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Inspection carried out on 6 December 2017

During a routine inspection

This inspection took place on 6 and 15 December 2017. Our visit on the first day of the inspection was unannounced. The provider was given notice before our second visit because we wanted the people who lived there to be available to speak with us.

Aire House is a 'care home'. It is owned by Parkcare Homes (No.2) Limited, which is part of the Acadia group. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Aire House accommodates eight people in one building.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection in November 2015, the service was rated Good. At this inspection we found the service remained Good.

At this inspection there were eight people living at Aire House. There was a manager in post who had registered with CQC. The registered manager was assisted in the day to day management of Aire House by a service manager. The registered manager, service manager and an operations manager were available and assisted with the inspection.

People told us they were happy living at Aire House and they liked the staff who supported them. When we visited we found there was a welcoming, relaxed atmosphere. Staff were knowledgeable about the people they supported and they knew about their likes and dislikes and interests.

Staff were recruited safely and they received appropriate training and support to meet people’s needs effectively.

Arrangements were in place for the safe administration and storage of medicines.

Care and support was planned and delivered in a way that reduced risks to people’s safety and welfare. People’s medicines were managed safely.

Health and safety checks were completed to ensure people lived in a safe environment.

People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Information was provided in easy read format to assist people to understand the care available to them. People were supported to maintain a balanced diet and had access to a wide range of health and social external professionals.

The relationships between staff and the people they cared for were friendly and positive. It was apparent from out observations that people were treated with dignity and respect and they were actively involved in the running of the service.

Staffing was flexible to afford people the opportunity and support to lead full lives. People were supported to have jobs, maintain relationships, access the local community and go on holidays.

People using the service and their relatives, where appropriate, were involved in the planning of their care. There was a complaints procedure in place and people who used the service and relatives were aware of how to make a complaint.

The management team understood the importance of monitoring the quality of the service and reviewing systems to identify any lessons learnt. Managers regularly consulted with people, relatives and staff to gain their views about the service.

Further information is in the detailed findings below.

Inspection carried out on 12 and 13 November 2015

During a routine inspection

This inspection was unannounced and was carried out on 12 and 13 November 2015. The last inspection of this service was on 28 April 2014 and at that time the home was meeting all the regulations we inspected.

Aire House is registered to provide accommodation and personal care for up to 8 people with learning disabilities. The service is a converted house with private gardens close to local amenities. On the day of the inspection there were 8 people living at the service.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. We had not asked for a Provider Information Return (PIR).The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

People and their relatives told us they felt safe at Aire House. Staff knew the correct procedures to follow if they considered someone was at risk of harm or abuse. They received appropriate safeguarding training and there were policies and procedures in place to follow if there was an allegation of abuse.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act 2005. This is legislation that protects people who are not able to consent to care and support, and ensures people are not unlawfully restricted of their freedom or liberty. The manager and staff understood the requirements and took appropriate action where a person may be deprived of their liberty.

People’s needs were regularly assessed, monitored and reviewed to make sure the care was current and relevant. The care records were person centred and descriptive, ensuring staff - had specific information about how they should support people. Care records included guidance for staff to safely support people by reducing risks to their health and welfare.

People were supported to keep healthy. Any changes to their health or wellbeing were acted upon and referrals were made to social and health care professionals to help keep people safe and well. Accidents and incidents were responded to quickly. Medicines were managed safely and people had their medicines at the times they needed them.

Staff recruitment practices helped ensure that people were protected from unsafe care. There were enough qualified and skilled staff at the service. Staff received ongoing training and management support and had a range of training specific to the needs of people they supported.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff.

Staff were patient, attentive and caring in their approach; they took time to listen and to respond in a way that the person they engaged with understood. They respected people’s privacy and upheld their dignity when providing care and support.

People were provided with a range of activities which met their individual needs and interests. Individuals were also supported to maintain relationships with their relatives and friends.

There was an open and inclusive atmosphere in the service and the registered manager showed effective leadership. People at the service, their relatives and staff were provided with opportunities to make their wishes known and to have their voice heard. Staff spoke positively about how the registered manager worked with them and encouraged team working.

The provider completed a range of audits in order to monitor and improve service delivery. Where improvements were needed or lessons learnt, action was taken.

Inspection carried out on 28 April 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

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

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

This is a summary of what we found:

Is the service safe?

People told us they were treated with respect and dignity by the staff. They said they felt safe. We found safeguarding procedures to be robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continuously improve.

The home had proper policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The manager told us about applications that had been submitted. We also found relevant staff had been trained to understand when an application should be made, and how to submit one. This meant people were safeguarded as required.

The home had safe systems in place to ensure people received their medication as prescribed; this included regular auditing by the home and the dispensing pharmacist. Staff were assessed for competency prior to administering medication and this was reassessed regularly.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that any unsafe practice was identified; this helped to protect people who used the service.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in

developing their plans of care. People told us they were included in decisions about how their care and support was provided.

New staff had received relevant induction training which was targeted and focussed on improving outcomes for people who used the service. This helped ensure the staff team had a good balance of skills, knowledge and experience to meet the needs of people who used the service.

Is the service caring?

People told us they were supported by kind and attentive staff. People we spoke with said that staff were kind and �friendly�. One person said �I can talk to the staff about anything, they are great!�.

People's preferences, interests, aspirations and diverse needs were recorded and care and support was provided in accordance with people's wishes.

Is the service responsive?

People�s needs were met in accordance with their wishes. We saw evidence of the service assisting people in achieving their aspirations; for example attending college courses.

The service carried out an annual satisfaction survey. Results were collated and analysed and action plans in response were agreed and actioned.

People we spoke with knew how to make a complaint if they were unhappy.

Is the service well-led?

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance systems in place. This helped to ensure that people received a good quality service. They told us the manager was supportive and promoted positive team working.

Inspection carried out on 9, 10 April 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service including talking to people and observing the care provided. We spent time with people and we saw staff being friendly and warm towards people. We observed that staff and people who lived at the service had positive relationships. People appeared relaxed and comfortable with their surroundings; with staff and the activities they were engaged in. We saw that staff supported people to make choices about their daily living.

We spoke with five people who used the service and they told us that they had been included in decisions about what care and support they received. One person told us "It's a fantastic place to live. I decided how my bedroom was decorated and where I went on holiday." Another person said "The staff are brilliant. We all decide what meals we have and have a rota to help with the cooking.�

We spoke with two members of staff who were able to demonstrate a good understanding of the needs of the people who lived at Aire House. They told us that they were well supported by managers of the home and there were good opportunities for training.