CQC report explained · a nursing home
What the CQC found at Piper Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Piper Court rated Requires Improvement; inspectors found unsafe record-keeping, although people felt safe and staff were caring.
This was an unannounced focused inspection on 1, 3 and 6 March 2023. Inspectors checked whether the home had acted on an earlier improvement plan, mainly looking at Safe and Well-led.
The home remained Requires Improvement in both areas. Medicine records were not always accurate, and records about dietary risks, maintenance and safety checks were incomplete. Night staff had not taken part in recent fire drills.
Inspectors found people felt safe, safeguarding concerns were handled properly, infection controls were suitable and staff worked with outside professionals. People and relatives also described a warm and respectful atmosphere.
The home had made some improvements but was still breaking Regulation 17 about good governance. This was the third inspection in a row where it had not achieved a Good rating. The other three key question ratings were carried over from the previous inspection.
People felt safe
People and relatives told inspectors they felt safe at the home. Safeguarding concerns were dealt with appropriately.
“People felt safe living at Piper Court. Relatives also told us they felt their family members were cared for safely.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements to prevent and manage infections, including the safe use of protective equipment.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Warm and respectful culture
People, relatives and staff described a positive atmosphere. Relatives said staff were respectful and welcoming.
“The atmosphere between the staff and the residents is absolutely lovely. The staff are also all very respectful to the residents.” from the report
Involving families
People and relatives said they could discuss care and raise concerns. The home held meetings and gathered feedback.
“Relatives also felt involved in their loved ones' care.” from the report
Working with professionals
The home worked with outside professionals and agencies to help people receive the support they needed.
“The manager and staff liaised with external professionals to ensure people had access to the support they needed.” from the report
Medicine records
seriousRecords did not always clearly explain how medicines should be given. Records for creams and medicines taken when needed did not always show what had been given or whether it had worked.
“The provider had not ensured accurate and complete records were in place to support the safe management of medicines.” from the report
Risk and safety records
seriousRecords about dietary risks, people's weights, maintenance and safety checks were incomplete. Management checks had not identified all the gaps.
“The provider had not ensured accurate and complete records were in place to ensure people were supported safely.” from the report
Fire drills
needs fixingNight staff had not taken part in recent fire drills. The drills did not reflect the smaller number of staff normally working at night.
“Night staff had not taken part in recent fire drills.” from the report
Quality assurance
seriousThe provider's audits and checks did not identify all the problems found by inspectors. This meant the home could not reliably monitor risks and improve care.
“The provider's quality assurance systems had not been effectively implemented.” from the report
Staffing feedback
needs fixingPeople and relatives gave mixed views about staffing. Some people felt there were not enough staff at certain times, particularly at night, while agency staff were used during recruitment.
“We received mixed feedback from people and their relatives about staffing levels.” from the report
- 01What has been done to make sure medicine records are accurate, including records for creams and medicines taken when needed?
- 02How are you now recording and reviewing risks linked to people's diet, malnutrition and weight?
- 03Have night staff completed realistic fire drills, and how often will these drills now take place?
- 04How are management audits checking medicine records, care plans, maintenance and safety records?
- 05How are staffing levels being reviewed at night, and how often are agency staff currently being used?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried over from the previous inspection. This explanation was written from the published report of 28 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2022
Rated Requires Improvement and no longer in Special Measures; inspectors found progress but medicines were still not managed safely.
This was an unannounced, focused inspection on 25 and 26 November 2021. Inspectors spoke with people, relatives, staff and a healthcare professional. They reviewed care records, medicine records, staff files and the home's management checks.
There had been clear improvement since the previous inspection. Infection prevention, staffing, safeguarding, accident monitoring and controlled medicines had improved. However, some medicines were unavailable, records for creams and as-needed medicines were incomplete, and one person's self-administered medicines were not properly assessed.
The overall rating changed from Inadequate to Requires Improvement. The ratings for Safe and Well-led were both Requires Improvement. The home was no longer in Special Measures, but the inspection found a continuing legal breach about medicines.
Improved infection control
Inspectors were assured that the home had effective arrangements for preventing and managing infections, including safe visits, protective equipment and testing.
“We were assured that the provider was using PPE effectively and safely.” from the report
Safeguarding
The home had a safeguarding system, and staff had been trained to recognise and report concerns.
“An effective safeguarding system was in place. The management team had a clear understanding of what procedures to follow in respect of safeguarding concerns.” from the report
Staff support
Most staff said they felt supported and described an improving culture and morale.
“Staff morale has greatly improved even from when I started.” from the report
Working with health professionals
The home worked with healthcare professionals, and inspectors found that advice from them was acted on.
“We spoke with a visiting healthcare professional who told us they were very happy with the way their advice and guidance was acted upon.” from the report
Controlled medicines
The arrangements for controlled medicines had improved and matched the home's policy.
“The systems in place to manage controlled drugs had improved since the last inspection and was now in line with policy.” from the report
Medicine records and availability
seriousInstructions and records for creams, lotions and some as-needed medicines were incomplete. Medicines for three people were unavailable and could not be given.
“There was no clear record of medicines ordered mid cycle and medicines for three people were not available and could not be administered.” from the report
Self-administered medicines
seriousOne person's care plan did not clearly record that they managed some of their own medicines. There was no risk assessment to show this was safe.
“There was no risk assessment to show this was safe.” from the report
Risk assessments
needs fixingRisk assessments had improved, but some were still not detailed, complete or tailored to the individual.
“However, not all the records were comprehensive, detailed or person centred.” from the report
Management checks
needs fixingThe home carried out regular checks, but these had not found or resolved all the problems with medicines.
“However, regular quality audits had not identified or resolved the issues we had, which included those in connection with medicines management.” from the report
Communication with relatives
minorSeveral relatives said they had not been kept informed about changes in management.
“I don't know the manager. Not been informed of the current manager” from the report
- 01How do you now check that creams and lotions are recorded with the correct medicine and application area?
- 02What happens if a prescribed medicine is not available, and how do you record and follow up missed doses?
- 03How are as-needed and variable-dose medicines linked to each person's care plan and instructions?
- 04How do you assess and record whether a person can safely manage some of their own medicines?
- 05How will relatives be kept informed when there are changes to the manager or other senior staff?
This was a focused inspection of Safe and Well-led, mainly checking improvements after the previous inspection; the other key-question ratings were not assessed and previous ratings were carried forward. This explanation was written from the published report of 12 January 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Piper Court
8 rated inspections over 8 years: the service has improved, from Inadequate to Requires improvement.
- March 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2022Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- June 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- June 2019Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- June 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015Inspected but not ratedSafe: Requires improvement
- February 2015InadequateSafe: InadequateEffective: InadequateCaring: GoodResponsive: GoodWell-led: Inadequate
- October 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 1 November 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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45 live-in carers within about an hour of Stockton-on-Tees
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,190 a week. 40 can care for a couple. 10 years' experience on average.
“I found Alison to be kind , caring helpful concencious... Alison has a heart of gold”
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.