Archived: Piper House

Updated 7 May 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27, 29 and 30 January 2015. The first day of the inspection was unannounced.

The inspection was carried out by an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses services, in this case services for adults with learning disabilities.

Prior to the inspection we reviewed the information we held about the service including the last inspection report from May 2014 when we judged that the provider was meeting the regulations we inspected. We reviewed notifications we had received from the provider and other agencies since our last inspection. We also reviewed complaints and concerns reported to us by the relatives of people who use the service.

Some people living at the service were out during our inspection attending colleges and day centres. During the visit, we spoke with four people who used the service. Some people could not let us know what they thought about the service because they could not always communicate with us verbally. We spent time observing the interactions between staff and people living at Piper House to check whether the manner in which staff spoke with and interacted with people had a positive effect on people’s well-being. We also spent time observing care and support in communal areas.

We spoke with eight care staff, a cleaner and the registered manager. We looked at nine care records, five staff records and records relating to the management of the service.

Following our visit we spoke with three family members of people living at the home and contacted two health and social care professionals to hear their views on how the service was performing.

Updated 7 May 2015

This inspection took place on 27, 29 and 30 January 2015. The first day of the inspection was unannounced. When we last visited the home in May 2014 we found the service was meeting all the regulations we looked at.

Piper House provides accommodation, care and support for up to 12 people with a range of complex needs including learning and/or physical disabilities, epilepsy, autism and behaviours that may challenge services. People have their own self-contained one bedroom flats all of which are wheelchair accessible. Flats on upper floors are accessed by stairs and a lift.

The home had a registered manager. 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 living at Piper House and their relatives told us they were happy with the care provided and got on well with staff. The registered manager was accessible and approachable and people told us they felt able to raise any concerns should they need to.

People and their family members were involved in the care planning process. People were encouraged to make choices and decisions around how their care and support was provided. Where people were not able to make these decisions on their own, relatives and health and social care professionals were asked to make decisions in people’s best interests in accordance with the relevant mental health legislation. We noted that not all care plans had been signed and dated by the relevant parties.

A range of risk assessments had been completed for each person using the service. These covered areas such as falls, nutrition and diet, pressure area care and moving and positioning. We found that staff were not always following the guidelines and recommendations set out in these assessments.

People were supported to take their medicines by staff who had completed training in medicines management. However, we found that medicines were not always managed or administered appropriately.

People were supported to shop for and prepare their preferred food choices. Where people were not able to do this independently, staff liaised with family members to ensure people were able to eat and drink according to their individual preferences.

Staff supported people to attend health care appointments and maintained regular contact with the relevant health and social care professionals involved in people’s care and welfare. People had been booked for or had attended their annual health reviews with their GPs and dentists.

Staff had received training in safeguarding adults, the Deprivation of Liberty Safeguards and the Mental Capacity Act (2005). These safeguards are there to make sure people in care homes, hospitals and supported living services are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and this should be done in a way that is safe and in line with the correct procedures.

Staff demonstrated that they understood how to recognise the signs of abuse. Staff told us they would report any concerns they might have to senior members of staff who would then assess the situation and report to local safeguarding teams, the Care Quality Commission (CQC) and the police if and when appropriate.

Audits were carried out across various aspects of the service, these included the administration of medicines, care planning and fire safety. However, where audits had identified that improvements were needed, action had not always been taken to improve the service for people using it and audits had failed to identify some of the shortfalls found during our inspection.