Archived: Peat Lane House

Updated 3 July 2015

We carried out this focused 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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We undertook a focused inspection of Peat Lane House on 9 March 2015. This inspection was completed to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on 13 September 2014 had been made. We inspected the service against two of the five questions we ask about services: is the service safe and is the service responsive. This is because the service was not meeting legal requirements in relation to those questions.

The inspection was undertaken by an adult social care inspector, a specialist professional advisor, and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection we reviewed the information we held about the home, this included the provider’s action plan, which set out the action they would take to meet legal requirements.

At our inspection we spoke with 12 people who lived in the home, three relatives of people living in the home, the acting manager and five care staff. We observed care and support in communal areas, spoke with people in private and looked at the care records for five people.

We met with the provider to discuss the action plan and the consultation on the future plans for Peat Lane House.

Updated 3 July 2015

Peat Lane House provides accommodation for up to 19 people who have a learning disability and/or a physical disability and require support of varying degrees. Accommodation is set out in one large building divided into five separate flats. These flats accommodate between three and five people, and a further provides a three bedroomed flat for short respite breaks. Each flat has its own kitchen, living room, bathroom and bedrooms. A separate staff team is provided to each flat.

We carried out an unannounced comprehensive inspection of this service on 12 September 2014 at which a number of breaches of legal requirements were found. This was because: there were insufficient staff to meet people’s needs: the home was found not to be clean and infection control measures were not being followed; and people’s needs were not being met as the choices offered to them were limited. We told the provider to take action to improve and provide us with an action plan to set how they would do this.

After the comprehensive inspection, the provider sent us an action plan to say what they would do to meet legal requirements in relation to the breaches. We undertook a focused inspection on the 9 March 2015 to check that they had followed their plan and to address the areas of concern highlighted by our inspection. This report, of 9 March 2015, only covers our findings in relation to these areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Peat Lane House’ on our website at www.cqc.org.uk’

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 and associated Regulations about how the service is run.

At the inspection of 12 September 2014 we found that the design and delivery of the services meant that people’s choice of how to spend their time was limited. We found that everyone was expected to leave the home and attend a day service on weekdays between 9am and 4pm. This aspect of the service was not tailored to people’s individual needs.

We told the provider that people should be offered more choice, and that the type of service they were providing people with was institutional and out-dated. The provider began to look at options available that would meet people’s needs in a more person-centred way. In the action plan the consultation process described how everyone in the home, their relatives and other stakeholders would be involved in redesigning the service.

At this focused inspection on the 9 March 2015, we found that the provider had met some areas, and had made progress towards meeting their plan in others. When we looked at the progress of redesigning the service to offer people more choice we found that while some progress had been made, this had been limited.

The provider told us the steps they had taken and said that the process had been complex. One of these factors being that Peat Lane House was owned by a housing association. People living in the home had license agreements, while the local authority had a lease agreement with the housing association. Any changes to the building and the type of services offered had to be negotiated, and with the agreement of the housing association, the people living in the home, and with the local authority funding and commissioning teams.

The provider had held relatives meetings and had started to work with the local social work team to ensure that everyone had an up to date review of their care needs. These reviews were to ensure that all the needs of people were known so that services offered would be designed around meeting these individual needs.

We alerted the provider to practices that may place restrictions on people’s ability to make choices, such as the model of care imposed upon them, as described. The provider had assured us that as part of the full review of people’s needs that deprivation of liberty assessments where being carried out, and appropriate referrals made to ensure people’s rights were being lawfully protected.

We found that the home was now kept clean and that infection control measures had been actioned to reduce risk to people living and working in the home. This ensured that people where provided with a safe place to live and that their personal care was carried out to high standards.

We saw that staffing levels had been increased. There were now domestic staff hours for the whole home, instead of these only covering the communal areas. The staffing levels at night had been increased to two waking night staff and one sleep-in supervisor. This meant that people had a better level of supervision and more responsive care during the night shift. Extra hours had also been added to the day shift to allow staff to take people out at weekends.

On the inspection of 9 March 2015 we explored with the provider the details of people’s licence agreement. This indicated that people held tenancy agreements with the housing association, and this requires the service to be registered under a different regulated activity with the Care Quality Commission (CQC). In effect anyone with a tenancy agreement is regarded as living in their own home and where this is the case the home cannot be registered as a care home. The provider was taking action to ensure that they were registered correctly with us, CQC.

While improvements had been made we have not revised the overall rating of ‘Requires Improvement’. To improve the rating to ‘Good’ would require a longer term track record of consistent good practice, and for the reconfiguration of the service to demonstrate that it was meeting people’s needs. We will review our rating at the next comprehensive inspection.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and this corresponds to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of this report.