Inspection on 24/07/07 for Aire House

This inspection was carried out on 24th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Aire House 14/07/08

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 08/07/2008.

CARE HOME ADULTS 18-65 Aire House 6 Westcliffe Grove Harrogate North Yorkshire HG2 0PL Lead Inspector David White Key Unannounced Inspection 24th July 2007 08:30 Aire House DS0000007903.V343661.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.V343661.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.V343661.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 Limited 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) ****Post Vacant**** Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006 Brief Description of the Service: Aire House 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 home does not have a registered manager at present but is being managed by a deputy manager, with support from the registered manager of another nearby Craegmoor home. The current fees at the time of the site visit on 8th August 2006 ranged from £373 to £1408.80 per week and do not include costs for hairdressing, toiletries and activities. Current information about services provided at Aire House is available in the form of a statement of purpose that explains the care and services on offer at the home. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • Reviewing information that has been received about the home since the last inspection. This report follows an unannounced site visit undertaken on the 24th July 2007. This visit was carried out by one Regulation Inspector and took 6.5 hours with 4 hours preparation time. The commission sent out pre-inspection questionnaire information before the site visit. However the acting Area Manager for the home reported that this information had not been received and so could not be sent back. The lack of this information meant that no surveys could be sent out prior to the site visit. Time was spent talking to three people who live at the home; a member of care staff and the deputy manager. Telephone contact was had with the acting Area Manager who has responsibility for the home. Part of the visit was spent at the Vocational Skills Centre (VSC) that is run by Craegmoor Healthcare and attended by all the people living at the home. Records relating to people at the home, staff and the management activities of the home were inspected and some care practices were observed in the brief time that people were at the home. This helped in gaining an insight into what life is like for people living in Aire House. The deputy manager was available for some of the inspection. Findings from the site visit were discussed via telephone contact with the acting Area Manager. What the service does well: The people who live at the home say that staff are kind and helpful. People living at the home say that they are able to make their own choices about how they live their lives. People at the home are involved in the planning of the menus and this means that they always like the food that is on offer at the home. People can have visitors at any time. This helps them to maintain their relationships with family and friends. Proper checks are done before any new member of staff starts working at the home. This helps to keep people safe from any possible harm. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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.V343661.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.V343661.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): 1 and 2. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Proper pre-admission procedures are followed before people move into the home. This helps to ensure that only suitable people are admitted to the home. EVIDENCE: Information is on display in the home about the care and services on offer. People are given this information to help in their decision-making about moving to the home. Although some of this information is available in other formats such as pictures it would be beneficial to people with communication difficulties if more information was available in these formats. Since the previous inspection visit the home has admitted one person. The care records for this person show that relevant information was obtained before they were admitted to the home so that staff were clear about the person’s needs. A needs assessment had been carried out for the person and a care plan was drawn up from this describing how the identified needs are to be met. The person who has recently moved into the home said that they were able to visit the home with their care manager before making a decision about whether they would like to live there. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 9 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): 6, 7 and 9. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are encouraged to be independent and make their own choices where possible. This is partly supported by the care planning and risk assessment systems although improvements are needed in keeping them up to date with current information. EVIDENCE: Person centred plans are in the process of being developed for every person in the home. This will encourage people to make their own choices about how they are to be supported in meeting their aims and objectives. The individual plans of care provide staff with information about what help and support to give to meet people’s needs. The plans of care are easy to understand and are generally in written format. Other alternative formats should be considered, as this would enable people with communication difficulties to have more involvement in the planning and updating of their care. Care plan reviews do involve people at the home, their relatives and relevant others who have input Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 10 into their care. However, in one case the information from the care plan review had not been received from the person’s placing authority and this had not been followed up even though the meeting had taken place some months earlier. This could mean that staff are not always aware of changes to a person’s care and could lead to people’s needs not being fully met. A range of risk assessments is in place for aspects of daily living to encourage the independence and safety of people living at the home. The assessments include information about why decisions have been made where people could be restricted in what they are able to do. One person has recently been experiencing some mental health problems. As a result this person’s behaviour has become more challenging to the service. Initially a risk assessment had been carried out to identify possible risks from the behaviour and actions to be taken to minimise this. However the assessment had not been updated when the person’s behaviour was becoming increasingly difficult to manage and the risks were becoming greater. Daily records are generally up to date and reflect the care being given. The deputy manager said that verbal handovers take place between shifts to make sure that relevant information is shared between staff. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 11 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): 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Overall people enjoy a lifestyle to suit their needs. However, they would benefit from better planning that would enable them to have more opportunities for personal development and to pursue their leisure interests. EVIDENCE: People at the home feel that they are encouraged to be “as independent as much as possible”. Most of the people living at the home are able to communicate their needs verbally. One person living at the home has communication difficulties and uses Makaton language to express their needs and choices. In order to communicate effectively with this particular person, staff have received some Makaton training. Everyone living at the home attends the Vocational Skills Centre (VSC) that is run by Craegmoor Healthcare and which provides opportunities for people to Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 12 attend workshops in arts and crafts, computers and woodwork. Part of the site visit was spent at the VSC to speak to people living at the home. They all clearly enjoy attending the centre and staff said that it provides people with some structure and stability. One person said that visiting the centre gave them a “sense of purpose” and another “a chance to meet up with friends”. Apart from attending the centre people at the home tend to have little involvement with other local services although one person does attend an educational facility that had been arranged for them by their care manager. It is recommended that the home should look at developing closer links with other services such as educational, voluntary and employment agencies to help people with their personal development. People living at the home said that they enjoy visits to the local pubs, cinema and swimming baths but said that opportunities to do these things recently has been limited because of the staffing levels. The records from the house meetings involving people at the home show that outings have been discussed but are dependent on sufficient staffing levels. People said “we would like to go on some day outings” and one person could not recall going on any outings this year. Another person expressed disappointment that no holidays have as yet been arranged for the coming year. The current arrangements for the planning of activities need to be better planned to enable people to go out more and enjoy trips away from the local area. The home has flexible visiting arrangements. One person said that they enjoy going home to stay with their family on most weekends. The care records show where relatives have been kept informed of care matters affecting their relative. People said that they “like the quality of the meals and the choice available”. Menus are planned with people in advance and staff and people from the home jointly do the shopping. Alternative meals are available at each mealtime and these include healthy eating and non-meat options. People are able to have drinks when they choose and snacks between meals such as fruit. The commission had received some information prior to the site visit suggesting that some people did not always have breakfast before attending day services. At the time of the site visit people were just finishing their breakfast. Most people could get their own breakfast and had a choice of what to eat. Others who need more assistance receive support from staff in making sure that their nutritional needs are met. One person did say that if they chose not to have any breakfast then the staff team would respect this decision. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 13 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): 18, 19 and 20. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People receive personal support to suit their wishes and have access to healthcare services. Some improvements are needed in the way the home communicates with healthcare services to make sure that changing needs are addressed appropriately and promptly. EVIDENCE: Each person’s personal plan describes how support is to be given. People said that support is provided in private and in the way the person wishes. People living at the home have a General Practitioner (GP) and have access to dental and chiropody services. One person said that a chiropodist was visiting the home on the evening of the site visit. Another person who moved into the home from another area made comments that the home is arranging for dental services to be provided more locally. There have been improvements in the way health care information is recorded so that it is clear as to the reasons for appointments and outcomes from these. This helps staff in knowing what actions they need to take to meet people’s health needs. The staff team Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 14 support people in attending appointments. There have been some concerns in the past that some overseas staff who work at the home have language difficulties and had been asked to accompany people on appointments. This could lead to health information not being shared properly. However the deputy manager said that only certain members of staff now accompany people for appointments to make sure that this does not happen. One of the people living at the home has been having some mental health problems and displays behaviour that challenges the service. The care records show that the home made a referral to the Behaviour Management Team who are a specialist healthcare service who offer advice and support in helping to manage people who have challenging behaviour. Over a period of time the records indicate there were an increasing number of incidents involving the person concerned. However, there is little information in the care records to show that the Behaviour Management Team had been kept informed of this when it was clear that the problems were escalating and the risks from the behaviour were becoming more serious. This meant that there was a delay in the person receiving specialist support to address their health needs. Since that time appropriate measures have been taken by the home to make sure that the person receives the proper care and treatment they need and this has led to the person being admitted into hospital. Two people at the home have epilepsy and their care records contain a chart that staff had been asked to complete to record when a seizure has occurred. In one person’s case whilst the daily records provide information that seizures had occurred, this information had not been recorded on the epilepsy chart. This lack of recording could lead to inaccurate information being passed on about the person so that the person does not receive the proper care and treatment that they need. None of the people living at the home are able to administer their own medication. Medication is administered using a safe, recognised system, which minimises the chances of mistakes happening. Medication Administration Records are up to date, although in one instance the incorrect coding was being used to explain the reasons why one person was not having their medication. Advice was given to the deputy manager who is addressing this matter. All staff who administer medication in the home have received the appropriate training. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 15 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): 22 and 23. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Proper actions have been taken in response to allegations of abuse to safeguard people at the home from possible harm. The lack of a formal system for logging complaints could lead to people’s concerns not being fully addressed and acted on. EVIDENCE: The home has a complaints procedure that is on display in the home and which details how people can make a complaint and what actions would be taken from this. People who live at the home did know who they would need to speak to if they have any concerns. The home has not received any complaints since the previous inspection visit. If a complaint were received then it would currently be recorded in a complaints book, as there is no system in place to log individual complaints. A report of the findings from a recent audit of the home by Craegmoor’s Clinical Governance Team had also identified that there were no systems in place to individually log complaints. This needs addressing so that proper procedures are followed in the event of a complaint being made and appropriate actions are taken to safeguard people at the home. This will also help Craegmoor to monitor the number and nature of complaints received by the home in order to improve their services. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 16 Since the previous inspection visit there have been three incidents of alleged abuse. Proper procedures were followed in response to each of these allegations and each matter was referred to the appropriate agencies. Two of the three allegations were fully investigated and the organisation took appropriate action to deal with them. The investigation into the other allegation is still ongoing. All staff receive training on safeguarding vulnerable adults from harm and this is included as part of induction training so that staff know what to do if they suspected abuse. Some people living at the home display behaviours that challenge the service. Staff have had some CPI (Crisis Prevention Intervention) training and this includes learning techniques that can be used to calm down situations. Individual risk assessments are carried out to identify any risks from behaviour and measures to be taken to reduce risks. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 17 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): 24 and 30. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is clean and comfortable for people living there. Improvements in some aspects of the environment would make the home more pleasant, safer and for one person more private. 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. A person who enjoys using a computer has one in their bedroom. 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.V343661.R01.S.doc Version 5.2 Page 18 Since the previous inspection visit a thermostatically controlled valve has been fitted in the kitchen so that people are no longer at risks from scalding from the hot water from the kitchen sink. In the fridge it could be seen that packed foods when opened are now sealed and dated so that staff know when foods have to be eaten by to prevent food contamination. The home is clean and free from any offensive odours. Although some refurbishment work was carried out last year the general décor in most communal parts of the home is in need of updating and this includes exterior paintwork. The lock on one person’s bedroom door had broken and had been removed. Staff did not have a spare key for the room so the door is left unlocked and there is a small hole where the lock had been removed so that people could see into the bedroom. The deputy manager reported that the lock had been reported as being broken three months earlier but had still not been repaired. This needs addressing in order to keep the bedroom secure and to offer more privacy to the person whose bedroom it is. Some certificates are on display on the walls leading between stairs. At the time of the site visit some of these were loose and their coverings were cracked where they had fallen from the walls. This needs addressing so that people’s safety is not put at risk. Staff attend to people’s personal clothing and bedding and procedures are in place to reduce any risk of infection. Hot water temperatures are being monitored on a regular basis and a random check of the temperatures was found to be satisfactory. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 19 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, 35 and 36. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Recruitment procedures are followed to safeguard people from harm. Shortfalls in staffing levels and the lack of a stable staff team mean that people’s needs are not always fully met. EVIDENCE: Staff at the home show a commitment to providing good care and people living at the home describe them as “kind and helpful”. The duty rotas show that there are two staff on duty up to 9 am when all of the people at the home go to day services. On return from day services there are three staff on duty to support the people at the home. At night there is one person on night duty and another member of staff sleeps on the premises. The home currently has only two permanent members of staff. Other shifts are covered by staff from other Craegmoor homes who are working extra hours and by agency staff. People using the service said that they are not always familiar with the agency staff as these are not always the same people and tend to change a lot. The deputy manager made comments that whilst Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 20 the home tries to use agency staff who are familiar with the home this is not always possible. This is not helpful in ensuring that people with complex needs receive consistent care from people who have a good understanding of their needs. One person said that they “would like to go out more”. Another person who needs to be supported by a member of staff when going out said “I am no longer able to have time out of the home on my own because of the staffing levels. I now have to go out in groups”. Staffing deficits also mean that people have had limited opportunities to go on any day trips. Staffing arrangements need to be better planned around the needs of the people at the home to accommodate this. Information provided by the acting Area Manager shows that the home is in the process of recruiting new care staff pending satisfactory pre-employment checks. If all these people are appointed then the current staffing deficit of 254 hours per week will be reduced to 38 hours per week. This will mean that the home will have a more permanent and stable staff team and will lead to a reduction in the use of agency staff. Some of the staff are from overseas and have strong accents, which some people struggle to understand. One person did say that they are not always able to “understand what some of the staff are saying”. This was discussed with the deputy manager who said that there are plans in place for some staff to do distant learning courses to improve their language and literacy skills. Although no new staff have been employed since the previous inspection visit, the home has followed proper recruitment procedures in the past. Proper preemployment checks are being carried out on the newly appointed staff prior to them starting work in the home and this safeguards people living at the home from possible harm. In the past Creagmoor Healthcare have experienced difficulties in recruiting new staff, however measures have been taken to address this issue by introducing improved rates of pay. This has led to a better response to job vacancies. Craegmoor Healthcare has an induction programme that all new members of staff are expected to complete. There are training records showing what training each member of staff has undertaken and needs and there is information available about when training needs updating. These records show that some staff need updates in fire safety, health and safety and moving and handling. This will help in making sure that people are receiving care from staff that have up to date knowledge and skills of good practice. Staff supervision arrangements have previously been in place. However staff did say that these arrangements have lapsed with all the management changes and that they have not had any supervision for some time. This needs addressing so that staff receive the support they need to carry out their jobs and any management issues can be discussed with them. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 21 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 the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Management arrangements need to be better to improve the consistency of care and services for people living at the home. Systems are in place to enable people to be involved in the running of the home and on the whole proper attention is given to people’s health and safety. EVIDENCE: There have been a number of management changes since the previous inspection visit. A person was recently appointed to take on the role of manager at the home but decided against taking the job shortly before they were due to start in post. The management responsibility for the home is currently being shared between the deputy manager and a manager from a nearby Craegmoor home. The acting Area Manager did say that the Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 22 appointment of a suitable manager for the home is a priority and that the manager’s post has been re-advertised. This situation needs rectifying as soon as is practically possible so that the home is managed more consistently in a way that makes sure people’s needs are being properly met. Both staff and people living at the home said that the lack of a manager is having a negative impact on the home. Activities are not being properly planned and this is placing restrictions on people living at the home. There is a lack of organisation in some aspects of the home, staff are not having supervision and some areas of record keeping are not up to date. There are systems in place to find out the views of people about the running of the home. House meetings are held and records are kept and show how people have been involved in decision-making. Relatives and professionals who are involved in a person’s care are invited to attend care plan review meetings and their views and opinions are sought about the care and services on offer. The acting Area Manager for the home has been meeting up with relatives on an individual basis to address any issues they may have. Staff meetings are being held to enable staff to voice their views. Craegmoor Healthcare has a Clinical Governance Team who have recently carried out an audit of the home. The findings from their visit have been reported on and action is being taken to make the necessary improvements. Overall proper attention is given to health and safety matters. Fire safety is maintained through fire safety checks and a previous manager has carried out a fire risk assessment of the premises so that fire risks have been identified and control measures put in place to minimise risks. Whilst staff receive a range of health and safety training, some are in need of updates in fire safety, health and safety and moving and handling. Health and safety records are up to date. Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 23 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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 1 X 3 X X 2 X Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA19 Regulation 12 Requirement The registered provider must take measures to make sure that the home maintains good communication with health care services in order to ensure that people’s health needs are responded to promptly. The registered provider must have a system in place to record all individual complaints, details of any investigations and outcomes and actions taken as a result of this process. This will help in ensuring that people’s concerns are properly addressed to safeguard their interests. Timescale for action 24/07/07 2. YA22 22 24/08/07 3. YA24 13 (4) (a) Arrangements must be put in 24/07/07 place to make the certificates on display on the walls of the stairs more secure to protect the safety of the people at the home. Arrangements must be put in place to address the problem with the one person’s bedroom door lock as discussed at the time of the site visit. This will make the bedroom more secure DS0000007903.V343661.R01.S.doc 4. YA24 12 (4) 24/08/07 Aire House Version 5.2 Page 25 and private for the person in there. 5. YA32 18 (1) Measures must be taken so that there are sufficient numbers of staff on duty at all times to ensure that the needs of the people living at the home are being fully met. The registered provider must appoint a manager so that the home is consistently run in a way that meets the needs of the people at the home. The registered provider must make arrangements for all staff to receive training where appropriate in the following areas: • Fire safety • Health and Safety • Moving and Handling 24/08/07 6. YA37 8 24/09/07 7. YA42 13 24/08/07 Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 26 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 YA1 Good Practice Recommendations A wider range of information should be made available in alternative formats that are more suited to people with communication difficulties. Records from care plan reviews should be obtained so that staff have up to date information about how to meet each person’s needs. Risk assessments should be kept under regular review and updated as needed so that any changing needs can be identified and acted on to minimise any risk. Activities should be better planned and structured so that people have more opportunities for trips out. The home should look at developing stronger links with educational, voluntary and employment services to promote the personal development of people living at the home and to enable them to have better opportunities to access these services. Correct coding should be used to clearly explain the reasons why prescribed medication has not been. The general décor of the home including external paintwork should be updated to improve the living environment for people at the home. The registered provider should take action to address the issues around the language skills of some members of staff in order to develop their communicate skills with people using the service. Better supervision arrangements should be put in place so that staff receive the necessary support in meeting people’s needs. 2. YA6 3. YA9 4. 5. YA12 YA12 6. 7. YA20 YA24 8. YA35 9. YA36 Aire House DS0000007903.V343661.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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.V343661.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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