for care because there were not always enough staff, and staff had limited time for conversation and choice. Management checks had not found or fixed these problems.
There were also positive findings. People received their medicines safely, the home was clean, staff had training and people had access to health professionals. People and relatives generally described staff as kind, and activities and person-centred care were provided.
The overall rating was Requires Improvement. Safe, Caring and Well-led were rated Requires Improvement, while Effective and Responsive were rated Good. This was the second consecutive inspection with an overall rating of Requires Improvement.
Medicines
People received their medicines safely and records were completed accurately. Medicines were stored safely and stock checks helped ensure supplies were available.
“Medicine administration records (MAR) were in place and completed accurately.” from the report
Kind and respectful staff
People and relatives were positive about staff attitudes. Inspectors saw staff being kind, and people's privacy and dignity were maintained.
“Staff were observed supporting people in a kind and caring way.” from the report
Health support
People had access to doctors, nurses and other health professionals. Staff escalated health concerns and followed professional advice.
“People were supported to access health care services and maintain their health and wellbeing.” from the report
Activities and relationships
People could take part in activities and social events and maintain important relationships with visitors.
“People were supported to engage in activities and social events.” from the report
Unassessed risks
seriousSome people's safety risks were not assessed and care plans did not always explain how to reduce those risks. Inspectors said this placed people at risk of harm.
“People did not always have risks to their safety assessed and plans put in place to meet them.” from the report
Staffing and time
needs fixingPeople sometimes waited for care, especially at busy times. Staff had limited time for conversation, choice and supporting independence.
“People were still having to wait on occasions for their care and support and staff had limited time for social interaction.” from the report
Management checks
seriousThe provider had not acted enough on concerns from the previous inspection. Its checks did not reliably identify gaps in risk plans, care records, staffing, training or the environment.
“Governance systems were not effective in identifying concerns and this limited action taken to make improvements to the service.” from the report
Choice and independence
needs fixingPeople were not consistently offered choices about where they sat, where they ate or when they got up. Some people said staffing levels limited their independence.
“We saw people were not consistently offered a choice.” from the report
Dementia-friendly environment
minorThe environment had adaptations such as ramps, handrails and a lift, but inspectors recommended further consideration of adaptations for people living with dementia.
“Consideration about further adaptations to provide a more effective environment for people living with dementia was required.” from the report
- 01What action has been taken to make sure every person's risks, including diabetes, anxiety, fluid intake and repositioning, are assessed and clearly recorded?
- 02How many staff are on duty at busy times, especially mornings, mealtimes and nights, and how do you check that people are not waiting for care?
- 03What has changed to give staff more time to talk with people, offer choices and support walking or other independence goals?
- 04How do you now check that care records, best-interest decisions, staff training and recruitment records are complete and up to date?
- 05What changes have been made to the environment for people living with dementia?
This was an unannounced planned inspection based on the previous rating, covering the home and care provided and assessing all five CQC key questions. This explanation was written from the published report of 18 March 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Amber Court Residential Care Home
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- April 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Amber Court Residential Care Home →
- March 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Amber Court Residential Care Home →
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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