CQC report explained · a residential care home
What the CQC found at Amberside
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found improved safeguarding, risk management and staffing. Medicine records were accurate, and incidents were reviewed so lessons could be learned.
- Effective?
- Good
- People's needs were assessed before they moved in, and staff had received relevant training. Food, drink, healthcare and consent were managed effectively.
- Caring?
- Good
- People described staff as kind, caring and respectful. People were involved in decisions about their care and were supported to maintain their dignity, privacy and independence.
- Responsive?
- Good
- Care plans reflected people's preferences and choices. Inspectors found a much-improved activities programme and a complaints system that investigated and resolved four complaints.
- Well-led?
- Good
- The manager had introduced stronger checks, clearer staff responsibilities and regular supervision. Inspectors found an open culture and evidence that the earlier action plan had been completed.
What inspectors found, November 2019
Amberside was rated Good; inspectors found safe, kind and personalised care after major improvements.
This was an unannounced follow-up inspection over three visits in September 2019. Inspectors spoke with people, staff and professionals, and reviewed care plans, medicine records, training information, complaints and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safer safeguarding and risk systems, accurate medicine records, better training, respectful care and more personalised support.
The home had previously been rated Inadequate and placed in Special Measures. Inspectors found that the provider had acted on the earlier failings, was no longer in breach of regulations, and the home was no longer in Special Measures.
Safeguarding and risk
Staff had been trained to recognise and report concerns. Individual risks, including falls and pressure ulcers, were assessed and managed.
“People were supported by staff who had been trained to identify and report concerns.” from the report
Medicines
The home had introduced daily medicine audits. Inspectors checked eight medicine records and found them accurate.
“We checked eight medicines and records, and found all records were accurate and in order.” from the report
Kind and respectful care
People told inspectors that staff were kind and respectful. Inspectors observed warm, gentle and meaningful interactions.
“Staff had respectful, caring and friendly relationships with people they supported.” from the report
Personalised support
Care plans recorded people's preferences, routines and goals. People were involved in agreeing their care.
“People received personalised care and support which met their needs and reflected their preferences.” from the report
Improved management
The home had introduced regular audits and recorded the actions taken when checks found shortfalls.
“Robust records were kept showing what action had been taken to address any shortfalls they identified during their checks.” from the report
End of life records
minorNo one was receiving end of life care during the inspection. The report says some end of life information was still being developed and was due to be completed by the end of November 2019.
“the registered manager had identified that these records were still being developed” from the report
Some staff training
minorRefresher training had been booked for some staff whose training had expired. Families may wish to check that this training was completed.
“refresher training had been booked for some staff whose training had expired.” from the report
Bedroom decoration
minorSome bedrooms could benefit from redecoration. The manager knew about this and was arranging the work.
“We found that some bedrooms could benefit from being re-decorated” from the report
- 01How do you make sure safeguarding concerns are recorded, reported and reviewed now?
- 02Have all staff whose refresher training had expired now completed it?
- 03Have the bedrooms identified for redecoration now been completed?
- 04How are you making sure each person's end of life wishes are fully recorded?
- 05How do you check that the improvements found at this inspection are maintained?
This was an unannounced follow-up inspection covering all five key questions and checking action taken after the previous Inadequate inspection. This explanation was written from the published report of 6 November 2019 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 2019
Rated Inadequate and placed in special measures; inspectors found serious risks involving staffing, safety, care planning and management.
This was the home’s first CQC rating. Inspectors visited without notice on 5 December 2018, and returned on 11 December to check actions taken. They spoke with people, relatives and staff, observed care, and reviewed care, medicines, training and management records.
Inspectors found that staffing levels did not match people’s needs. Some people waited for meals, drinks and personal care. Risks involving pressure ulcers, nutrition, deteriorating health, medicines, fire safety and people’s behaviour were not managed well.
Care was not consistently based on people’s choices or needs. People were not always involved in care decisions, activities were limited, and some people said they felt bored or unsafe. Staff could be kind and attentive when they had enough time, but staff training and support were not sufficient.
The home was rated Inadequate overall, and also Inadequate for Safe, Responsive and Well-led. Effective and Caring were rated Requires Improvement. The home was placed in special measures, and CQC immediately restricted admissions after reviewing the concerns.
Infection control
The home was clean and tidy, and staff used protective equipment and followed good infection control practices.
“Staff followed good infection control practices and used personal protective equipment (PPE) to help prevent the spread of healthcare related infections.” from the report
Food presentation
People who ate a regular diet had choices, enough food and drink, and appeared to enjoy the food.
“People who ate a regular diet had choice and access to sufficient food and drink throughout the day; food was well presented and people appeared to enjoy it.” from the report
Medicine stock checks
Medicine stocks were checked and matched the records, even though medicines were not always given safely.
“Regular checks were carried out of the medicines stocks. We found that there were no errors or omissions in the medicines record, and stocks tallied.” from the report
Too few staff
seriousStaffing did not match people's needs. People waited for personal care and were left without enough monitoring or support.
“The provider had not ensured enough staff were on shift so that people received support in a safe manner.” from the report
Fire and environmental risks
seriousUneven flooring created a trip hazard, and important actions from a fire assessment had not been completed. Inspectors referred this to the fire protection officer and local authority.
“The provider had not taken action following a fire assessment in March 2018.” from the report
Pressure care and nutrition
seriousSome pressure risks were assessed incorrectly or lacked suitable equipment. Food, drink and blood glucose records were not always accurate or acted on.
“People at risk of developing pressure ulcers did not have appropriate assessments in place to mitigate the risk.” from the report
Medicines
seriousSome medicines were given at the wrong time, and staff did not always check that people had swallowed them. Guidance for as-required medicines was missing.
“People did not always receive their medicine as prescribed.” from the report
Consent and involvement
seriousThe home did not consistently follow the legal process when people could not make decisions for themselves. Relatives signed some consent forms without the required legal authority.
“The process relating to assessing the persons capacity and best interest had not been applied when seeking consent.” from the report
Limited activities
needs fixingPeople had few opportunities for activities or social inclusion. Planned activities did not always happen, and people told inspectors they felt bored or lonely.
“People told us they felt bored at times.” from the report
- 01How many staff are now on each shift, and how do you match staffing levels to each person's changing needs?
- 02What has been done to correct the fire safety concerns and the uneven flooring identified in the report?
- 03How do you now check pressure care, nutrition, hydration and blood glucose records, and what happens when a risk is identified?
- 04How do you ensure medicines are given at the right time and that people have swallowed them safely?
- 05How are people now involved in decisions about their care, including capacity assessments, best-interest decisions and activities?
This was an unannounced planned comprehensive inspection covering all five key questions and the overall rating, with a return visit to check actions arising from the first visit. This explanation was written from the published report of 5 March 2019 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 Amberside
2 rated inspections over a year: the service has improved, from Inadequate to Good.
- November 2019Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- October 2017
Registered with the Care Quality Commission on 4 October 2017.
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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