Inspection on 23/05/07 for 8 Piggy Lane

This inspection was carried out on 23rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Piggy Lane 30/10/06

8 Piggy Lane 14/02/06

8 Piggy Lane 13/12/05

8 Piggy Lane 11/01/05

8 Piggy Lane 06/08/04

8 Piggy Lane 17/03/04

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 8 Piggy Lane Bicester Oxfordshire OX26 7HT Lead Inspector Andy McGuckin Unannounced Inspection 23rd May 2007 09:30 8 Piggy Lane DS0000013125.V335549.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 8 Piggy Lane DS0000013125.V335549.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. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 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.V335549.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 30th October 2006 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. A housing association owns the property and the Oxfordshire Learning Disability NHS Trust manages the home. The Trust has changed its name to Ridgeway Partnership NHS Trust. The home is registered for five people with learning and physical disabilities. The home employs experienced, trained staff who are led by the nurse team leader and a deputy. The home provides 24-hour support. The fees are £308 per week. 8 Piggy Lane DS0000013125.V335549.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”. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that the CSCI has received about the service since the last inspection. The inspection took place on a weekday morning and involved a visit to the home. The inspector looked at core documentation relating to the regulations and standards. The inspector spent some time with the manager and staff and spoke to one resident. The inspector made informal observation of four residents and witnessed staff interaction with residents. The inspector toured the building and was shown residents’ living accomodation. The inspector interviewed two staff members and spoke to the deputy manager. The home’s medications systems were tested and found to be safe. The inspector was satisfied that the home could meet the needs of the current resident group. 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. The inspector would like to thank the manager, staff and residents for their assistance in the inspection process. What the service does well: The home offers care and accommodation to five residents, four of whom would be assessed as having high needs. The home provides staff in sufficient numbers and with appropriate skills to meet the needs of its residents. The organisation has produced a new Service User Guide and a Statement of Purpose in a format that will be understood to a wider audience. Service users are encouraged to take as active a part in lifestyle choices as they are willing or able. Activities are matched to the individual’s abilities and wants. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 6 Residents are encouraged to access mainstream healthcare professionals on a regular basis. The home has a good range of policies and procedures to assist staff to do their job well. Staff are well managed, supervised and trained. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. 8 Piggy Lane DS0000013125.V335549.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 8 Piggy Lane DS0000013125.V335549.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inspector was shown new documentation aimed at providing information to a wider audience. EVIDENCE: The organisation has produced a new Statement of Purpose and Service User Guide, which is appropriate to the needs of many of its service users. Only one resident of Piggy Lane would benefit from these documents. For these residents the home ensures that information and decisions are usually made in a one-to-one situation, giving residents time to gain a good understanding of what is on offer and available to them. Residents’ files evidenced that residents are being consulted and informed where possible about changes and challenges that are available to them. All residents have a weekly timetable. At the time of the inspection, due to staff shortages and the shortage of drivers for the home’s transport, much of the timetable has been house bound or very local during the day. The inspector was informed that the staffing situation has been resolved and that more drivers will be identified. Activities provided by the home were, however, satisfactory. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 9 New residents are encouraged to visit the home prior to making a final decision as to the suitability of the home. This also enables the home to assess its suitability to meet the residents’ care needs. Regular reviews take place to ensure that this is still the case. The last resident joined the home in 2006. The home has a formal process, which starts with initial assessment and carries through to first review. Evidence was found at inspection that prospective service users visit the home several times prior to a decision being made. Service users have individual written contracts and terms and conditions. These are held by the purchasing authority. Relatives or advocates are involved in the contracting process to assist the individual resident to be safeguarded. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ files showed evidence that they were encouraged to make lifestyle choices. EVIDENCE: All service users’ care plans were seen. They included excellent information about personal care routines, showed how much support individuals need, and how to give it. Parts of the care plans are produced in user-friendly formats to assist service users to understand as much of it as they are able. Individual support plans include a short life history, what is vital for staff to know, likes and dislikes, achievements, level of support required, the best way to get to know the service user, what they like and don’t like and what worries them to enable staff to provide care and support in a way which the service user would wish to have it. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 11 The future needs and aspirations are noted on reviews which service users are supported and encouraged to attend. Families also attend reviews and sign the review notes. There is a description on individual files of the service user’s ability/limitations with regard to decision making and how to ensure that they are given appropriate choices, such as sampling different activities before being asked what they want their daytime activities programme to consist of. There are group staff meetings and handover meetings held, at which various subjects are discussed, including activities for the week, the rotas, complaints, health and safety and any other issues arising. These meetings are recorded and were seen to be appropriate at this inspection. Staff use a variety of activities to keep service users interested and occupied. All residents are able to communicate their needs in various ways, albeit some are limited. Any specialist need is identified and recorded on file, staff are informed of these needs and any areas of training are identified. Evidence was found at inspection that where a resident had a specialist need or has a particular medical condition, detailed information is held on file and staff sign to say they have read and understood it. Risk assessments seen were detailed and regularly reviewed. All staff had signed all other documentation held in the service user file, to evidence that they had read and understood it. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Activities are made available to residents to match their needs, wants and abilities. EVIDENCE: The home has been experiencing past difficulties with staff recruitment and retention, as well as a shortage of drivers. The inspector was informed that these had now been resolved. Due to the above factors many of the activities have been in-house. Recently, however, residents have been going out for meals and to see friends and go shopping. One resident attends a friendship group. Evidence was found at inspection that thought is given to the age appropriateness of the activities and outings on offer and these are regularly reviewed to establish that they remain appropriate. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 13 The local community is very much a part of the activity programme, for leisure but also for maintaining the household, shopping and travel training. Residents are encouraged and enjoy involvement in the weekly shop, both to the local shop and to the supermarket. The home has much pictorial evidence of the residents’ outings and holidays. Holidays are being planned for this year. Residents are encouraged to maintain contact with family and friends, both in the local community and beyond. Evidence was found at inspection that all residents had contact with family and friends on a regular basis. Residents are encouraged to have appropriate sexual relationships and are not open to exploitation. Evidence was found at inspection that residents’ rights and responsibilities are being respected and that residents are encouraged to take calculated risks. Risk assessments are in place for those areas deemed to require them. Residents are encouraged to take an active part in the selection of the daily menu, which is presented in a pictorial way. On the day of the inspection evidence was found that ingredients were being bought in and cooked from fresh. Residents usually are out at some stage during the day, so lunch tends to be a snack with the main meal being taken as a group in the evening. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ files evidenced that they have regular access to community health services. EVIDENCE: Service users’ care plans are very detailed and include all necessary information. This ensures that staff can meet their individual personal support needs in a manner in which they prefer to be supported. Health records are well kept and accurate, service users are supported to have regular health checks and attend the GP/specialists as necessary. Residents also have access to alternative therapies including massage. Incidents and accidents are recorded and immediate action is taken if necessary and appropriate. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 15 The medication administration system is robust and all staff have received training in its administration. On the day of the inspection a member of staff showed the inspector how the system worked. The staff member was very competent and confident. The system has very good built in safety procedures involving a second member of staff countersigning. Evidence was found in residents’ files that information on what should happen in the event of serious illness or death is being recorded and would be acted on in the event. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 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 policy and procedure for dealing with complaints and concerns which enables individuals to know how to complain and to whom. EVIDENCE: The complaints procedure is produced in a service user-friendly format and is up-to-date. The home has a complaints log. No complaint has been recorded since the last inspection. A requirement was made at the last inspection that the Commission’s details are added to the complaints policy, and this has now been done. Evidence was found in the service users’ files that staff are explaining the complaints procedure in a one to one session and in a manner appropriate to the needs of the service user. The Commission for Social Care Inspection has received no information about complaints or safeguarding adult issues. All staff have received Protection of Vulnerable Adults Training and staff members were able to describe the action that be would taken if they had any concerns about the safety or well being of service users. The inspector was assured that residents’ finances are appropriately managed and monitored by external agents on a regular basis. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 ,26, 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. One bedroom in the home requires alteration to comply with regulation. This issue reduces the rating to adequate. EVIDENCE: On the day of the inspection the grounds were very overgrown and the grass very long. The inspector was informed that this work was between contracts and that it would be resolved shortly. The inspector was shown the new contractor’s details prior to leaving the building. As previously stated, one resident’s bedroom is not of sufficient size to appropriately meet her needs. Some remedial action had been taken to reduce the health and safety issues to the staff. A requirement has been made that the organisation informs the Commission of its plans to redress this issue. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 18 The home has the atmosphere and ambiance of a comfortable home. Some redecoration and refurbishment had already taken place with an ongoing programme of improvement planned. With residents’ permission the inspector was shown all the residents’ bedrooms. All residents’ bedrooms were individually furnished and reflected the residents’ hobbies and personalities. All residents have their own rooms. Specialist equipment is provided to those who require it. Toilets and bathrooms in the home offer privacy and comfortable safe areas in which to bath. On the day of the inspection the home was clean and hygienic. The home is able to provide sufficient space to enable quiet private areas where residents can be quiet or alone. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A recent recruitment drive has resulted in the home about to be fully staffed. EVIDENCE: The home has until recently had staff vacancies. A recent recruitment drive has resulted in extra staff being taken on. The home hopes to train people who can drive the home’s transport. This will result in more residents being able to go further for their recreation. The inspector looked at four staff files and found evidence that staff are being recruited, trained, supervised and managed in a professional manner. Files kept in the home are limited in the amount of information they contain as the main staff file is kept at head office. The home’s files, however, are sufficient for their needs. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 20 The inspector formally interviewed two staff members who evidenced that they were being supported and appropriately trained. One staff member has been recently recruited and her file showed that the appropriate checks and references had been obtained. The registered manager is supported by a deputy manager. Staff files showed that regular support and supervision was taking place and that staff were being trained in an appropriate manner. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is professionally managed. EVIDENCE: The home is managed by a part time registered manager and a full time deputy manager. This situation does not affect the day to day management of the home but means that, in effect, the deputy manager is operating as the full time manager. The inspector would suggest that this position is reviewed with a view to providing a full time registered manager. Service users are encouraged to have as active a part in the running of their lives as they are willing or able. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 22 Service users and their relatives’ or advocates’ views are taken into account and are reviewed at regular intervals. All residents were assisted to fill in a questionnaire to obtain their views, and no negative comments were made. Comments made to the inspector include the following: • • • “It keeps me well informed about things that concern my sister and that means everything “ “It’s ideal for my sister’s needs “ “From my point of view I have always found staff to be well informed, co-operative and to have the best interests of the clients at heart “ Professional feedback included the following: • “The staff team respond appropriately to challenging needs while maximising the individual’s potential to experience opportunities and activities of their choosing.“ The home has policies and procedures, which are known to the staff and are in place to ensure the consistency of care and the safety and well being of both its staff and service users. All records required to be kept by the Commission were found to be well recorded and accurate. The home is supported by its parent organisation, which ensures that the home is competently run and is accountable. The home has the support of a health and safety officer who makes regular visits to the home to check on the health, safety and well being of the residents. 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. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 3 5 3 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 2 25 3 26 3 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 24 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 YA25 Regulation 23 Requirement The registered person must notify the Commission in writing of its plans to meet the needs of one service user who is in a bedroom which is smaller than required by the stated regulation. Timescale for action 01/07/07 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 YA36 Good Practice Recommendations The home should review the roles and responsibilities of the registered manager and give consideration to returning this role to a full time position. 8 Piggy Lane DS0000013125.V335549.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V335549.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!