Amberwood House

Amberwood House 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.

At our last inspection we rated the service good. At this inspection we found the rating of the service had improved to outstanding.

There was a strong emphasis on people eating and drinking well. There was a relaxed atmosphere at meal times. People requiring assistance were helped in a manner which respected their dignity and demonstrated knowledge of their individual needs. A 'Night Owl' menu was available for people to have hot or cold food when the chef is not at the home, and a smoothie menu to help increase people's intake. The chef met regularly with clinical staff to monitor people's nutritional needs.

Training was tailored to meet staff members' learning styles and to ensure staff were able to meet people's needs. We were told that the service had introduced an online training and recording system. This enabled staff to allowed staff to access their own electronic update training and records when it suited them. 'Dementia Friends' training was included to enable staff to support people who are living with dementia.. Nursing staff were supported to maintain and develop their clinical skills. A Registered nurse on duty on the second day of inspection had recently attended a 'Clinical Excellence day'. The provider told us the home had champions at the service to help improve outcomes for people. The service had champions within the home, these included roles relating to health and safety and end of life care..

People's views were taken in consideration in how the premises was used. The provider told us three of the four smaller lounges on the first and second floors were being refurbished in response to people's feedback. One lounge had been made into a café, whilst the second was used by people to enjoy arts and crafts.

There was effective engagement with people, and actions taken as a result of the feedback they provided. Meetings with people, staff and relatives took place. Actions from these were updated, reviewed and actioned. We were told one example was that people were involved in a 'Caring without plastic' initiative aimed at reducing the amount of plastic in use in the home. The provider told us people had highlighted the large number of aprons used by staff. As a result, biodegradable aprons had been sourced for trial.

The home had made strong links with the community. Coffee mornings were run, open to people, families and carers, as a way to introduce people to the home informally. A new initiative with Prama care called Colten Prama Chat was been developed. This involved telephone befriending with people from Colten Care homes reaching out to those who may be isolated. Staff had participated in a local meeting regarding priorities in the local area for groups including older people. Staff had also sponsored refreshments at a local sporting event, which people attended.

There was a commitment to continuous learning. We were told that lessons from CQC inspections were shared at home manager's meetings. Nurses forum meetings also took place where information was shared in an open and transparent way.

People were protected from avoidable harm as staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. When people were at risk of falling or skin damage staff understood the actions needed to minimise avoidable harm. The service was responsive when things went wrong and reviewed practices in a timely manner. Medicines were administered and managed safely by trained and clinical staff.

People had been involved in assessments of their care needs and had their choices and wishes respected including access to healthcare when required. Their care was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. People had their eating and drinking needs understood and met. Opportunities to work in partnership with other organisations took place to ensure positive outcomes for people using the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their families described the staff as caring, kind and friendly and the atmosphere of the home as warm and inviting. People could express their views about their care and felt in control of their day to day lives. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs, their life histories and the people important to them. A complaints process was in place and people felt they would be listened to and actions taken if they raised concerns. People's end of life wishes were known including their individual spiritual and cultural wishes. Activities took place in the home and were enjoyed by people.

The service had an open and positive culture that encouraged involvement of people, their families, staff and other professional organisations. Leadership was visible and promoted teamwork. Staff spoke positively about the management and had a clear understanding of their roles and responsibilities. Audits and quality assurance processes were effective in driving service improvements. The service understood their legal responsibilities for reporting and sharing information with other services.

Further information is in the detailed findings below

The five questions we ask about services and what we found