Archived: Amberley House Care Home - Stoke-on-Trent

Updated 20 August 2020

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 following concerns being raised by the local authority. 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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and one assistant inspector.

Service and service type

Amberley House Care home – Stoke-on-Trent is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission, however they were not present on the day of inspection. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the 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. The local authority told us they had concerns with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service. We were unable to speak with relatives as care homes are not accepting visitors due to the pandemic. We spoke with eight members of staff including nurses, senior care workers and care workers. In addition to this, we also spoke with the four members of the provider’s management and quality assurance team. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including audits and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional care records, building safety records and quality assurance records.

Updated 20 August 2020

About the service

Amberley House Care Home – Stoke-on-Trent is a care home providing personal and nursing care to up to 74 people. At the time of the inspection there were 46 people living there. There are three separate units accommodating people with differing needs. Some of the people living in the home are living with dementia, mental and physical disabilities.

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

The provider had consistently failed to make improvements that were effective or sustained. People were exposed to an extended period of poor-quality care and the service had continued to be rated less-than-good. Systems to monitor the safety and quality of care were ineffective and did not always identify areas for improvement.

People were not always being protected from the risk of cross infection. Risks to people’s health and well-being were not always adequately assessed and planned for. Care files contained inconsistencies which put people at risk of receiving inconsistent care. Lessons were not always learned when things went wrong. Medicines were not always managed safely. Staff were not always deployed effectively so they did not always have time to spend with people and to keep up to date with people’s changing needs.

People were protected from intentional abuse by staff who knew how to recognise and report concerns. The provider worked in partnership with the local safeguarding authority to report and act upon concerns raised. The provider acted upon their duty of candour responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 September 2019) and there were three breaches of regulation. The provider was required to send us monthly updates about actions they had taken following the last inspection which we reviewed and was used to help us plan this this inspection. The update was about how they supported people to feedback about their care, medicines checks and action taken in response to medicine error. At this inspection, enough improvement had not been made or sustained and the provider was still in breach of regulations.

This service has been rated requires improvement for the last six consecutive comprehensive inspections. This will be the seventh consecutive time the provider has failed to achieve a good rating in safe and well-led.

Why we inspected

We received concerns in relation to how people were being supported with their nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained requires improvement overall, however the rating for well-led has deteriorated to inadequate. This is based on the findings at this inspection.

Enforcement

We have identified continued breaches in relation to the safe care and treatment of people and the monitoring and sustainability of quality and safety at this home.

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.