This inspection took place on 8 and 9 February 2017 and was unannounced. At our last inspection in December 2014 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

Amberley House is a privately owned care home for older people in Enfield. The home is registered to accommodate 30 older people, some of whom may have a diagnosis of dementia. The registered provider had recently opened a new extension to the property.

There was a newly 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.

People told us they felt safe at the home and risks to people’s safety and been identified, acted on and, where possible, were being reviewed with the person.

Staff were aware of their responsibilities to keep people safe from potential abuse.

There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately.

Staff were positive about the management and told us they appreciated the clear guidance and support they received.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and knew that they must offer as much choice to people as possible in making day to day decisions about their care.

People told us they enjoyed the food and staff knew about any special diets people required either as a result of a clinical need or a personal preference.

People had good access to healthcare professionals such as doctors, dentists, chiropodists and opticians.

Staff knew about various types of discrimination and its negative effect on people’s well-being. Staff understood that people’s diversity was important and something that needed to be upheld and valued.

Staff demonstrated a good understanding of peoples’ likes, dislikes, needs and preferences.

People told us that the management and staff listened to them and acted on their suggestions and wishes.

They told us they were happy to raise any concerns they had with any of the staff and management of the home.

People we spoke with confirmed that they were asked about the quality of the service and had made comments about this.

People told us the service took their views into account in order to improve.

This inspection took place on 16 December 2014 and was unannounced. At our last inspection in September 2013 the service met all the regulations we looked at.

Amberley House provides accommodation and personal care for up to 16 older people. There are 15 rooms, one of which is a shared room. A large extension to the property has been built and the provider told us that there would be a further 14 bedrooms available from April 2015.

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 and associated Regulations about how the service is run.

People told us they felt safe at the home and safe with the staff who supported them. They told us that staff were patient, kind and respectful.

People and their relatives said they were satisfied with the numbers of staff and that they didn’t have to wait too long for assistance when they used the call bell.

The registered manager and staff at the home had identified and highlighted potential risks to people’s safety and had thought about and recorded how these risks could be minimised.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and told us they would presume a person could make their own decisions about their care and treatment in the first instance. They told us that if the person could not make certain decisions then they would have to think about what was in that person’s “best interests” which would involve asking people close to the person as well as other professionals.

People and their relatives said they had good access to healthcare professionals such as doctors, dentists, chiropodists and opticians. We met with the local doctor who was visiting the home on the day of our inspection. They were positive about the registered manager and staff at the home.

Food looked and smelt appetising and the cook was aware of any special diets people required either as a result of a clinical need or a cultural preference.

People told us they liked the staff who supported them and staff listened to them and respected their choices and decisions.

People using the service, their relatives and friends were positive about the registered manager and management of the home. They confirmed that they were asked about the quality of the service and had made comments about this. People felt the service took their views into account in order to improve service delivery.

At the last inspection on 9 July 2013, we had some concerns that the manager had not implemented their own infection control policy with regards to the standards of cleanliness in the home.

During this inspection we found all areas of the home to be clean and the provider had fully implemented their infection control policy. We also reviewed the maintenance of the property as we had identified peeling wallpaper, exposed walls and broken furniture and fittings during the last inspection. The provider has since undertaken refurbishment of all identified areas, and staff and the manager were documenting regular checks of the home in the maintenance book. Recent reports of gas, electrical and fire safety were available.

People and their relatives told us that staff were respectful and patient. One person's relatives told us the staff were "so caring and very helpful." Another said their relative was "so well looked after."

Care planning and reviews took place regularly with involvement from people, and relatives were regularly involved in this process. We found that the staff understood people's care needs. People had a choice of suitable and nutritious food which was available in sufficient quantities. Recruitment processes were robust and evidence from staff files showed that appropriate checks were in place before care staff commenced working with people who use the service.

Overall, the home appeared clean and staff understood the requirements of their role to reduce the risk of transmission of infections. We had some concerns that the provider had not implemented their own infection control policy with regards to the standards of cleanliness in the home. Thus, we have asked the provider to address this concern.

We looked at the personal care or treatment records of people who use the service, reviewed information sent to us by other organisations, carried out a visit on 6 December 2012 and observed how people were being cared for. We talked with people who use the service, talked with carers and / or family members, talked with staff and talked with stakeholders

We found that the registered manager had acted in accordance with the consent of people who use the service in respect to the care and treatment provided. We also found that the care and welfare needs of the people using the service were assessed and delivered in line with the support need outlined in their care plans.

The premises were found to be of a suitable design and lay out taking into account the needs of the people who use services. In regards to staffing, we found that the provider had sufficient numbers of suitably qualified, skilled and experienced people in order to safeguard the safety and welfare of the people who use services.

We also found that the provider had taken measures to assess and monitor the quality of the service provided.

Having spoken to people who use services and their representatives, we found that people were complimentary about the service provided and spoke positively about their experiences of the home.

The three people spoken with told us that staff involved them in decisions about care and treatment. They received the care and support they needed. One person’s comments were typical when they said, "Staff understand my needs." The four staff spoken with confirmed they were told about the needs of people.

People spoken with confirmed that they trusted staff and felt safe. A person said, “I am safe.” People said to us that staff were available to help them. People told us and we observed that staff listened to them. Staff responded to any suggestions they made about the service.