This inspection took place on 24 and 26 July 2018 and was unannounced.

The last inspection was in June 2016, and the service was rated 'Good' in all key questions. At this inspection in July 2018, we found three breaches of regulation. This was related to person centred care, assessment of risk and governance.

Amber 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.

The care home accommodates up to 22 people in one adapted building. At the time of this inspection there were 16 people living in the service.

There was a registered manager in post. 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.

The provider's governance systems had failed to identify the areas we found as requiring improvement. Auditing systems needed to be improved upon to ensure all areas of people's care was considered.

Risk assessments relating to people's care were not always sufficiently detailed, or reviewed regularly to ensure they were still relevant. Some did not contain sufficient detail to guide staff in how to mitigate risks.

Risks relating to the environment had not been identified by the provider, however, they acted promptly to address these.

Care plans were not standardised across the service. Some contained historical information that was no longer relevant, and inaccurate information about people's needs. Care plans were not reviewed regularly to ensure they contained up to date information about people's current needs.

Care plans in relation to people’s end of life care needed to be more detailed to ensure the full scope of people’s wishes were known.

People received their medicines safely, however, some improvements were needed in how the service stored temperature sensitive medicines and in documentation.

There was sufficient numbers of staff to support people safely, and to enable people to access the community and pursue their hobbies and interests.

Staff took appropriate precautions to ensure people were protected from the risk of acquired infections.

Staff had regular supervision and they had been trained to meet people's individual needs effectively.

The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people's consent prior to care and support being provided. People were supported to have maximum choice and control of their lives.

People had been supported to have enough to eat and drink to maintain their health and wellbeing. They were also supported to access healthcare services when required.

People were supported by caring, friendly and respectful staff.

The provider had an effective system to handle complaints and concerns.

The manager provided stable leadership and effective support to the staff. They worked well with staff to promote a caring and inclusive culture within the service.