The Piers

Updated 11 October 2019

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

One inspector carried out the inspection.

Service and service type

The Piers is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service did not provide nursing care.

The service had a manager registered with the Care Quality Commission. This means 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

The first day of this inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since our 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. 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. This information helps support our inspections. We used all of this information to plan our inspections.

During the inspection

We met all three people who lived at The Piers and spent some time with them. We observed and listened to how staff interacted with people. During the visit we spoke with the registered manager, the operations director, the quality improvement lead, and five members of staff.

We observed how people were supported and, to establish the quality of care people received we looked at records related to people’s care and support. This included two people’s care plans, care delivery records and all of the Medicine Administration Records (MAR). We also looked at records relating to the management of the service including: staffing rota’s, staff recruitment, supervision and training records, premises maintenance records, quality assurance records, training and staff meeting minutes and a range of the providers policies and procedures.

After the inspection

Immediately following the inspection one relative and two health professionals provided written feedback on the service and we spoke with a further two relatives to obtain their views on the service. We also reviewed training schedules the provider had sent us.

Updated 11 October 2019

About the service

The Piers is a care home registered to provide accommodation and personal care for up to three people diagnosed with autistic spectrum disorders and learning disabilities. At the time of this inspection there were three people living at the home.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive of them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

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

People told us they were happy and comfortable living at The Piers. Our observations showed people liked the staff, who knew them well and provided their support and care with warmth, kindness, patience, respect and dignity.

We received positive feedback from relatives and health professionals about the service provided by the management team and staff at The Piers. Staff understood how to identify and report abuse and were well supported in their roles. Staff received regular team meetings, supervision and annual appraisals and completed a variety of training courses to enable them to carry out their roles competently.

Risks to people’s health, safety and well-being were assessed and management plans put in place to ensure risks were reduced as much as possible.

People were supported by safely recruited staff. There were enough appropriately trained and experienced staff to support people in ways that suited them. Communication styles and methods were tailored to individual people and staff supported people to understand the choices available to them.

People were supported and enabled 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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The service worked collaboratively with health care professionals to ensure people received the best care and support at all times. Staff were responsive to people’s changing support needs and adapted care and support according to their health needs.

Medicines were managed, stored and administered safely. People were supported to take their medicines safely by staff who had received the appropriate levels of training.

There was an open, honest and supportive culture within the home. Relatives and staff spoke positively of the registered manager and felt the service was well led. There were robust quality assurance systems in place to drive improvement and ensure the home offered a safe, effective, caring and responsive service.

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 good (published March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.