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Phoenix Care & Domiciliary Service Limited Good

Inspection Summary


Overall summary & rating

Good

Updated 21 March 2018

This announced inspection took place on 26 and 27 February 2018. We visited the office on 26 and 27 February 2018 and carried out phone calls and home visits to people who used the service and their relatives on 27 February 2018.

Phoenix Care & Domiciliary Service Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults. Not everyone using the service receives support that is a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’, including help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 28 people were receiving personal care from the service. People who use the service live in Torbay and the surrounding areas.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the previous inspection in November 2016, we identified concerns relating to systems for governance. The registered manager had not taken appropriate action after an allegation of abuse was made. We took enforcement action and issued the service with a warning notice. The service was rated ‘Requires Improvement’. Two of the key questions (is it safe and is it well-led) were rated ‘Requires Improvement’.

At this inspection, we found the registered manager had reviewed the safeguarding policy and procedures. When another allegation of abuse had been made, the registered manager had taken appropriate action and worked with the local safeguarding authority and police. They had also notified the CQC of the concerns. We found the service had taken sufficient action to meet the warning notice. The registered manager had taken guidance from a training and consultancy company to support them. A representative from the company was present for part of the inspection. They were working with the registered manager and planned to introduce further audits. We saw there were systems in place to monitor the service.

People were supported by a strong, stable staff team who knew them well and focused on ensuring they received the highest quality of care. Without exception, people and their relatives told us they were happy with the care they received. People said staff were kind and caring, and they were always treated with respect and dignity. Comments included “They’re nice and cheery, give a lot of care, and we have a laugh”, “They come in sit down and have a chat before they start, they’re interested” and “They are wonderful, I’ve got the best carers.” A community professional told us, “I’ve worked closely with them and always found them very good” and “they provide high quality care.” We found examples of where staff had gone over and above their responsibilities, in their own time, to support people and their families. For example, one person was in hospital. Their relative had previously planned a break away. The registered manager spoke with the relative and arranged to visit this person throughout their stay in hospital, ensuring they had everything they needed.

People told us they felt safe and comfortable when staff were in their home and when they received care. People were provided with a copy of the staff rota so they knew who was due to visit them. Staff knew how to recognise signs of potential abuse and understood how to report any concerns in line with the service's safeguarding policy.

Safe staff recruitment procedures were in place. This helped reduce the risk of the provider employing a person who may be unsuitable to work in care. People told us staff knew how to meet their needs. One person commented, “They do things exactly as I want them to.” Community professionals told us, “They take initiative, communicate well, provide thorough feedback and are quick to raise concerns.” Staff were happy with the training they received. They said they felt well supported and had regular opportunities to discuss their work.

Staff knew people well and were able to tell us how they supported people. Care plans were developed with each person. They described the support the person needed to manage their day to day health needs. People’s communication needs were met. The service was complying with the Accessible Information Standard (AIS). The AIS applies to people using the service who have information and communication needs relating to a disability, impairment or sensory loss.

People’s care plans identified their communication needs and contained details of how they communicated and how staff should communicate with them. This ensured people’s needs were met in the way they wanted. At the time of our inspection, one person did not have capacity to make decisions relating to their care. Their relative had a power of attorney to enable them to make decisions relating to their relation’s care. Staff told us they gained consent from people before carrying out personal care and respected people's choices. People confirmed this happened.

Risks had been assessed for each person and were safely managed. Risk assessments had been carried out in relation to falls, epilepsy, skin care, and mobility. Risk assessments relating to each person's home environment had been completed. Where concerns were identified, action had been taken to reduce the risks to people. People were supported safely with their medicines and told us they were happy with the support they received. Staff completed medication administration record (MAR) sheets after giving people their medicines. The MAR sheets were audited to ensure people had received their medicines as prescribed to promote good health.

The service sought regular feedback. People told us they were asked for feedback over the phone, during visits and care plan reviews. People and their relatives felt able to raise concerns or make a complaint. They were confident their concerns would be taken seriously. People told us they didn't have any complaints. Comments included, "I’ve got no worries” and “I couldn’t fault them in any way.”

People told us the management were approachable and they were very happy with the service. People told us, “They’ve been very good, if I’m stuck I can ring them”; “I wouldn’t have managed without them” and “very good communication.” Staff said, “I’m very happy, you only have to phone and we can talk things through” and “It’s lovely.”

The registered manager was keen to develop and improve the service. The registered manager attended local provider forums and accessed professional websites. This meant they kept up-to-date with good practice and knew what was happening in the care profession. They had devised a set of questionnaires linked to CQC’s key questions; is the service safe, effective, caring, responsive and well-led. These asked staff to consider what was happening for people and to identify improvements. The registered manager had worked in partnership with healthcare professionals to ensure ‘joined up’ care was delivered to people. This meant people benefited from high quality care and improved outcomes. Records were well organised and up-to-date. An audit system was in place to monitor the quality of the service. Checks to observe staff's competency were carried out on a regular basis.

Inspection reports are produced in different formats, such as easy read, audio or large print and are available upon request.

Inspection areas

Safe

Good

Updated 21 March 2018

The service was safe.

People received safe care and support. They were protected from the risk of abuse through the provision of policies, procedures and staff training.

People were protected from risks to their health and wellbeing because staff took action when issues were identified.

There were enough competent staff to carry out people's visits and keep them safe.

Safe and robust staff recruitment procedures helped to ensure that people received their support from suitable staff.

Effective

Good

Updated 21 March 2018

The service was effective.

People’s care and support was planned and delivered effectively to ensure the best outcomes were achieved.

People were treated as individuals and were not discriminated against when making their care and support decisions.

People benefited from having staff who were skilled and supported in their job role.

People were supported by staff who were trained in the Mental Capacity Act and understood the need for consent.

People were supported by staff who sought advice from health care services to ensure their needs were met.

Caring

Good

Updated 21 March 2018

The service was caring.

People benefited from staff who took time to listen to them and get to know them. Staff had formed caring relationships with people.

People and their relatives were involved in their care and staff respected people's wishes.

People benefited from staff who promoted their independence and encouraged them to do as much for themselves as possible.

Responsive

Good

Updated 21 March 2018

The service was responsive.

Care plans were developed with the person. They described the support the person needed to manage their day to day health needs.

Staff responded to people's requests and met their needs appropriately. The service was flexible and responded to changes in people's needs.

People’s communication needs were met. The service was complying with the Accessible Information Standard (AIS).

People were encouraged to give their views and raise concerns and complaints if the need arose.

Well-led

Good

Updated 21 March 2018

The service was well-led.

Systems were effective in assessing, monitoring and improving the quality of care provided to people. The service had used a consultancy company for guidance and support.

People benefited from a service that had a registered manager and a culture that was open, friendly and welcoming.

People received good quality care as the provider had created a positive staff culture.

People benefited from a service that worked in partnership with other professionals to ensure joined up care was delivered to people.