CQC report explained · a nursing home
What the CQC found at Amberley Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People's risks were assessed and managed, staffing was considered sufficient and medicines were mostly administered safely. Inspectors saw one lapse in hand hygiene between medicine administrations, which the manager addressed immediately.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- Care was personalised and included people's histories, communication needs, interests and relationships. Relatives were involved in care planning and people were supported with activities, visitors and end-of-life care.
- Well-led?
- Good
- The management team had improved its quality systems and worked openly with people, relatives, staff and professionals. Some care record inconsistencies had not been identified by audits, but these were corrected during the inspection.
What inspectors found, October 2022
Rated Good; inspectors found safe, personalised care, but hand hygiene and care records needed closer checking.
This was an unannounced focused inspection. Inspectors visited on 26 September 2022 and completed inspection activity on 3 October 2022. They observed care, spoke with people, relatives, staff and health professionals, and checked care, medicine, staffing and management records.
The home was rated Good overall. Safe, Responsive and Well-led were rated Good. People were supported with medicines, moving, meals and communication. Staff knew people well, involved relatives in care planning and supported relationships, activities and end-of-life wishes.
There were some issues. A nurse did not wash their hands between giving medicines, although the manager acted during the inspection. Audits had not always found inconsistencies between care plans and daily records. The previous Requires Improvement rating and breaches had been addressed, and the provider was no longer in breach.
This was not a full inspection of all five areas. Effective and Caring were not inspected during this visit, so their previous ratings were used in the overall rating.
Personalised care
Care plans included people's life histories, preferences and important relationships. Relatives were involved in building this information.
“People received personalised care and support.” from the report
Managing health risks
Staff followed care plans for moving and positioning people and for those at risk of choking. Modified diets were provided at the correct consistency.
“We observed people being safely assisted to move and position.” from the report
Kind and informed staff
People, relatives and professionals gave positive feedback about staff. Staff knew people well and adapted support when people could not easily communicate their wishes.
“People and their relatives gave positive feedback about the staff.” from the report
Improvement since 2019
The home had addressed the problems found at the previous inspection. The provider was no longer in breach of the regulations checked at this visit.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Open management
People, relatives and staff felt able to raise concerns and make suggestions. The management team acted on feedback and worked with health and social care professionals.
“The provider and registered manager had created an open culture where people, their relatives and staff could approach them with concerns, suggestions and ideas.” from the report
Hand hygiene during medicines
needs fixingA nurse gave medicines to different people without sanitising their hands between administrations. The manager spoke to staff straight away and planned to include hand hygiene in audits and competency checks.
“We observed a staff member administering medicines to different people without sanitising their hands between administration.” from the report
Care record checks
needs fixingAudits had not always identified inconsistencies between care plans and daily notes, including records about repositioning. The manager corrected the records and said monitoring would be strengthened.
“Audits of care plans had not always identified some inconsistencies in people's care records.” from the report
- 01How do you now check hand hygiene between each person's medicines?
- 02What changes have you made to care record audits since inspectors found inconsistencies?
- 03How will you make sure daily notes match each person's care plan, especially for repositioning?
- 04What were the previous ratings for Effective and Caring, which were not inspected this time?
- 05How do you check that people at risk of choking receive the correct food consistency?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 15 October 2022 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 2022
Targeted inspection, not rated; inspectors found good COVID-19 arrangements but gaps in cleaning and visitor-testing records.
This was an unannounced, targeted inspection on 15 February 2022. It focused on infection prevention and control during a COVID-19 outbreak, and on whether staffing pressures affected care.
Inspectors found that visiting, isolation, social distancing, personal protective equipment and testing arrangements were generally in place. Staff supported people to keep in touch with relatives and provided activities and one-to-one time during isolation.
There were weaknesses in the records and checks for cleaning the visiting room and for monitoring visitors' testing. The home was meeting the COVID-19 vaccination requirements in force at the time.
The home was inspected but not rated. This means the inspection did not give an overall rating or a rated score for the five questions.
Contact with relatives
The home provided a designated visiting area and supported visits in people's rooms where appropriate. People were helped to keep in touch with loved ones during the outbreak.
“The provider had ensured that visiting was facilitated within the home and people were able to maintain contact with their relatives during the COVID-19 outbreak.” from the report
Support during isolation
Staff considered the effect of isolation on people's wellbeing and used one-to-one time for conversation and activities such as music or reading.
“Staff understood the impact of isolation on people's wellbeing and had thought of ways to address this.” from the report
Team response
Staff changed roles and shared responsibilities to manage staffing pressures during the outbreak.
“Staff had adapted and changed their roles to enable them to support people when colleagues were in isolation and to manage any staffing pressures resulting from the outbreak.” from the report
Infection control arrangements
Inspectors were assured that the home used PPE safely, accessed testing, followed isolation and distancing rules, and kept its infection control policy up to date.
“We were assured that the provider was using PPE effectively and safely.” from the report
Visiting-room cleaning records
needs fixingRecords showing enhanced cleaning of the designated visiting room were not up to date. This meant the home could not be sure that cleaning schedules were being followed to reduce the risk of cross-contamination.
“Records to demonstrate the room was subject to enhanced cleaning in line with government guidance were not up to date or maintained.” from the report
- 01How do you now record enhanced cleaning of the designated visiting room?
- 02Who checks that the visiting room cleaning schedule has been completed?
- 03How do you identify whether a resident has an essential care giver?
- 04How do you record and check visitors' testing requirements?
- 05What staffing measures are in place if staff are absent during an outbreak?
This was an unannounced targeted inspection of infection prevention and control and COVID-19-related staffing pressures; the service was inspected but not rated and the other key questions were not assessed. This explanation was written from the published report of 17 March 2022 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 Amberley Lodge Care Home
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- October 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2022Inspected but not ratedSafe: Inspected but not rated
- October 2019Requires improvementdown from GoodSafe: Requires improvementResponsive: GoodWell-led: Requires improvement
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 23 November 2010.
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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