Piper Court

Updated 28 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, a medicines 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 this type of care service. The Expert by Experience contacted people by phone to request feedback.

Service and service type

Piper Court is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Piper Court is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for two months and had submitted an application to register with CQC. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 10 relatives about their experience of the care provided. We spoke with 11 members of staff including the manager, nurses, senior care workers, care workers and domestic staff. We also spoke with 2 visiting professionals.

We reviewed a range of records. This included 9 people’s care records. We looked at the governance arrangements for the safe handling of medicines including the provider’s policy and audits. We looked at medicines records and medicine stock. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 28 March 2023

About the service

Piper Court is a residential care home providing personal and nursing care to up to 60 people. The service provides support to adults including older people, people living with dementia and people with mental health conditions. At the time of our inspection there were 38 people using the service.

People’s experience of using this service and what we found

Medicines records were not always accurate or up to date. The management of risk around people’s dietary requirements was not always clearly documented. Records around maintenance and safety checks were not always completed. Night staff had not taken part in recent fire drills and we have made a recommendation about this.

People told us they felt safe living at Piper Court. The manager handled safeguarding concerns appropriately. A safe recruitment procedure was in place. We received mixed feedback from people and their relatives about staffing levels. Some people were happy there were enough staff but others felt they would benefit from more staff at certain times of day. We shared this feedback with the provider. The provider was recruiting for new staff so at times agency staff were used to cover shifts to ensure sufficient staff were always available.

The provider had appropriate measures in place to minimise the spread of infection. Lessons were learned following accidents and incidents.

The manager and staff liaised with external professionals to ensure people had access to the support they needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 January 2022). At this inspection we found the service remained rated requires improvement. This is the third consecutive inspection where the provider has failed to achieve a good rating.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made but the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 25 November 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Piper Court on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to good governance, specifically relating to quality assurance and record keeping.

We have made a recommendation about fire safety, specifically around fire drills.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.