About the service: Amberwood Care Home is a residential care home providing personal care and accommodation for up to 44 people. There were 41 people living at the service at the time of our inspection.

People’s experience of using this service: People felt safe living at Amberwood Care Home. Staff knew how to keep people safe whilst caring for them. People were supported to take their medicines in a safe way. There were systems and procedures in place to ensure staff administered medicines in a timely and safe manner. People felt there were enough staff overall to support them, risks associated with people’s care were assessed and managed correctly.

People were supported with their eating and drinking requirements and support from healthcare professionals was sought by staff when required. People were supported by staff who were appropriately trained in line with best practice, national guidelines and legislation.

People felt they were cared for by kind and respectful staff. We observed staff speaking in caring manner with people and treating them with respect.

People’s plans of care were individualised and gave staff the information to care for people in a personalised way. People had the opportunity to engage with a variety of activities and make suggestions to improve the service.

People and their relatives felt the service was well-led, that staff and management were approachable, and any concerns were dealt with appropriately. The registered manager had comprehensive monitoring systems in place, they were aware of their duties and worked together with other agencies to ensure people received quality care and support.

Rating at last inspection: Requires Improvement – last report published 09 May 2018.

Why we inspected: At the last inspection in February 2018 we found three breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. The service was rated overall Requires Improvement with a Requires Improvement rating in the Safe and Well led domains and a Good rating in the Effective, Caring and Responsive domains. Requirement notices were served.

Following our inspection, the provider informed us what they would do to meet the regulations.

We carried out this comprehensive inspection to check if they had now met the regulations. Our visit was unannounced. This meant the staff and the provider did not know we would be visiting. During this inspection we found the provider had implemented the necessary improvements. At this visit we found evidence to demonstrate and support the overall rating of Good.

Follow up: We will continue to monitor the service through the information we receive.

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

Amberwood Care Home Limited is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 44 people in one adapted building. On the day of our visit, there were 44 people using the service.

The service had three registered managers. 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.

This inspection took place on 1 and 2 February 2018 and was unannounced.

This was the second comprehensive inspection carried out at Amberwood Care Home Limited. The last inspection was carried out in November 2015 and the service was rated as Good. At this inspection we found areas that required improvement.

The provider did not have sufficient systems in place to assess, monitor and evaluate the quality and safety of people using the service. This had impacted on the levels of staff, response to people’s feedback, health and safety and medicines management.

The provider had not ensured that people were always protected from health and safety risks associated with accessing areas such as the kitchen and laundry.

The provider had not always deployed enough staff to meet people’s needs. Staff did not always follow systems to manage medicines in a safe way.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. Risk assessments were in place but these were not always reviewed regularly; people received their care as planned to mitigate their assessed risks.

Safe recruitment processes were in place. People received care from staff that had received training and support to carry out their roles. People were supported to have enough to eat and drink to maintain their health and well-being.

People were supported to access relevant health and social care professionals.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.

We made recommendations that the provider implemented a system to record all complaints and systems to capture people’s wishes and preferences they want at end of life.

At this inspection we found that Amberwood Care Home Limited were in breach of three regulations relating to the health and safety, staffing and governance, as the provider did not have sufficient systems and processes in place to ensure the quality and safety of the service.

You can see what action we told the provider to take at the back of the full version of the report.

A person who used the service told us, "It's wonderful here. I have a beautiful room. I like everything about living here. I'm very well looked after day and night. The food is good, we have lots of choice. When I use my buzzer staff come quickly." Another person told us, "I'm looked after so well. I get the care I need. The home had arranged for a GP to visit me when I felt out of sorts. The staff remind me about the medicines I need to take. The staff help me to be as independent as I can be. I get up when I want to, the meals are marvellous and there is always a variety to choose from. There are lots of activities to enjoy."

Relatives of a person who used the service told us, "We were involved in the assessment of our mother's needs and reviews of her care plan. We've had opportunities to provide feedback. The staff understand our mother's needs. The staff are attentive, we can't fault the staff. All of the staff, from manager to the cleaners, care about the people who live here. There are plenty of opportunities to take part in activities. It couldn't be a better home. We have recommended it to other people."

We found that the service provided a safe and caring environment and that the home was well run.

The provider may wish to note that the home does not provide treatment of disease, disorder or injury nor diagnostic screening procedures; and may therefore wish to review their registration for those regulated activities.

We spoke with one person who used the service and a relative of another person. The person who used the service told us, "It's a nice friendly home. I'm well looked after. The staff are very good. They always come to me quickly when I call them. We get plenty of opportunities to say what we'd like. We play games and sing, we have plenty to keep us occupied. I like it because the home is nice and clean and I like the food. We always have a choice about what to do or what to eat." A relative told us, "The home is more than I could have wished for. I visited the home before deciding it was where I wanted my relative to be. I've been absolutely involved in decisions about my relative's care. The home have kept me fully informed of things. I cannot fault the quality of care. The staff are attentive and friendly. Nothing has been too much trouble for them."

Our observations of how staff supported and inter-acted with people throughout the day tallied with what people had told us and what we saw in people's care plans. We saw that staff had been attentive to people's needs and that people had engaged in a variety of meaningful and stimulating activities. The home was very clean and comfortably furnished throughout. The home had the latest modern equipment for assisting people with their mobility.

Most people who used the service had visited the home prior to deciding to move in.

People told us they could make choices about their day to day routines and that in most instances staff responded promptly when they asked for help.

People told us they were satisfied with the care and support they received. One said; “I cannot fault any of it.”

This was an unannounced comprehensive inspection that took place on 10 and 11 November 2015.

Amberwood Care Home is a care home registered to accommodate up to 44 people who are aged over 65 and who may also have a physical disability. The home is located on two floors, with lift access to both floors. All bedrooms are en-suite and there are five bath or shower rooms. The home has a variety of communal rooms and areas where people can relax. At the time of the inspection 43 people were using the service.

The service had a registered manager. 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 feedback from relatives we spoke with was that they felt people were cared for very well.

People received care and support that was centred on their individual needs. Their care plans included information about how they wanted to be supported.

People told us that they felt safe. Staff knew how to identify and report abuse and the provider had a system in place to protect people from the risk of harm.

The provider had a robust recruitment process in place and carried out pre-employment checks.

People received their medicines safely and at the right time.

Staff were supported through training and supervision to be able to meet the needs of the people they were supporting.

People were involved in decisions about their care and support and care plans included assessments of risks associated with this. Support was offered according to people’s likes, dislikes and preferences.

Staff knew people well and understood their care needs. Staff treated people with dignity and respect.

People were supported to take part in a wide range of activities.

Staff and relatives told us they were happy to raise any concerns with the manager and felt confident they would be listened to.

There were effective systems in place to monitor the service being provided.