This unannounced inspection took place on 9 August 2017. The home was previously inspected in November 2016 when we identified breaches of the following regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 11 (consent); Regulation 12 (safe care and treatment); Regulation 15 (maintenance and infection control of the premises) and Regulation 17 (governance). We judged the overall rating of the service to be ‘Inadequate’. In response to this we took enforcement action against the provider and the registered manager. We also placed the service into special measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Amphion View Limited’ on our website at www.cqc.org.uk’
During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. Although we saw improvements have been made and the service is no longer in special measures, we saw areas where further improvements are required particularly in relation to good governance to ensure the monitoring systems are fully effective and embedded into practice.
Amphion View care home is located close to the centre of Doncaster. It provides en-suite accommodation for up to 35 people on two floors. Care is provided for people who have needs associated with those of older people, including people living with dementia.
The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.
On the day of our visit there were 33 people living at the home. The people we spoke with all said they were very happy with the care and support provided.
Staff we spoke with were aware of safeguarding policies and knew the procedure to follow if they suspected abuse. Staff were also familiar with the company’s whistleblowing procedures.
People’s needs had been assessed before they moved into the home and we found they had been involved in formulating care plans. Information in some care files was difficult to access as they were being rewritten and we found some conflicting information in one file. Risk assessments were in place, but they were not always sufficiently detailed to ensure staff could meet people’s needs. However, we found no evidence that these shortfalls had any adverse impact on people.
Medication systems protected people against the risks associated with the unsafe use and management of medicines. Appropriate arrangements were in place for the recording, safe keeping and safe administration. However, we identified some minor issues that had been identified in an audit in March 2017, but had still not been addressed.
A robust recruitment system had been undertaken, which helped the employer make safer recruitment decisions when employing new staff.
At the beginning of their employment staff had received an induction into how the home operated, and their job role. Staff told us they received essential training and regular support sessions to help them meet the needs of people who used the service. Although we saw there were some gaps in staff training, the registered manager had identified where further training or refresher courses were required. A training plan was underway to ensure staff completed the required training.
Overall the service was meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards [DoLS]. However, we found some of the information about people’s capacity to make decisions was unclear.
People were supported to maintain good health, have access to healthcare services and received on-going healthcare support. The care records we checked showed they had received support from healthcare professionals when required.
We found staff approached people in a kindly manner. We observed staff were caring and considerate. Staff respected people and treated them with dignity. However, at times we saw staff lacked direction to ensure people’s needs were met in a timely way.
The standard of cleanliness at the home had much improved and we found the service was clean at the time of our inspection. Refurbishment work was on going at the time of our inspection, which meant some areas of the environment still required attention.
People received a well-balanced diet that met their nutritional needs and preferences. However, we found the mealtime experience varied depending on which dining room people sat to eat.
An activities co-ordinator was employed to facilitate regular social activities and stimulation to meet people’s needs and preferences. People told us they enjoyed the activities provided.
We saw the complaints policy was easily available to people using and visiting the service. The people we spoke with told us they would feel comfortable speaking to any of the staff if they had any concerns. When concerns had been raised we saw the correct procedure had been used to record, investigate and resolve issues.
People using the service, relatives and staff were happy with the way the service was run. They spoke positively about the registered manager and how staff delivered care.
An audit system had been used to check if the home was safe and well maintained, and staff were following company polices. However, shortfalls had not always been identified and where they had, timescales had not always been met. This meant the system was not fully effective in improving the quality of the service provided.
We found one continued breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the end of this report.