Inspection on 05/10/06 for 4 Piggy Lane

This inspection was carried out on 5th October 2006.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

4 Piggy Lane 01/02/06

4 Piggy Lane 04/08/05

4 Piggy Lane 06/01/05

4 Piggy Lane 01/10/04

4 Piggy Lane 23/03/04

4 Piggy Lane 18/12/03

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 4 Piggy Lane Bicester Oxfordshire OX26 7HT Lead Inspector Catherine Kane Unannounced Inspection 5th October 2006 11:50 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 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 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 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. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 4 Piggy Lane Address Bicester Oxfordshire OX26 7HT 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) 01869 249533 pearl.whiteley@oldt.nhs.uk Oxfordshire Learning Disability NHS Trust Mrs Pearl Whiteley Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5), Physical disability (5), of places Physical disability over 65 years of age (5) 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 5 1st February 2006 Date of last inspection Brief Description of the Service: 4 Piggy Lane is a large purpose built modern bungalow and is part of a complex of houses supporting adults with learning disabilities. The home is situated in the North Oxfordshire town of Bicester and is close to local shops and services. A large staff team employed by Oxfordshire Learning Disability NHS Trust supports five adults with complex needs. Support is provided on a 24-hour basis. The range of fees for this service range from £12.64 to £21.68 per hour. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 11.50am on Thursday, 5 October 2006. The inspector was in the service for just over three hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. The registered manager was on duty at the time of the inspection and the inspector also spoke with a senior manager of the organisation. She spoke with three members of staff on duty and one agency staff member. The inpsector saw some residents having their breakfast and lunch and saw how staff help residents look after and take their medicines. She also looked at residents’ care plans and other records kept in the home and made a tour of part of premesis. The inspector would like to thank the staff team for their assistance with the inspection. She also thanks residents and all others who shared their experience of this home. What the service does well: What has improved since the last inspection? The staff team has learnt more about how to support residents who may want to make a complaint. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 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. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 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 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure is good. EVIDENCE: There have been two new admissions to the home since the last inspection. The pre-admission assessment records were seen and these included a full care needs assessment for one resident. The manager informed the inspector that the pre-admission assessment for another resident had been completed but this was not available at the time of the inspection. Generally admissions are not made to the home until a full needs assessment has been undertaken. The home is then able to confirm that it can meet the needs of the individual through the service it delivers as detailed in the statement of purpose. Evidence confirms that the assessment is conducted professionally and sensitively and has involved the family or representative of the person who uses the service. Prospective new residents are given the opportunity to spend time in the home. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 9 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system in place to provide staff with the information they need and for assessing risk is good. EVIDENCE: During the inspection the inspector viewed two person-centred care plans. These were easy to understand, written in plain language and considered all areas of the individual’s life including health, personal and social care needs. The plan is regularly reviewed and includes comprehensive risk assessments. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural backgrounds. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 10 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): 12, 13, 15, 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Opportunities for people who use this service to take part in a variety of interesting activities is limited. EVIDENCE: On the day of the inspection the inspector was in the home during the afternoon. She spent this time with all five residents and the staff on duty. Three residents had some limited communication and were able to tell the inspector about some things that are important for them. Most residents are elderly or prefer a slower pace and lifestyle. Many activities provided were in-house. These included listening to music, looking at magazines and colouring books. The inspector overheard one resident ask a member of staff “Can you take me out today, I haven’t been out”. The manager stated that her staff team is stretched providing personal care to residents in the home and that they do not have time to support residents to go out as much as they would like. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 11 The extra staffing allocation for two residents is regularly taken up providing care for other residents. The senior manager confirmed that requests for the placing authority care managers to review the care packages for the other residents have been made in order to address this. It was clear from notes kept in the home that certain individuals found it frustrating not to be able to get out and about as much as they would like. It is detrimental to the well being of residents if their social activities are being restricted due to staff allocated specifically to them being used for other purposes around the home. One relative or friend of a resident returned a questionnaire with comments that they are satisfied with the care provided in the home and that their friend seems well settled and content. The inspector arrived in the home while some residents were having their breakfast. This was around 12.00 noon. From discussions with the manager and staff and from daily notes seen, some residents wish to lie in later in the morning and this is respected. A snack lunch was served at 2.30pm. The evening meal is usually served between 5.00pm and 6.30pm. This means that on this occasion some residents would be having their three main meals within a six-hour period and a potential gap of 18 hours before their next main meal. Regular drinks and snacks are available. The manager stated that drinks and a biscuit are offered when residents take their morning medication and evening medication is administered when supper is served. The inspector recommends that the home seeks advice from an appropriate healthcare professional on how best to support the residents to make sure that their dietary needs are fully met. A varied menu is provided and residents special dietary needs are catered for. One resident said “I had cheese and pickle today”. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 12 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, 20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of residents are well met. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and make sure that they get to see their local GP and other community healthcare services when needed. During the inspection visit the district nurse and the physiotherapist visited residents in the home. Two comment cards were returned from residents’ GPs. They indicated that they were satisfied with the overall care provided in this home. Residents’ medicines are securely kept in locked medicine cabinets located in the home’s laundry room. During the inspector’s visit the laundry equipment was in full use. The room was hot and the humidity was high. The inspector recommends that the home should seek the advice of their supplying pharmacist on the good practice and best storage location for residents’ medicines. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 13 The home uses a pharmacist produced medication administration record (MAR). Staff confirmed that records were kept of staff assessed as competent to administer residents’ medicines and these were seen during the visit. During the inspection two staff members confidently demonstrated how a resident’s medicines are looked after and how residents are helped to take their medicines. The home was able to support a resident with their wish to be cared for at home through their illness and another resident who was supported in hospital. Staff have received bereavement training and other residents were supported by the manager and her staff team through a difficult and sad time. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 14 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a protection from abuse policy and the complaints procedure is good. EVIDENCE: Following recommendations made at the last inspection the manager arranged for staff to meet with the person who deals with complaints made about the organisation. This was well received and staff commented that it was very useful. The manager declared that the home has received no complaints in the last year. The Commission has received no information relating to complaints in the last year. Staff have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures in line with the Oxfordshire Multi-Agency Codes of Practice. The Commission has received no information relating to adult protection issues in the last year. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 15 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was neat, tidy and clean at the time of the inspection. EVIDENCE: During this inspection the inspector had a tour of the shared areas and was invited by a guest to see their bedroom. The lounge, dining room and kitchen were furnished and decorated in a modern style and were clean and tidy. The home has been kept in a good state with a programme of maintenance and repair. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 16 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): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home’s recruitment procedures and training for staff to do their jobs well is good. EVIDENCE: During the inspection the inspector spoke with three staff and met one agency staff member. Staff commented that morale is high. A new member of staff commented that, “There is always someone to help, it’s really good working here, everyone has been very welcoming”. Since the last inspection three staff have left and two new staff have joined the team. The inspector visited the HR department at the head office on Thurday, 22 June 2006 as part of the inpection of another service run and managed by this organisation. Files seen were well maintained. The home keeps a checklist with the staff member’s file at the home, which states where certain documentation is kept. The recruitment process is thorough. The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they have undertaken. Staff confirmed that supervision takes place. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 17 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has a good understanding of management areas in which the home needs to improve and has plans in place to address this. EVIDENCE: It is expected that the registered manager shall undertake further training qualifications at Level 4 NVQ in both Management and Care. Therefore this standard is rated as ‘standard almost met’ - scored 2. The registered manager is currently undertaking the Registered Managers’ Award. The manager has been complimented by a social care professional for her ‘can do’ attitude. The registered manager is competent to run the home and meet its stated aims and objectives. The manager has sound knowledge and experience in care of people with a learning disability and older people with a learning disability, quality assurance systems, equal opportunity issues, development 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 18 and implementation of the service’s policies and procedures, good people skills, strong leadership of staff which leads to confident workers, responds to need and provides an excellent role model and manages the service efficiently. She has a strong ethos of being open and transparent in all areas of running the home and is aware of current developments, both nationally and by CSCI, and plans the service accordingly. A monitoring audit of the services provided in this home completed by the local authority was shared with the inspector. The comments made were generally positive. The manager completes a monthly quality monitoring checklist. However, there have been only two proprietor’s representative’s monthly visit reports issued since the last inspection. Whilst the Commission no longer requires that a copy of this report be sent to CSCI, a copy must be kept in the home and made available for inspection. Prompt action was made to respond to recommendations from the last inspection. The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure that the home meets relevant health and safety requirements and legislation. Records kept were generally adequate and are routinely completed. Where issues have been identified these have been acted upon successfully to ensure that residents’ care is not compromised. Oxfordshire Learning Disability NHS Trust, operating as Ridgeway Partnership, who run this service, has financial and accounting systems subject to internal and external audits. 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 19 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 X 2 X X 3 X 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 20 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 Standard YA13 Regulation 16(2)(m) Requirement The responsible person must provide details of how the home will ensure that residents are consulted and arrangements are made to enable them to engage in activities of their choice, both in the home and local community. The responsible person must ensure that they, or their representative, complete a monthly unannounced visit to the home and a copy of the report is kept in the home and is made available for inspection. Timescale for action 30/11/06 2 YA39 26 31/10/06 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 21 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 YA2 Good Practice Recommendations The inspector recommends that copies of pre-admission assessments of new residents should be kept in the home as evidence that the home can meet the residents’ needs. The inspector recommends that the home should seek advice from an appropriate healthcare professional about the spacing of main meals and how best to support the residents to make sure their dietary needs are fully met. The inspector recommends that the home should seek the advice of their supplying pharmacist on good practice and best storage for residents’ medicines. 2 YA17 3 YA20 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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. Extracts may not be used or reproduced without the express permission of CSCI 4 Piggy Lane DS0000013123.V314450.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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