Archived: Amber Lodge - Leeds

Amber Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Amber Lodge provides accommodation and personal care for up to 40 people. The building is a two-storey purpose built home, situated in a residential area of Wortley, close to the city of Leeds. All of the bedrooms are single occupancy and have en-suite toilet facilities. Communal lounges, dining rooms and bathing facilities are provided on the two levels. It has a garden to the rear of the building and a car parking area located at the front of the building.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in November 2016 we found the service required improvement. At this inspection we found the service had improved.

The provider and registered manager continually assessed, monitored and evaluated the quality of the service. We found audits had identified issues and actions were progressed in a timely manner.

Staff understood their responsibilities to safeguard people from harm and followed the provider's policies. People were supported to take their prescribed medicines safely. There were enough suitably skilled staff on duty to meet people's needs. Staff had been recruited using safe recruitment practices.

Staff sought people's consent before providing care and people's mental capacity was assessed in line with the Mental Capacity Act 2005. The registered manager understood their responsibilities and referred people appropriately for assessment under the Deprivation of Liberty Safeguards.

People received care from staff that had received training to meet people's specific needs, and had supervision to assist them to carry out their roles. People were supported to access healthcare professionals and staff were prompt in referring people to health services when required. Staff understood people's dietary needs and people received a balanced diet, which they enjoyed.

The environment and equipment was appropriately maintained and serviced when required. Adaptations to the building had been made to support people with their daily life. Staff knew about infection prevention and wore personal protective equipment when supporting people.

Staff treated people with respect and helped to maintain their dignity. People received care from staff they knew, which helped them to develop positive relationships. Staff supported people emotionally and practically to promote their independence and well-being. People knew how to make a complaint, and raised them if they wished.

Care plans were updated regularly and people and their relatives were involved in their care planning where possible. Risks to people's health and well-being were assessed and staff had followed plans that were centred on the person as an individual. People were supported to pursue their hobbies and interests and continued to celebrate special days.

Amber Lodge provides accommodation and care for up to 40 older people living with dementia. The home is purpose built and there is car parking available. The home is divided over two floors and people living there have en-suite rooms. Both floors have communal lounges, dining rooms and bathing facilities. The home has a garden to the rear of the building which is secure.

At the time of our inspection the service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were systems in place to ensure that people received their medication as prescribed.

The provider checked with the disclosure and barring service (DBS) whether applicants had a criminal record or were barred from working with vulnerable people and obtained references. One file only contained one reference but two should have been received; the registered manager said two references were received and one must have been misplaced. The registered manager showed us evidence of this reference which had been misplaced after the first day of inspection.

We looked at staff employment histories and found gaps in two of the files we looked. We spoke to the human resources department who stated these should have been followed up and told us these would be looked into. The registered manager told she would ensure an audit of all staff files would be completed straight away to identify any gaps.

There were enough staff to meet people’s needs. However these were not always located on the staff rota. We spoke to the registered manager who told us this had been an oversight and would complete this straight away. On the second day of inspection this was completed. The service had incorporated an electronic system which was to start in the next week; this would capture all staff signing in and out each day. This would ensure the rota would be more robust. Staff told us they received training to be able to carry out their role.

Staff were aware of the supervision and appraisal process and felt supported by the registered manager. Staff had completed supervisions and an annual appraisal, however the supervisions were not in line with the policy. This stated ‘each care staff member will receive formal staff supervision at least twice a year’ and supervision will cover ‘all aspects of practice associated with the provision of care to residents’ and ‘the colleagues career development needs’. We spoke to the registered manager who explained a new electronic system had being introduced due to the old process not been as effective for staff which focused more on aspirations and competencies; each member of staff had completed the first stage and had identified what they did well and how they wanted to develop, and the registered manager was completing the second stage where they provided feedback about each member of staff’s performance.

Staff were aware of the processes in place to report incidents of abuse; and had been provided with training on how to keep people safe from abuse and harm. Processes were in place to manage identifiable risks and to promote people’s independence.

People were supported to eat and drink well and to maintain a varied and balanced diet of their choice. People had access to healthcare facilities and support that met their needs.

People had developed good relationships with the staff team who treated them with kindness and compassion. Systems were in place to ensure that their views were listened to; and their privacy and dignity was upheld and respected.

People's needs had been assessed and care plans outlined their preferences and how they should be supported. Staff showed a good knowledge of these preferences.

People were able to enjoy activities of their choice. Arrangements were in place for people to maintain links with the local community, friends and family. The home had an open door policy for all friends and family of people living at amber lodge.

The service had quality assurance systems in place which were used to drive continuous improvements. However no audits of staff files had been completed. The registered manager had put a plan in place on the second day of inspection.

We reviewed five care records. We found care records were person centred, detailed and individualised. Risk assessments identified where people were at risk of harm and were used to develop guidelines for staff to follow. People's weight was recorded monthly.

We observed that the home was clean and did not have any unpleasant odours. We reviewed the cleaning schedule which was in place. One visitor said: "The rooms are always clean". Another relative said: 'The home is always clean when I visit'.

We reviewed the duty rota for four weeks, including the week of our visit. They reflected that there were six staff on duty, except on two occasions where four staff were on duty during the afternoon shift and twice where two staff were on duty for the night shift.

Staff told us they worked well together and were a 'good team'. Staff said they had access to training and felt supported by the manager. They had opportunities to talk to their manager about their work and had regular supervision.

The provider had systems in place to identify, analyse and review risks or incidents. Information about quality and safety was gathered and monitored to identify risks and areas for improvement.