Inspection on 07/11/05 for Aire House

This inspection was carried out on 7th November 2005.

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 6 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 24/07/07

Aire House 08/08/06

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 Terry Downey Unannounced Inspection 7th November 2005 4pm Aire House DS0000007903.V263323.R01.S.doc Version 5.0 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.V263323.R01.S.doc Version 5.0 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.V263323.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Aire House Address 6 Westcliffe Grove Harrogate North Yorkshire HG2 0PL 01423 509285 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) Parkcare Homes (No. 2) Limited ****Post Vacant**** Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th April 2005 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 Craegmmoor Healthcare. The responsible individual is Mrs M Hill. 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 Glenavon, a care home nearby. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the inspection process on 7th November 2005. Caroline Long a new inspector from the York Office assisted with the inspection, which was timed to coincide with the residents returning from their day services. The deputy manager Ms Raquel Arcega was on duty and helped with the inspection. We also spoke to six of the residents, two members of staff and the acting manager Mrs Kath Charnley. The inspection also involved a check on the requirements and recommendations from the previous inspection, a tour of the premises and a check on some of the records kept by the home. What the service does well: What has improved since the last inspection? The admission procedure for new residents has improved. The manager does the assessments and existing residents are involved which makes sure that the right people are admitted into the home. Residents are involved more in the running of the home and feel it is their home and said they were very happy. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 6 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. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 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.V263323.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5. The admission procedure has been improved which ensures that prospective residents are suitable and that their needs can be met by the home. However the home still has a resident who was inappropriately admitted over a year ago. EVIDENCE: Two new residents have been admitted since the previous inspection. Comprehensive assessments were carried out by the manager and other professionals and support needs were identified and agreed. Records showed that the new residents were invited for visits before admission and had the opportunity to meet the staff and other residents. This helped them to get to know the residents and staff. Staff were also able to assess if they could meet their care needs. One of the new residents was said to use Makaton to communicate but none of the staff are able to use Makaton. The deputy manager said that staff training has been organised. The resident’s key worker considered that she could communicate her needs well and understand the spoken word so the lack of Makaton training was not an obstacle. One resident who was inappropriately admitted over a year ago is still in the home and this is creating problems for her, the staff and especially the other residents. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 9 All residents have an individual contract and reasonable steps have been taken to ensure that it is explained to them. This makes sure that they are aware of the terms and conditions of their stay in the home and that their needs can be met by the staff in the home. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10. Generally the residents health and personal care needs are met and they are encouraged and supported to make choices about their daily lives. This helps them to have control over their lives in the home. Some require more detail and staff involvement. EVIDENCE: Comprehensive assessments and care plans identify their personal and social care needs. Risk assessments are included in the care plans so that both staff and residents are aware of the support required. It would help the residents if the plans showed not only what outcomes were to be expected but how they were to be achieved. One resident requires independence training to be continued to allow her to move to a supported living unit. There was no evidence that this was being provided and there is a real danger that the resident will lose the skills unless staff provide the support she requires to help herself. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 11 There were many examples of residents making decisions in the home and about their lives and these included, choice of daily activity programmes, leisure activities, and menu planning. The residents were pleased to discuss these and they were aware that some required support and others could be more independent in different activities. The information in the home is kept securely in the office and the residents were aware that they were confidential and could only be shown to others with their permission. This gave them confidence in the manager and staff team that any concerns that they shared with them would be treated with respect. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,16,17. The residents enjoy a full range of activities and are part of the local community EVIDENCE: The residents returned from day services during the inspection and were keen to talk about their life in the home. They were all happy but were still having difficulties understanding what ‘ having rights’ actually means for them. It had been recommended at the previous inspection that more support be given so that residents could be clearer about their rights but this has not happened yet. It was a resident’s birthday so they were having a party later which turned out to be a buffet supper dancing and singing. Residents from other homes attended and they were really enjoying themselves. All day activities are chosen individually with each resident and provide stimulation as well as personal development Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 13 All residents use the local facilities in Harrogate e.g. cinema, pubs, and clubs. Two residents also help a neighbour with his garden. Before the previous manager left the residents and some of the staff had started a healthy eating and get fit course. In her absence this had lapsed but the deputy manager and some of the residents have started again and are hoping for some positive results. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,21. The residents personal and emotional health needs are met. EVIDENCE: The residents all helped to write their care plans which deal with personal support as well as their physical and emotional needs. They were happy that these were met in the way they wanted and staff felt confident that they were only doing what the resident had agreed to. Records showed that residents had been consulted about death and dying and arrangements for funeral services were recorded. Residents said they were happy to be asked about this and one had even chosen the hymns she wanted. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. The residents are protected from abuse, neglect and self harm. EVIDENCE: Since the previous inspection a major confrontation between two members of staff and a resident resulted in a member of staff being dismissed and another disciplined. The enquiry was not dealt with very well by the management of the organisation which resulted in all staff being given further training in the adult abuse procedure and senior managers and key staff being given training in how to report incidents and conduct investigations. The Operations Director has also given assurances that the Adult Protection Procedure will be reinforced 6 monthly to refresh the staff’s knowledge. At the inspection the staff spoken to were confident that they knew how to recognise abuse and how to report it. Concern however does need to be expressed about the level of understanding by one of the overseas carers. The home has a detailed complaints procedure but residents have not used it but felt safe knowing that it was there. They also said they could talk to the manager and staff and knew that they would take them seriously The residents are part of the community, go out regularly, make choices, and have lots of advocates. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,30. The environment is homely and provides a comfortable place where the residents say they are ‘very happy to live’ EVIDENCE: A lot of work, including new windows, two new bathrooms, and several rooms redecorated, was carried out prior to the previous inspection making the home much more comfortable and this is still being enjoyed. The residents are very proud of their bedrooms since they were decorated and had signed a form giving the inspector permission to look at their rooms should he call when they were out. The communal rooms are well furnished and decorated and residents said they were happy to bring people into the home. The home was clean and hygienic and free from offensive odours. There is an infection control policy to alert staff and ensure good hygiene practices. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 17 At the time of the inspection there was a problem with the first floor landing, and bathroom lights. This constituted a hazard to both residents and staff. The deputy manager stated that an electrician had been contacted and was due to repair the work the following day. She was advised to ensure that it was brought to the attention of the residents and staff and additional care procedures implemented. (The inspector carried out a check a few days later and the work had been carried out.) Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35. The residents are well supported by trained staff. EVIDENCE: The home is a member of staff short but has appointed someone subject to suitable references. There is a settled staff team which helps with the continuity of care. Staff work at times suitable for the residents who all felt supported by them. Staff also felt that there were enough staff on duty to meet the needs of the residents. Staff training records were well kept and showed that all staff were doing NVQ level 2 and 3 and all statutory training was up to date except fire training. The ability of one member of staff to speak and understand English could compromise her understanding of the training. The home is doing the Investors in People Award and the work for this means that staff are kept up to date with best practice and recent legislation which benefits the residents in the way their care is given. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. The lack of up to date fire records and training could put staff and residents at risk. EVIDENCE: The residents have regular meetings as individuals and as a group to talk about the home so they feel that they have control over their lives. Craegmoor Healthcare have an official form asking for the resident’s opinions of the home. This gives the residents a chance to tell the owners of the home what they like and don’t like about the home. As mentioned previously in this report some of the residents are not sure about their rights or what they are allowed to say and more input is required to help to empower them. Records regarding health and safety showed that fire training for staff was last given in April and that the alarm system is only tested monthly not weekly as is recommended. Fire training for day staff should be given at least 6 monthly and for night staff three monthly. An overseas carer responded knowledgeably to a question about the fire procedure but her response was both inappropriate and potentially harmful. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 1 3 3 Standard No 22 23 Score 3 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 1 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Aire House Score 3 3 X 3 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 1 x DS0000007903.V263323.R01.S.doc Version 5.0 Page 21 no Are there any outstanding requirements from the last inspection? 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 2 Standard YA3 YA6 Regulation 14 15 Requirement The home must ensure that all residents are appropriately placed in the home. Care plans must be detailed enough to explain how the outcomes will be achieved and the staff must provide the support required. The home must ensure that staff whose English is not good are fully able to understand the training provided. This particularly refers to adult protection and fire training. The home must be maintained in such a way as to ensure the safety of the residents and staff. Timescale for action 31/12/05 31/12/05 3 YA23YA35YA42 18 31/12/05 4 YA24 23 31/12/05 Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 22 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 16 Good Practice Recommendations Some residents will need more suport to fully understand what having rights actually means and to help them to become more assertive. Aire House DS0000007903.V263323.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 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. 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