Archived: Airthrie Homes - 56 Airthrie Road

Airthrie Homes - 56 Airthrie Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service provides accommodation and support to four people with a learning disability. At the time of our visit, there were three people using the service.

There was no registered manager in place as the registered provider was in day to day charge of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and their representatives were happy with the care and support they received from the service. They felt safe using the service and when staff were in their homes. The provider had safeguarding procedures in place and staff had a good understanding of what constituted abuse and how to report any concerns to keep people safe. Risks associated with people's care and support had been assessed.

People were supported by sufficient numbers of staff to meet their individual needs and wishes. The provider had a robust recruitment system was in place.

There was a comprehensive medicines policy in place. People received their medicines safely when they should.

Staff were supported to maintain and develop their skills through training and development opportunities. They received on-going training whilst working for the provider. They also had regular one to one meetings with their line manager to discuss their care practice and identify training needs.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Care plans contained information about people’s wishes and preferences. These were regularly reviewed and updated.

Staff were aware of the Mental Capacity Act 2005 and had undertaken training to make sure they had knowledge and skills to support people who did not have capacity to make their own decisions.

People were supported to maintain good health and to access healthcare services when they needed them. Their dietary needs were considered and were monitored appropriately.

People were offered support in a way that upheld their privacy and dignity. Staff knew their needs and preferences and their privacy and encouraged them to participate in activities that were meaningful to them.

There was a complaints procedure in place which provided information on the action to take if someone wished to make a complaint and what they should expect to happen next.

People and their representatives felt the service was well managed and staff felt supported.

There were systems in place to monitor the quality of the service and to identify shortfalls or areas for improvement. People and their representatives were regularly asked for their views through satisfaction surveys.

At the last inspection on 22 and 24 November 2016, we found the provider was in breach of regulations in a number of areas such as people were not always protected from being cared for by suitable staff because the provider’s recruitment processes were not always followed. We also noted staff were not regularly trained and people did not always receive their medicines as the prescriber intended. There were no records of medicines being received in the service and we noted gaps in the medicine administration records.

People who used the service, staff and visitors were not protected from the risk of harm as the provider did not always adhere to health and safety regulations. There were delays in dealing with maintenance issues which had been identified during daily checks carried out by staff.

Notifications of events affecting people and the operation of the service were not always made to us when required. The provider had systems in place to check and monitor the quality of the service provided, however, there was no formal mechanism in place for people and their representatives to express their views about the service.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the breach. We carried out this focused inspection to check if they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those breaches. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Airthrie Homes - 56 Airthrie Road on our website at www.cqc.org.uk.

Airthrie Homes - 56 Airthrie Road provide accommodation and support with personal care for up to four adults with learning disabilities.

There is no registered manager in place as the registered provider is in day to day charge of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At this inspection, we found the registered provider had taken sufficient actions to address all the concerns identified at the last inspection.

There is no registered manager in place as the registered provider is in day to day charge of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Airthrie Homes - 56 Airthrie Road provides accommodation and support with personal care for up to four adults with learning disabilities. At the time of our visit, there were three people using the service.

At our previous inspection on 8 June 2016, we found a breach of regulations in relation to safety of premises and equipment. We noted that the shower heads in two bathrooms could drop below the water level when the baths were in use and could create a backflow which is an unwanted flow of water in the reverse direction. This could be a serious health risk for the contamination of potable water, which people and staff consumed. During this visit, we saw the provider had taken action to rectify the situation, however, we saw two shower heads could still reach below the water level when the baths were in use. On the second day of our visit the provider had taken action and fixed the shower heads.

We found people were not always protected from being cared for by suitable staff because the provider’s recruitment processes were not always followed. There were sufficient numbers of staff to ensure people's needs were met.

Although staff demonstrated the appropriate skills and knowledge to care for the people they supported, they had not been regularly trained.

People's health and wellbeing were at risk as they did not always receive their medicines as the prescriber intended. There were no records of medicines being received in the service and we noted gaps in the medicine administration records.

People who used the service, staff and visitors were not protected from the risk of harm as the provider did not always adhere to health and safety regulations. There were delays in dealing with maintenance issues which had been identified during daily checks carried out by staff.

People's needs had been identified, assessed and reviewed on a regular basis. Staff had enough information to be able to care for the people they supported. People had been involved in the planning of their care.

There were quality assurance systems in place to review and monitor the quality of the service provided, however, it was not always effective at seeking people and their representatives’ views about the service. We noted not all relevant notifications had been received by the Care Quality Commission in a timely manner.

People were supported to have access to healthcare services and the provider worked effectively with other health care professionals and referred people for treatment as and when necessary.

There were safeguarding procedures in place to protect people from potential abuse. Staff received training and were knowledgeable about the signs to look for. Accidents and incidents were recorded and monitored.

People's rights were protected in line with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People had given their consent for staff to provide care and support.

Staff felt supported by the management team and felt able to raise any issues or concerns. There were regular meetings where staff had the opportunity to make suggestions and feedback on the service.

People were supported to be part of the local community. They were able to take part in various activities and to follow their interests and hobbies. There was information available should people wish to have an advocate. Staff understood their role in supporting people to make choices and respected their privacy and dignity. They encouraged people to be as independent where possible.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one of the Care Quality Commission (Registration) Regulations 2009. You can see what actions we have told the provider to take at the back of the full version of this report.

At the last inspection on 18 November 2015 we found the service to be breaching regulations as there was not always sufficient numbers of staff to meet the needs of people. We also noted staff had not been having regular supervision sessions to enable them to carry out the duties they are employed to perform. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Airthrie Homes - 56 Airthrie Road on our website at www.cqc.org.uk.

Airthrie Homes - 56 Airthrie Road provides accommodation and support with personal care for up to four adults with learning disabilities.

There is no registered manager in place as the registered provider is in day to day charge of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At this inspection we found the registered provider had taken sufficient action to ensure people were looked after by sufficient number of staff. We saw evidence the staff were supported through regular supervision sessions. However we noted that the provider was failing to prevent contamination of water supply to the service and this could put people as well as staff at risk of consuming contaminated water.

Airthrie Homes - 56 Airthrie Road provides accommodation and support with personal care for up to four adults with learning disabilities.

There is no registered manager in place as the registered provider is in day to day charge of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were not always sufficient numbers of staff to meet people’s needs and keep them safe. Staff were given training and support they needed to help them look after people appropriately. However there was a lack of regular supervision and appraisals for staff.

Control of Substances Hazardous to Health (COSHH) cleaning materials were not kept locked.

Staff recruitment procedures were robust to ensure staff were suitable for their positions and staff were knowledgeable about how they could identify and report preventable abuse.

People were appropriately supported to take their medicines and secure storage arrangements were in place to hold people’s medicines.

People were treated with kindness and compassion and their privacy was respected. Staff supported people to be independent and they were involved in activities both inside and outside the service.

People had access to a range of health professionals and staff supported them to attend health appointments when necessary.

People and their representatives were involved in decisions relating to the care and support being provided. Care was planned and delivered based on people’s preferences and regularly reviewed with people. Individual risks to people had been assessed and recorded in their care plans.

There were systems in place to enable people living at the service, staff and other professionals to comment on the service provided.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Below is a summary of what we found. The summary describes what the staff told us, what we observed and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People told us that they received their medicines on time and were happy with the way the staff administered their medicines to them.

Is the service effective?

Staff understood people’s care and support needs, and were familiar with their likes and dislikes. We saw people using the service and their relatives were involved in helping staff plan peoples care plans. Their views and experiences were used to develop their care plan.

Is the service caring?

Staff understood the need to respect people's privacy and dignity and staff interactions with people using the service were sensitive and respectful. People who used this service were able to make choices with regard to their daily lives such as what they would like to wear or to eat or whether they would like to join in any activities.

Is the service responsive?

People’s needs were assessed and care and support was planned and delivered in line with their individual care plan. We looked at the care records of three people and found them to be comprehensive. We saw people's care plans had been reviewed or updated when their needs had changed.

Is the service well-led?

People told us they were well supported by staff in their daily lives. We observed staff interacting with people who used the service in a very kind, respectful, and professional manner.

The service was located in a suitable and well maintained building. People said they enjoyed having parties in the garden. The provider had made sure people would be protected in an emergency. One person said "we all go outside if there is a fire." Staff were well supported by the provider and had the knowledge and skills to give people safe and effective care.