We carried out a review of the data available to us about Phoenix House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Phoenix House, you can give feedback on this service.
Phoenix House is a residential care home providing accommodation and personal care for up to nine younger adults with a physical and learning disability. At the time of the inspection, eight people were living at the home.
The building was on one level and people had a single room with en-suite facilities. Communal spaces included a kitchen, dining area, television room, sensory room and accessible gardens.
People’s experience of using this service and what we found
People felt safe and relatives had no concerns about safety. Staff knew what to do to keep people safe and were confident any concerns would be taken seriously. There were people whose behaviours at times placed them, the staff and others at risk of harm. Guidance on how staff were to manage incidents were in place which the registered manager monitored and analysed.
People were supported by sufficient numbers of suitably trained staff.
Medicines were safely managed. Information showed when staff should administer medicines that were prescribed as required.
The service was well led. There was a registered manager at the home who maintained oversight and had effective quality assurances systems in place. The registered manager was supported in their role by the operations team who visited regularly. People and staff had regular meetings to discuss their views, if needed, actions were identified and acted on.
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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Not all Key Lines of Enquiry were assessed at this inspection, so the principles of Right support, right care and right culture were only reviewed in relation to the areas inspected.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• Staff knew how to engage with people meeting their specific communication needs and we saw positive responses to staff from people.
• Staff genuinely showed a passion for improving outcomes for people and promoting choice.
Right care:
• People appeared comfortable with staff and there was much laughter and interaction throughout the day.
• Care practices were designed with people to meet their specific needs.
Right culture:
• The service promoted a positive culture and put people first.
• Morale was high, and this was felt throughout the service.
• Staff were encouraged to share ideas and knowledge about what worked best for people.
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 27 December 2019).
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check the service had made the necessary improvements 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.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. 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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Phoenix House on our website at www.cqc.org.uk.
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.
People had a single room with en-suite facilities and there were a range of communal rooms. This included a lounge, television room and sensory room. All the rooms were located on the ground floor and each person had a small garden.
The service has been developed and designed in line with the principles and values that underpin 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 for them.
The service was bigger than most domestic style properties. It was registered for the support of up to nine people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
There were enough staff during the day, but not always enough at night to ensure people’s safety. This meant in the event of two staff supporting a person, whilst having a seizure, other people were not supervised. The registered manager had introduced a new 7pm to 2am shift but this was not consistent. The provider had not acted to ensure people’s safety at night.
Risks, which balanced safety and independence had been considered. However, there had been one recent incident which impacted on a person’s safety. Lessons were learnt when things had gone wrong. Staff were aware of their responsibilities to identify and report a suspicion or allegation of abuse. The home was clean and there were measures in place to prevent and control infection.
People were supported to have enough to eat and drink. A range of health care professionals assisted people to meet their health care 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 by staff who were valued, well supported and trained.
People were treated well and with compassion. Their privacy, dignity and rights to independence were promoted. People were supported, often by their relatives, to direct their support. This included developing their support plan and its review.
People received personalised support based on their individual needs and preferences. Staff knew people well and had a clear understanding of each person’s individual way of communicating. People had a detailed, support plan, which was regularly reviewed. A range of social opportunities were available to people. This included regularly going out within the local community. There was a positive approach to complaints.
The registered manager had a strong presence within the home and gave strong leadership. There was a caring culture which promoted good outcomes for people. Regular audits were in place to monitor and assess the safety and quality of the 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 26 May 2017)
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Phoenix House on our website at www.cqc.org.uk.
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.
The home is purpose built, set in a village location and within easy reach of several larger towns. Accommodation was provided on one floor and people had their own en-suite bedrooms and spacious shared areas to spend time in.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
A registered manager was employed by the service and was present throughout our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were protected against the risks of potential harm or abuse. Staff had received relevant training and understood their roles and responsibilities in relation to safeguarding people from abuse and harm.
Safe recruitment practices were followed to ensure staff were of good character and suitable for their role and people were supported by sufficient numbers of staff with the right skills and knowledge to meet their individual needs.
Risks to people and their safety had been identified and actions taken to minimise these. Risk management plans were in place to ensure people received safe and appropriate care.
People’s medicines were managed safely. People’s health care needs were managed effectively in response to their changing needs and had access to health and social care professionals when required.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were treated with compassion and kindness in their day to day care. Staff worked well together and had a good understanding of people’s needs including how they expressed their individual needs and preferences.
Care plans were personalised and contained detailed information about the person’s preferences, likes, dislikes and what was important to them. Staff were knowledgeable about people’s care and support needs and acted in accordance with the guidance in their care plans.
People had a range of activities they could be involved in which they said they enjoyed. People were supported to form bonds with each other and had good links to the community.
There were quality assurance systems in place which enabled the provider and registered manager to assess, monitor and improve the quality and safety of the service people received.
Further information is in the detailed findings below.
This was an unannounced inspection which took place on 4 March 2015.
The service offers accommodation and support to nine people who have learning and associated physical disabilities. The home is purpose built, set in a village location within easy reach of several larger towns. Accommodation is provided on one floor. Individuals have their own en-suite bedrooms and there are spacious shared areas.
There is a registered manager running the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People, staff and visitors to the home were kept as safe as possible by using a variety of methods. Staff were trained in and understood how to protect people in their care from harm or abuse. Relatives of people who use the service told us they felt their family members were very safe and they could talk to staff and the registered manager about any concerns or worries they had. Individual and general risks to people were identified and managed appropriately. The home had a robust recruitment process to try to ensure the staff they employed were suitable and safe to work there. Staff members had an in-depth knowledge of people and their needs. The staff team were well supported by the registered and area managers to ensure they were able to offer good quality care to people.
The service understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLS provide a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm. They had taken any necessary action to ensure they were working in a way which recognised and maintained people’s rights.
People were helped to look after their health. Staff were skilled in using individual’s specific communication methods. They helped them to make as many decisions for themselves as they could. People were encouraged to be as independent as they were able to be, as safely as possible. The house was well kept, as homely as possible and very clean and comfortable. People’s rooms were specifically adapted to meet their needs and reflected their individual preferences and tastes.
People were given the opportunity to participate in a variety of activities both individually and with others. The service provided two specially adapted minibuses to enable people to go to activities in the nearby towns. People were treated with dignity and respect at all times. They were as involved as possible in all aspects of their daily life.
Staff and relatives of people who live in the home told us the home was very well managed with an open and positive culture. People and staff told us the registered manager was very approachable and was willing to listen and make any necessary changes to improve things for people.
We saw one person use sign language to thank the staff that served them their meal. Staff offered alternatives when two people refused the refreshment provided. The staff we observed engaged with people they spoke to people at eye level and we heard one member of staff tell the person the meal they were about to eat.
Staff used adapted cutlery to enable people to be independent when they were eating their meal. However, staff did not always tell people the tasks they were about to perform. For example, where they were going before they moved people away in their wheelchair.
We saw staff closely monitored people who were exhibiting signs of seizure activity.
We saw people were being supported by the staff and they were not waiting for attention from the staff. Staff told us the staffing levels were appropriate to meet people's needs. They told us staffing levels were to be increased and regular agency staff was being used until more staff were recruited.
Complaints' cards were available in the foyer of the property which told representatives of people who lived at the home and visitors how to complain. Annual surveys were also used to ensure relatives, visitors to the home, social and healthcare professionals knew how to make complaints.
We spoke to staff and they demonstrated a thorough knowledge of the people living at the service. This was confirmed by our observations and what we were told by a carer.
Records showed that people had been supported and encouraged to make decisions about their lives. We saw that people or their representatives had been involved in care planning and support. When needs changed, we found that records had been updated.
Staff spoken with showed understanding of how to safeguard from harm. Training records showed that staff received regular training to update their them on safeguarding.
Training records showed that staff were suitably trained and supported, including training specific to the people in the service.
Records showed the provider regularly assessed and monitored the quality of the service. We saw that people and their representatives were asked their views about the home in surveys. We saw records that showed these surveys had been acted upon.
We noted that some pictures in the dining room to inform people about choices were small. This meant that some people might not be able to see this information.
We saw that there were sufficient numbers of staff on duty to enable people to live the lives they chose. Systems were in place to maintain people's health, safety and welfare. People living at the home and their representatives were able to share their views and feel confident that they would be listened to.