We carried out an unannounced inspection of Amberley House Care Home on 23 October 2018. Amberley House is a ‘care home’ that provides nursing care for a maximum of 26 adults. 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. At the time of the inspection there were 20 people living at the service.

The building is a detached house over three floors. Stairs in the service had stair lifts to support people, with mobility problems, to access all floors. A passenger lift had recently been installed to further support people with mobility needs. At the time of the inspection work to upgrade all areas of the premises were taking place.

This was the first inspection for the service since it re-registered as a new legal entity in November 2017.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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.

During the inspection we spent time in the shared living area to observe staff interaction with people and how people responded to the care and support provided. We saw that people were relaxed and comfortable with staff, and had no hesitation in asking for help from them. People and their relatives told us they were happy with the care they received and believed it was a safe environment. Comments included, “You can come and go as you please”, “The staff manage everything and there have not been any problems” and “I have no complaints. I was told it was a good place and it is.”

Care records were personalised to the individual and detailed how people wished to be supported. They contained accurate and up to date information to enable staff to provide the agreed care and support for people. Risks were clearly identified and included guidance for staff on the actions they should take to minimise any risk of harm. Risks in relation people’s skin care and nutrition were being effectively monitored.

People were supported to access to healthcare services such as occupational therapists, GPs, chiropodists, community nurses and dentists. Staff enabled people to eat a healthy and varied diet. Comments from people about their meals included, “The food is good” , “It’s very nice food” and “We have lots of choice and lots to drink.”

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). 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.

Staff were supported in their roles by a system of induction, training, one-to-one supervision and appraisals. Some staff supervisions had fallen behind and there was a plan in place to rectify this within four weeks of the inspection. There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people's changing needs and wishes. Staff completed a thorough recruitment process to help ensure they had the appropriate skills and knowledge.

There were safe arrangements were in place for administration of medicines. People were supported to take their medicines at the right time by staff who had been appropriately trained and Medicine Administration Records (MARS) were completed appropriately.

People were able to take part in a range of group and individual activities. These included, craft work, themed events and board games. In addition, there were visits by external entertainers an