The Airedale Nursing Home provides a service for up to 57 people, who may have a range of care needs, including dementia, physical disabilities and sensory impairments. At the time of this inspection there were 54 people using the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good overall although, we identified some areas for improvement as follows:

Risks were managed so that people’s freedom, choice and control was not restricted more than necessary. However, staff had not followed one person’s care plan on the day of the inspection, which had placed them at possible harm of developing a pressure ulcer. After the inspection the registered managers provided evidence that they had taken swift action to ensure identified risks were managed in a more consistent way in future.

Systems were in place to ensure people’s daily medicines were managed in a safe way. People were also enabled to maintain their independence through managing their own medication as far as possible. However, this arrangement had not been risk assessed or recorded in another person’s care plan; placing them at possible risk of not receiving their medication in a safe way or as prescribed. Again, the registered managers confirmed they were taking action to ensure safe processes were followed for people wishing to take their own medication in future.

Staff understood how to protect people from avoidable harm and abuse, and the service managed incidents and safeguarding concerns promptly; demonstrating an open approach.

There were sufficient numbers of suitable staff to keep people safe and meet their needs, and the provider carried out checks on new staff to make sure they were suitable to work at the service.

People were supported to have their needs and individual preferences met by staff that had the necessary skills and knowledge. Staff ensured that the care and treatment provided was a sought in line with current legislation and guidance.

People had enough to eat and drink and were supported to maintain good health through access to relevant healthcare services.

Staff were caring and provided responsive care, support and treatment in a meaningful way; whilst promoting people’s privacy and dignity. They encouraged people to be as actively involved in making decisions about their care and to retain their independence as far as possible.

People were encouraged to take part in social activities and maintain relationships with people that mattered to them.

We saw that people’s concerns and complaints were encouraged and used as an opportunity for learning, in terms of improving the service provided.

The service demonstrated good management and leadership. There were two registered managers in post who worked effectively to promote a positive culture that was person centred, open and inclusive. Effective systems were also in place to monitor and deliver high quality in terms of service provision.

Further information is in the detailed findings below.

This inspection took place on 9 January 2015 and was unannounced.

The Airedale Nursing Home is a care home registered to provide accommodation for people who require nursing or personal care. The home provides a service for up to 57 people who may have a range of care needs including dementia, physical disabilities and sensory impairments. There were 46 people using the service at the time of this inspection.

There was a registered manager in post. 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.

We found that staff had been trained to recognise signs of potential abuse and keep people safe. People we spoke with confirmed they felt safe living in the home.

Processes were in place to manage identifiable risks within the service and ensure people did not have their freedom unnecessarily restricted.

There were sufficient numbers of staff who had the right skills and knowledge to meet people’s needs, and we saw that the provider carried out proper recruitment checks on new staff to make sure they were suitable to work at the home.

Systems were in place to ensure people’s medicines were managed in a safe way and that they got their medication when they needed it.

Staff had received training to carry out their roles, including support to achieve national health and social care qualifications.

We found that the service worked to the Mental Capacity Act 2005 key principles, which state that a person's capacity should always be assumed, and assessments of capacity must be undertaken where it is believed that a person cannot make decisions about their care and support.

People had enough to eat and drink. Assistance was provided to those who needed help with eating and drinking, in a discreet and helpful manner.

The home had developed positive working relationships with external healthcare professionals to ensure effective arrangements were in place to meet people’s healthcare needs.

Staff provided care and support in a caring and meaningful way and people were treated with kindness and compassion. People’s privacy and dignity was respected at all times.

We saw that people were given regular opportunities to express their views on the service they received and to be actively involved in making decisions about their care, treatment and support.

People’s social needs were provided for. We saw people actively participating in and enjoying activities that had been arranged on the day of the inspection.

A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to.

Systems were also in place to monitor the quality of the service provided including satisfaction surveys, meetings and internal audits. We saw that action had been taken to address concerns that had been received and improvements that had been identified, as a result of internal audits and feedback from people using the service.

During our inspection on 13 September 2013, we used a number of different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not always able to talk to us about their experiences. We spoke with, or observed, the care provided to eight people using the service. We also spoke with one person’s relative, 13 members of staff - including the provider, registered manager and a visiting health care professional.

People told us they were happy living in The Airedale Nursing Home. They said they felt well cared for and confirmed that they had agreed to the care and treatment provided to them.

People’s social needs were being met too. We observed lots of activities taking place, which people said happened regularly. One person living in the home told us: “I have no complaints, they couldn’t do any better.”

Overall people told us they liked the food and had enough to eat and drink. One person said “if I don’t like something I can ask for something else.”

We found that people using the service were protected from the risk of abuse, because the staff had the right skills and knowledge to identify the possibility of abuse and prevent it from happening.

Systems were also in place to monitor the quality of the service provided, and ensure people had their views listened to.

Before our visit, the Care Quality Commission had received some concerns about The Airedale Nursing Home. We were told that there were people working at the home who did not have permission to work in the United Kingdom (UK). We carried out an unannounced inspection on 24 January 2013 and found that appropriate checks had been undertaken for staff working in the home.

Records provided a clear audit trail of the recruitment and selection procedures in place, including systems for ensuring that staff were legally entitled to work in the UK.

During our visit on 11 October 2012, we used a number of different methods to help us understand the experiences of people using the service. We spoke with five people living in the home and seven members of care staff including the manager. We also spent time walking round the building and made observations about the care being provided.

We observed staff treating people with consideration and respect, and people that we spoke with told us they were happy living in the home. One person told us “it’s really very, very good here.”

People told us that they felt well cared for, the staff were friendly and helpful, and the care they received was appropriate for their individual needs. Another person said “nothing is too much trouble”, and told us that their quality of life had improved since moving into the home. Everyone was complementary about the food provided and the choices available.

We found that people were protected against risks from unsafe or inappropriate equipment because there were enough staff who had received the right training. However, we found some people had been left without a call bell within their reach. The manager took action to remedy this whilst we were there and said that she would remind staff of the importance of ensuring that people always have the means to summon assistance in an emergency or otherwise.

During our visit on 26 July 2012, we used a number of different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not able to tell us about their experiences.

We spoke with five people using the service, and observed the care and support provided to them and six other people. We also spoke with the relatives of two people and three members of staff.

One person told us that they had been involved in a thorough assessment process prior to their relative moving into the home. They said that their relative received the care and support that they expected, and that staff kept them up to date and informed. We were also told that the activities provided by the home were "marvellous", and that friends and families were made to feel welcome.

One person's relative commented that there seemed to be high levels of staff turnover, so staffing sometimes lacked consistency. However, they added that the staff were nice people.

We observed some positive interaction between staff and people using the service, which showed that staff understood the needs of the people they were supporting and how best to communicate with them.

During our visit on 14 February 2012 we did not speak with people living in the home as we were there to specifically look at records relating to nursing care.