Inspection on 14/02/06 for 8 Piggy Lane

This inspection was carried out on 14th February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

8 Piggy Lane 23/05/07

8 Piggy Lane 30/10/06

8 Piggy Lane 13/12/05

8 Piggy Lane 11/01/05

8 Piggy Lane 06/08/04

8 Piggy Lane 17/03/04

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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 8 Piggy Lane Bicester Oxfordshire OX26 7HT Lead Inspector Kate Harrison Unannounced Inspection 14th February 2006 09:30 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 8 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 jacki.berry@oldt.nhs.uk Oxfordshire Learning Disability NHS Trust Ms Jacqueline Berry 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) 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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 13th December 2005 Date of last inspection Brief Description of the Service: 8 Piggy Lane is a modern bungalow that is part of a purpose built complex situated close to local amenities in Bicester, North Oxfordshire. The home is registered for five people with learning and physical disabilities. A staff team employed by the Oxfordshire Learning Disability NHS Trust (OLDT) provides 24-hour support. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one morning and early afternoon and was unexpected. The registered manager was not present and the team leader was in charge of the shift. The inspector spoke to staff and saw all areas of the home. There were four residents at the home and the inspector saw all and had conversations with most of the residents. The inspector also observed the preparation of food and how lunchtime was managed. The inspector saw records and documents relating to the management of the residents and the home and discussed issues with the team leader. Only those key standards not assessed at the inspection on 13th December were assessed at this inspection. What the service does well: What has improved since the last inspection? What they could do better: The health implications of residents’ choices about food need to be assessed. The food record should be completed on a daily basis. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 6 The manager needs to check that staff will be supported if they want to complain on behalf of the residents. Staff need to know the home’s policy for the protection of vulnerable adults. 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. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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): The key standards were assessed at the inspection on 13th December 2005 and were not assessed at this inspection. EVIDENCE: 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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): The key standards were assessed at the inspection on 13th December 2005 and were not assessed at this inspection. EVIDENCE: 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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): 17 Meals are individualised though it is not clear that this benefits residents’ health. EVIDENCE: Some of the residents have difficulties with swallowing and guidance is available from the dietician for staff on how to prepare food. Staff are responsible for the preparation of food and all have had training in food hygiene. The inspector discussed with the team leader how individuals make their food preferences and daily meal choices clear. One individual’s lunch choice was a tinned meal and the inspector understood that this was a regular choice. The home’s food record shows that ready prepared food is used regularly, though the two week record seen by the inspector was incomplete. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 11 The inspector is concerned that staff should take the health needs of the residents into account as well as residents’ personal choice when buying and offering food choices. The inspector recommends that the registered manager review the quality of food served at the home for nutritional content, perhaps with input from the dietician, and take action to improve the food available for residents if necessary. Soon after the inspection the team leader contacted the inspector to say that the dietician had been contacted and that nutritional assessments would take place. To ensure accurate and complete record keeping the food record should be completed on a daily basis. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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 Residents receive personal support in the way they want. Residents’ health care needs are met. Medication is well managed, but procedures may need to change. EVIDENCE: The inspector checked two individual files, and noted that strong efforts are made to interpret all communication attempts by the residents in an integrated way. Staff understand how to react to gestures and sounds and records show that the residents’ wishes regarding how care is carried out are taken into account. All the residents have access to the GP for assessment every six months and advice from other health professionals is sought as necessary. Staff provide emotional support when necessary, and an example of this was seen during the inspection. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 13 No residents manage their own medication and the home has a policy and procedures to manage medication. The way medication is supplied by the pharmacy has recently changed and the registered manager should check that the home’s policy and procedures meet the change. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 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 & 23 Staff are usually able to address issues causing concern to residents, but staff have no process to support them to make formal complaints on behalf of the residents. Staff are trained to protect the residents but the Trust needs a policy on adult protection. EVIDENCE: The staff know and understand the needs of the residents very well and are able to quickly act if something needs to be done to improve life for the residents. The inspector saw the home’s simplified complaints procedure and understood that relatives also get a copy. The inspector discussed with the team leader how residents might make complaints. None of the residents could make a complaint independently, and the majority could not use the simplified complaints procedure. The inspector heard of instances where staff members complained on behalf of the residents on issues outside the home, but there is no formal procedure to support staff to do so, as the procedure is addressed to the residents. The inspector understood that the registered manager has contacted advocacy agencies to provide independent help for residents, but so far no advocate is available. The inspector recommends that the registered manager seek clarification regarding a formal process for staff to use if they or the staff team want to complain on behalf of the residents. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 15 All care staff have had training on how to protect residents from abuse and know about the home’s whistle blowing policy. Staff receive the ‘Guidance for Staff’ booklet from the Oxfordshire Multi-Agency Protection of Vulnerable Adults codes of practice, but were not clear about the Trust’s policy on adult protection. The inspector recommends that the manager work with staff so that the Trust’s policy on the protection of vulnerable adults is known and understood. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 16 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): The key standards were assessed at the inspection on 13th December 2005 and were not assessed at this inspection. EVIDENCE: 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 17 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): The key standards were assessed at the inspection on 13th December 2005 and were not assessed at this inspection. EVIDENCE: 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 18 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 The registered manager is qualified and experienced. Residents rely on staff to work on their behalf. EVIDENCE: The registered manager is a registered nurse and is experienced in managing the home. She has gained the NVQ Level 4 in Management. The home’s staff are well placed to understand the needs of the residents regarding quality issues at the home. The inspector heard how members of staff have recently taken up issues on behalf of residents and this is to be commended. Meetings are held for staff and residents together every two months. The inspector understood that the registered manager contacts relatives every six months to update them on issues concerning the residents and to enquire if they have any issues for discussion. Some relatives have chosen not to be contacted. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 19 The Oxfordshire Learning Disability Trust carries out unannounced monthly quality monitoring visits at the home, and copies are sent to CSCI. 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 20 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 X 3 X 4 X 5 X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 8 Piggy Lane Score 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME Standard No Score 37 3 38 X 39 3 40 X 41 X 42 X 43 X DS0000013125.V283619.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 22 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 YA25 Good Practice Recommendations The manager should monitor the restrictions for an individual who is currently using the smallest bedroom in the home and assess whether the size of the room meets the individual’s needs. This recommendation dates from the 13th December 2005 inspection, and is being addressed. The registered manager should assess the quality of food served at the home for nutritional content, and take action if necessary to improve the diet offered to the residents. To ensure accurate and complete record keeping the food record should be completed on a daily basis. The registered manager should check that the home’s medication policy and procedures meet the needs of the home, as changes have been made to the way medication is supplied. The registered manager should seek clarification regarding a formal process for staff to use if they want to complain on behalf of the residents. The inspector recommends that the manager discusses the Trust’s policy on the protection of vulnerable adults with staff so that it is known and understood. 2 YA17 3 4 YA17 YA20 5 YA22 6 YA23 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way 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 8 Piggy Lane DS0000013125.V283619.R01.S.doc Version 5.1 Page 24 - 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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