Archived: Phoenix Care & Domiciliary Service Limited

Updated 21 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. We also followed up on the warning notice we served after the previous inspection to check the required improvements had been made.

This inspection took place on 26 and 27 February 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.

Inspection site visit activity started on 26 February and ended on 27 February 2018. It included phone calls and home visits to people who used the service and their relatives, obtaining feedback from healthcare professionals who were involved with the service and meeting with care staff. We visited the office location on 26 and 27 February 2018 to see the registered manager and to review care records and policies and procedures. One adult social care inspector carried out this inspection.

Before the inspection we reviewed the information we held about the service. This included previous contact about the service and notifications we had received. A notification is information about important events which the service is required to send us by law. The provider also completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We sent questionnaires to 16 people receiving a service, and 16 relatives to gain their views on the quality of the care and support provided by the service. Of these questionnaires we received 12 back from people using the service.

We used a range of different methods to help us understand people's experience. We spoke with five people and their relatives over the phone. We visited two people and a relative in their homes. We spoke with three care staff, the registered manager, the director, and the consultant who supported the service. We received feedback from two community professionals.

We looked at care records for four people; three staff recruitment files; staff training, supervision and appraisal records and those related to the management of the service, including quality audits. We looked at how the service supported people with their medicines.

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.