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Phoenix Futures National Specialist Family Service Good

Inspection Summary


Overall summary & rating

Good

Updated 22 January 2019

We rated Phoenix Futures National Specialist Family Service as good because:

  • The service completed appropriate health and safety assessments of the environment including risks associated with mixed sex accommodation. The service had good facilities including the nursery, lounge and garden facilities with play equipment.
  • Staff directed clients to other services when appropriate and supported them to access those services. Staff supported clients to lead healthier lives. Clients had planned discharge exit packs which included harm reduction advice and details of their resettlement plans.
  • Safeguarding was fully embedded in the service. The service worked collaboratively with other agencies and referred, shared or escalated concerns as appropriate.
  • The service had improved and resolved issues relating to medicines management practices following our last inspection. Staff turnover and sickness rates were improving following recruitment to vacant posts.
  • The nursery within the service provided care for clients’ children in an outstanding rated OFSTED environment. This allowed parents to access the therapeutic program and have guidance on childcare and development from qualified childcare workers.
  • Clients were offered practical and emotional support by staff and others in the therapeutic community. Group meetings and therapy were delivered in a relaxed, friendly atmosphere.
  • Clients were fully engaged and participating in their care and treatment. Personal information, histories and recovery goals were evident in care plans and group discussions. Staff supported clients to maintain contact with their families and carers.
  • Families and carers spoke positively of the staff and care and treatment provided; they were happy with the outcomes of the treatment. The service sought client input and made changes following discussions.
  • Staff felt proud to work for the organisation. They felt valued and respected and could raise concerns without fear of retribution. Staff told us they felt connected to the company.
  • The service followed an effective and clear framework to share information. Team meetings, supervisions and handovers had a set agenda that ensured that staff were kept informed of essential information such as client risk and care and learning from incidents or complaints.
  • The organisation encouraged creativity and innovation to ensure up to date evidence-based practice was implemented and embedded. They had achieved recognition for their work from multiple external sources.

However:

  • The service did not have total oversight of the training completed. Sessional staff had not completed all the required training and night staff training compliance figures were not provided.
  • Staffing shortages and vacancies meant that clients’ one to one sessions did not always occur weekly as detailed in the provider’s local protocol and that client leave was not always accommodated.
  • The organisation did not provide clarity around the night staffing expectations.
  • Support plans and client files did not always reflect the levels of personal knowledge and support given by staff.
  • Actions on the continuous improvement plan had been marked as complete when they were not yet fully resolved.
  • The service did not have an overarching improvement plan that included the work the service was doing in response to client feedback. The service did not have any formal mechanisms to obtain feedback from carers about the service.
  • Governance policies, procedures and protocols did not include an equality impact assessment and the service did not have its own service level risk register.
Inspection areas

Safe

Requires improvement

Updated 22 January 2019

We rated safe as requires improvement because:

  • There was a lack of clarity regarding the  provider's training compliance target; the manager said the rate was 75%, however following the inspection, the head of quality said that there was no set target.
  • Although all sessional staff had started to complete mandatory training, all courses were not fully completed. 67% of sessional staff had completed paediatric first aid training and 20% had completed the care certificate. These figures were below the average training target of other similar services. 
  • Managing challenging behaviour training was not mandatory but was required for lone working and compliance figures did not meet the provider target. 59% of sessional staff and 50% of therapeutic staff had completed this training.
  • The service did not always provide a waking night member of staff even when staff sickness or shortage was expected.
  • Staffing shortages caused by vacancies and illness impacted on the availability of staff escorts and one to one key working sessions.
  • Children and adult’s risk management plans were not always updated following an incident.
  • Crisis planning documentation was limited and did not fully support staff to calm clients in a crisis.
  • The service did not use a structured program to continually review if all restrictions were necessary.

However:

  • The service had completed appropriate health and safety assessments of the environment including risks associated with mixed sex accommodation.
  • Staff turnover rates were improving following recruitment to vacant posts.
  • Client’s mental health needs were identified and acted on. Staff responded to sudden deterioration in clients’ health by engaging appropriate services.
  • Safeguarding was fully embedded in the service.
  • The service worked collaboratively with other agencies and referred, shared or escalated concerns as appropriate.
  • The service had improved and resolved issues relating to medicines management practices following our last inspection.
  • Learning and actions to respond to risks and incidents were shared at team meetings. Staff could describe investigation outcomes.

Effective

Good

Updated 22 January 2019

We rated effective as good because:

  • The staff team attended thorough and complete handovers where up to date information was shared.
  • Staff managed clients leaving the service in an unplanned way well. They completed an early leavers pack which included written advice on safe coping skills, contact numbers and emphasised the effects of drug use on themselves and others.
  • Staff used a recognised assessment tool prior to and on admission to help clients identify goals that were incorporated into their care plan
  • The service provided care and treatment interventions suitable for the client group based on recognised best practice guidance.
  • The nursery within the service provided care for clients’ children in an outstanding rated OFSTED environment. This allowed parents to access the therapeutic program and have guidance on childcare and development from qualified childcare workers.
  • Staff supported clients to lead healthier lives.
  • The service benchmarked its success against other services and monitored and compared treatment outcomes
  • The service provided all staff, including sessional staff and students, with a comprehensive induction.

However:

  • One to one sessions did not always occur weekly as detailed in the provider’s local protocol. Clients found this disruptive to their care.

Caring

Good

Updated 22 January 2019

We rated caring as good because:

  • We observed most staff to be caring, compassionate and respectful.
  • Clients were offered practical and emotional support by staff and others in the therapeutic community. Group meetings and therapy were delivered in a relaxed, friendly atmosphere.
  • Staff directed clients to other services when appropriate and supported them to access those services for example, mental health services or maternity care.
  • Clients received a clear induction to the environment and the expectations of the service on admission.
  • Clients were fully engaged and participating in their care and treatment. Personal information, histories and recovery goals were evident in care plans and group discussions.
  • The service sought client input and made changes following discussions
  • Families and carers spoke positively of the staff and care and treatment provided; they were happy with the outcomes of the treatment.

However:

  • Support plans and client files did not always document the levels of personal knowledge, care and support given by staff.
  • Some clients said that keyworker sessions and escorted leave were not always accommodated. They also described an inconsistency in house rules being applied.
  • The service did not have any formal mechanisms to obtain feedback from carers about the service.

Responsive

Good

Updated 22 January 2019

We rated caring as good because:

  • The service had clear admission criteria and a dedicated member of staff to complete all preadmission checks.
  • Client folders included support plans and risk management plans that reflected the complex needs of the clients.
  • Clients had planned discharge exit packs which included harm reduction advice and details of their resettlement plans.
  • The service had good facilities including the nursery, lounge and garden facilities with play equipment.
  • Staff supported clients to maintain contact with their families and carers.
  • All clients and families knew how to complain and felt comfortable doing so. Clients told us that complaints were acknowledged and responded to.

However:

  • We observed that clients were not allowed any food or drink in their bedrooms.
  • The choice of activities could have been improved and more targeted to the children’s age ranges.

Well-led

Good

Updated 22 January 2019

We rated well-led as good because:

  • Leaders had a good understanding of the services they managed. Managers had the skills, knowledge and experience to perform their roles.
  • Staff felt proud to work for the organisation. They felt valued and respected and could raise concerns without fear of retribution. Staff told us they felt connected to the company.
  • The service recognised staff achievements via awards ceremonies and service wide emails.
  • The service followed an effective and clear framework to share information. Team meetings, supervisions and handovers had a set agenda that ensured that staff were kept informed of essential information such as client risk and learning from incidents or complaints.
  • There was a clear quality assurance management and performance framework in place that was integrated across all organisational policies and procedures. The service had clear policies and local protocols.
  • The service used an accessible electronic information management system that allowed managers to collect data and analyse performance.
  • The organisation encouraged creativity and innovation to ensure up to date evidence-based practice was implemented and embedded. They had achieved recognition for their work from multiple external sources.

However:

  • Actions on the continuous improvement plan had been marked as complete when they were not yet fully resolved. The service did not have an overarching improvement plan that included the work the service was doing in response to client feedback.
  • Governance policies, procedures and protocols did not include an equality impact assessment and the service did not have its own service level risk register.
  • The organisation could not provide clarity around the night staffing expectations.
  • Sessional staff had not completed all the required training and night staff compliance figures were not included in the compliance data submitted by the service. The manager did not have total oversight of the training completed by staff.
Checks on specific services

Substance misuse services

Good

Updated 22 January 2019