Piper House

Updated 12 October 2021

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

Piper House provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support whilst taking into account any wider social care provided.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

Inspection activity commenced on 28 June 2021 and completed on 9 September 2021. We visited the service on 28 June and 7 July 2021. The first day of the inspection was unannounced.

What we did before the inspection

We reviewed information we held about the service, which included feedback from an anonymous source and the last inspection report. We spoke with the quality assurance officer from the local authority and reviewed the quality monitoring reports they sent to us. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We also reviewed notifications from the provider, which is information about important events which they are required by law to send us. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and two relatives about their experience of the care and support provided. We spent time with people who were not able to speak with us due to their disability and observed their interactions with staff. We reviewed a range of records, which included two people’s care plans, medicine administration records for five people and records relating to the management of the service, including policies and procedures. We spoke with four support workers, two team leaders, the operations manager and a member of the human resources team.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed two people’s care plans and the risk assessments for seven people. We looked at further documents including the complaints log, compliments, staff recruitment, training and supervision records, the minutes for meetings and the provider’s quality assurance audits and checks. We spoke by telephone with the relatives of four people. We contacted four health and social care professionals with knowledge and experience of the service and received comments from one professional. We conducted a remote meeting with the provider’s assistant director of services (the registered manager), operations manager and assistant director of health.

Updated 12 October 2021

About the service

Piper House is a purpose built, supported housing service comprising 12 self-contained studio flats. People may access a communal reception and seating area on the ground floor of the premises. Flats situated on upper floors are accessed by stairs and a lift. Ground floor flats open out onto a garden available to all tenants.

People living at Piper House have a range of complex needs including learning and physical disabilities, autistic spectrum conditions, epilepsy and behaviours that may challenge services. The service is staffed 24 hours a day and is registered to provide support to people with personal care needs. At the time of this inspection the service was supporting nine people.

People's experience of using this service

The provider had systems in place to monitor the quality of people's care and support. Although the monitoring systems now better enabled the provider to identify and address areas for improvement in recent months, we could not yet be confident these improvements were firmly embedded within daily practice and sustainable.

Safe recruitment processes were being adhered to in order to make sure staff were suitable for their roles and responsibilities. Some relatives thought the staffing levels were insufficient at night-time and were concerned that not enough senior staff were available at the premises at the weekends.

Risks to people's health, safety and welfare were identified and addressed. Staff understood policies and procedures to keep people safe. Medicines were safely managed.

People and their relatives were involved in the care planning process. Care plans were detailed and person-centred and were kept under review. They reflected people's healthcare needs and people were supported to meet their healthcare needs.

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.

People were supported to eat a balanced and appealing diet.

The provider had suitable safeguarding and whistleblowing policies and procedures in place and staff were advised about how to identify and promptly report any concerns they may have.

People were supported to engage in community activities and take part in their hobbies and interests. People were encouraged to give their views and be as independent as possible.

Staff completed a range of training which included training to meet the healthcare needs of people who used the service.

We have made a recommendation about the provider reviewing staffing levels and skill mix for night-time and weekend shifts.

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.

This was a focused inspection that considered whether people were provided with a service that was safe, effective and well-led. Based on our reviews of key questions Safe, Effective and Well-led the service was able to demonstrate how they were meeting the underpinning principles of Right Support, right care and right culture. People were encouraged to make meaningful choices, develop their independence and lead fulfilling lives. People’s care and support plans were produced in a person-centred way which considered their individual needs, wishes and views. Staff were familiar with people’s unique personalities and favoured routines.

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

Rating at last inspection

The last rating for this service was requires improvement (report published 7 December 2019).

Why we inspected

We carried out an unannounced inspection of this service on 10, 14, 15 and 16 October 2019. Breaches of legal requirements were 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 and good governance.

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 of Safe, Effective and Well-Led which contain those requirements.

This inspection was prompted in part due to concerns received from an anonymous source in relation to the safety and quality of the care and support provided to people living at Piper House. These concerns included the safety of night-time care, the standard of cleanliness in the premises, weekend and night-time cover by management staff and the choice of social activities for people who use the service. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective and well-led sections of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.