Inspection on 14/07/08 for Aire House

This inspection was carried out on 14th July 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Aire House 24/07/07

Aire House 08/08/06

Aire House 07/11/05

Aire House 12/04/05

Aire House 26/10/04

Aire House 25/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME ADULTS 18-65 Aire House 6 Westcliffe Grove Harrogate North Yorkshire HG2 0PL Lead Inspector Chris Taylor Key Unannounced Inspection 14th July 2008 09:00 Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aire House Address 6 Westcliffe Grove Harrogate North Yorkshire HG2 0PL 01423 509285 01423 509285 aire.house@craegmoor.co.uk www.craegmoor. Co.uk Parkcare Homes Ltd Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Wendy Yates Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2007 Brief Description of the Service: Airehouse is registered to provide residential personal and social care to eight adults with learning disabilities. The home is a large semi detached house situated close to Harrogate town centre and with good access to the town’s services and amenities. The registered provider is Parkcare Homes part of Craegmoor Healthcare. The current fees at the time of the site visit on 14th July 2008 ranged from £373 to £1408.80 per week and do not include costs for hairdressing, toiletries and activities. Current information about services provided at Airehouse is available in the form of a statement of purpose that explains the care and services on offer at the home. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This is what was used to write this report. • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called an Annual Quality Assurance Assessment (AQAA). An unannounced visit to the home. This lasted five hours and included talking to support staff about their jobs and the training they have completed. And checking some of the records polices and procedures the agency has to keep. Information from surveys. Six surveys were received from people who live at the home. Time was spent with people who live at Airehouse. • • • What the service does well: The information kept about people is good and is the right kind of information needed; this helps staff support people properly all of the time. People are involved in what is recorded about them and includes using pictures, diagrams and photographs. This helps make sure people understand what is recorded about them and gives them some control and choice about this. The training staff do is good, it includes training about people with learning disabilities and how to make sure people who have learning disabilities can have more choice and control in their lives. This means staff know how to support people to be as independent as possible, treated kindly and with respect. There are good relationships between people who live at the home and staff; staff showed kindness and respect towards people. One person said, “ I like the staff here, they help you be independent”. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 6 People have the chance to say what they think about Airehouse and how it could be better. Craegmoor, who run Airehouse send surveys to people who live at Airehouse with pictures to make it easier to understand and they organise meetings where people can get together and talk about what it is like getting support from Craegmoor and how it could be better. This is called “Your Voice” The manager and staff team work hard to improve the quality of lives of people living at the home. What has improved since the last inspection? What they could do better: More stable staffing arrangements would improve the consistency of care and support for people living in the home. Staff and managers do everything they need to run the home properly and they should continue to look at ways to improve the way they do things. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. People who use this service experience good quality outcomes in this area. Peoples’ needs are properly assessed prior to admission this helps make sure that staff know they will be able to meet all of the persons needs when they move into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff confirmed that people are admitted following a local authority care management assessment and the home’s pre admission assessment. This assessment includes information from the person, their family and other professionals and is particularly useful for those people who have complex needs and /or difficulties with communication. This document supports staff in making the admission for the person as smooth and as comfortable as possible. If at this stage the home believes they could offer a service then introductory visits commence and these are taken at a pace set by the person. New placements are under review and further assessments are completed. Usually after a six week settling in period a review is held to confirm that the person and other people in the house are happy with the arrangements. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 9 People are provided with and assisted in understanding the service user guide which is produced pictorially. One person had been admitted to the home since the last inspection. This person lived at a nearby Craegmoor home which has closed down. Despite this person being known well by staff at Airehouse the admission process was followed with preadmission assessments completed and discussion with the person, their representatives and care manager. Evidence of this was seen on the person’s file. She was able to talk about the move into Airehouse and said she had visited and talk to her parents before making a decision. A further two files were looked at and all contained preadmission assessments. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 People who use this service experience good quality outcomes in this area. Peoples’ needs are assessed and are met promoting independence, choice and respect for individuals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A new care planning format has been introduced. It is a pre printed document with sections to cover every aspect of the person’s life. It is also supported with pictorial prompts and diagrams. Four people’s care plans were looked at. They was an inconsistency in the dating and signing of the plans by both service user and staff member which makes it difficult to be sure about what is most current and whether the person agrees with the plans in place. One person was having her care plan reviewed at the time of the visit and she was involved in determining how she would like her support to be provided. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 11 Another person wanted to show me his care plan and he was able to talk me though the different sections included the sections he had written himself. Care plans are written in the first person and each section has an area to complete which identifies what the individual’s needs are and what action is needed to meet them. This is documented step by step to make sure the support is provide exactly how the person wants and needs. The care plans looked at were completed fully and included information about religious beliefs and how the individual should be supported in making choices and decisions. Support plans are reviewed regularly and are completed with the person. Also present were risk assessments with the purpose of supporting people to live as independently as possible with safeguards in place, these were also reviewed regularly. Risk assessments also covered instances any restrictions choice because the risk to the person is too great; going out unaccompanied for instance. Creagmoor provide a good induction and ongoing training for staff which makes sure people are treated with respect, dignity and are supported to make choices in their lives. This was reflected in the observations of staff working with people throughout the visit. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15,16 and 17. People who use this service experience good quality outcomes in this area. People are supported by the staff to make choices about their lifestyle, in developing new skills and to participate in activities. This supports them to lead full and active lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a weekly timetable of activities which is put together in consultation with the person. Activities relate directly to what people are interested in and supports people to develop skills. Activities include specialist day centres or college and days at home to participate in personal shopping, laundry and household tasks. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 13 Most people who live at Airehouse attend Craegmoor’s Vocational Skills Centre which provides opportunities to develop skills including cookery, computing, woodwork and craft. There was written information in peoples’ care plans about how people spend their days. Details about family, friends and significant events are recorded in plans. People talked about their contact with family and friends and during the visit one person made an independent phone call to their parents to arrange a visit. People said that they had arranged a holiday for later in the year and that they like to go to the local pub and cinema. Daily records provided a good picture of how people spend their day and would provide essential information to track any changes people may experience, with ill health or involvement in social activities. People said that they discuss menus in house meetings and take it in turns to help with the supermarket shopping. There is a weekly menu but people choose what they want to eat particularly at breakfast and lunch. The menus indicated that a healthy choice is available. Staff support these meal choices discreetly to make sure people are choosing a healthy diet and there was a record in house meetings of a discussion and house agreement to eat more healthy options. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards18, 19 and 20. People who use this service experience good quality outcomes in this area. People’s personal and healthcare is provided appropriately and sensitively according to individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the case records looked at included a Health Action Plan which included assessment and aims for holistic health needs and more specific health needs. For instance a record was made about whether a person wanted to attend well men and women clinics. Information included medical logs, referrals for medical interventions and any further requirements and medication. Health Action Plans were signed by the person. People can access psychology, physiotherapy, and art therapy, speech therapy and specialist community nursing from the local learning disability team. Staff said they have a good working relationship with this team and evidence was seen in case records of specialist assessments and guidance for staff. A monitored dosage system is in use with proper procedures in place for the receipt, storage, administration, recording and return of medicines. Staff Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 15 receive accredited medication training and are not permitted to administer medication until their competence is assessed. An annual competence test is carried out. Those people who require PRN (as required) medication have a risk assessment and procedure for staff to follow. This includes permission to administer the medication from the senior member of staff on duty or on call. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. People who use this service experience good quality outcomes in this area. People can be confident that concerns are listened to and appropriate action is taken. There are sufficient effective systems in place to safeguard people from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are provided with a complaints procedure which is produced pictorially. People spoken with were aware of who they could talk to if they had any concerns or complaints. Advocates are available to provide an independent voice for people. The process for recording information has been altered since the last inspection and this now meets with data protection guidance. One complaint had been received by a person living at the home. The appropriate documentation had been completed with a record of investigation and outcomes. There is a comprehensive policy and procedure with regard to safe guarding adults and the procedure to take if there is a suspicion of abuse. Staff demonstrated a good awareness of this. Staff receive training in adult Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 17 protection and safeguarding issues during induction and foundation training and as part of NVQ level 2 and 3. Some people take care of their own spending money and others need staff to do this on their behalf. Money is locked away and there is a recording sheet to record when money is spent and this is receipted. These records are audited by Craegmoor externally and are checked as part of shift change routine. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. People who use this service experience good outcomes in this area. Completion of re decoration work will ensure people live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has four floors that can only be accessed by stairs and there is no ramped access to and from the home. This makes the home unsuitable for people with mobility problems. Each person has their own bedroom and these are personalised to suit their tastes. Two of the bedrooms have en-suite facilities. Every person at the home has keys to their bedroom unless the risk assessment indicates that this is not appropriate for the person. The home has a lounge with a large flat screen television and a dining lounge where most people choose to eat. There is a paved area to the rear of the building where people can sit out Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 19 Most of the refurbishment work planned has been carried out but there is still a new kitchen to refit, new flooring in some bathrooms and dining room and new fire doors painted to complete. There are separate laundry facilities where people’s personal clothing and bedding are attended to and procedures are followed to prevent the risk of infection. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People who use this service experience adequate quality outcomes in this area. Recruitment procedures are followed to safeguard people from harm. More stable staffing arrangements would improve the consistency of care and support for people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All recruitment is managed by the oraginisation centrally by a human resources department. They ensure that references and appropriate police and POVA (protection of vulnerable adults) first checks are completed before contacting the person to agree a start date. Three staff files were checked and this process had been followed. Prospective staff attend for interview and complete a literacy test. This has been introduced specifically to ensure that staff whose primary language is not English has competent enough English. People who live at Airehouse are included on the interview panel and two people confirmed this. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 21 There have been significant staffing shortages at Airehouse and with recruiting and retaining staff. Improvements in conditions of service have resulted in recruiting four new members of staff who are due to start within the next month when Criminal Records Bureau checks have been returned. Current vacancies are covered by agency staff, most agency staff are well known by the home but there are occasions when this is not possible. People said that it has been difficult particularly when agency staff aren’t known to them. An example was given by someone was when requiring personal and intimate care. The home is registered for eight people but there are only five people currently resident. The home has made a decision not to admit any new people until staffing levels are more stable. There are usually three members of staff on duty when all service users are at home with two staff available at night, one awake and one asleep. There is also an on call system for emergencies. Training profiles were available and demonstrated that staff had completed a range of training which included statutory health and safety training as well as training specific to the need of people with learning disabilities. Craegmoor Healthcare has an induction programme that all new members of staff are expected to complete. The oraginisation has a policy and procedure with regard to supervision and appraisal called Personal Performance Agreement. In the absence of the permanent manager and the induction of temporary manager supervision have not been kept up to date. Staff meetings are held regularly. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People who use this service experience good quality outcomes in this area. The home is managed in such a way that promotes the best interests of the people who live at the home. Staff take proper precautions to ensure the health and safety of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A permanent manager has been in post for almost 12 months. She is not yet registered with the Commission for Social Care Inspection. She is currently absent from work and a temporary manager has been recruited and is in post. This manager was on annual leave at the time of the visit. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 23 Staff said that having a permanent manager had improved staff support and the support provided to people living in the home, and that training and supervision had improved. The area manager confirmed that the temporary manage has the necessary skills and experience to manager the home and has previously worked for the oraginisation so has prior knowledge of polices and procedures. There is a formal quality assurance system. This process includes collating surveys form service users, their families and friends and other professionals and staff. A development plan is formulated from the outcome of surveys and is monitored to ensure achievement. Surveys are provided in pictorial format for those who need it. Additionally, monthly audits are completed by a manager from another service, this includes talking to people about their experiences of living in the home. Records were seen which confirmed that equipment is maintained and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Staff receive training with regard to all health and safety matters and there is an effective system to ensure updates are completed. Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 x 3 3 x Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Care plans and risk assessments should be signed and dated by the author and the service user to ensure agreement by the service user and in order that staff are clear about what is most up to date. The current recruitment programme should be monitored to ensure a permanent staff team is established as soon as possible. This will improve the consistency of care and support for people living in the home. The lapse in regular formal supervision should be addressed to ensure staff receive the necessary support in meeting people’s needs. 2. YA33 3. YA36 Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Aire House DS0000007903.V368354.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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