Archived: Phoenix Care

Updated 2 July 2021

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We planned this inspection to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by two inspectors.

Service and service type:

This service provides 24-hour care and support to people living in ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. The CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service was registered for providing support for up to three people and three people were using the service at the time of the inspection. This is in line with current best practice guidance regarding small-scale supported living.

The service provider was an individual who also managed the service. The provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit. We needed to be sure that the provider would be available to facilitate this inspection.

What we did:

We used information the provider sent us in the Provider Information Return (PIR) to support our inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

We looked at information we held about the service including notifications they had made to us about important events. A notification is information about certain changes, events and incidents affecting the service or the people who use it that providers are required to tell us about. We also reviewed all other information sent to us from other stakeholders, for example the local authority and members of the public.

We visited the service where people were being supported to live. We spoke with the three people who lived at the service, the provider and the two support staff. We looked at records related to the running of the service. These included the support and risk management plans of the people using the service, the staff files for two support workers and records the provider kept for monitoring the quality of the service.

After the inspection we spoke with a social care professional involved with the service and two relatives of people who use the service.

Updated 2 July 2021

About the service:

Phoenix Care is a supported living service that provides 24-hour care and support to three adults with learning disabilities. A small team of staff support people during the day. One member of staff sleeps at the service each night. The provider was an individual and they were also the manager of the service. This was the only service they managed.

People’s experience of using this service:

The outcomes for people using the service did not fully reflect the principles and values of Registering the Right Support in the following ways. People's care and support was not always planned, proactive and coordinated. Support planning did not always focus on promoting people’s choice and control in how their needs were met or how to support them with behaviours that may challenge others. People did not receive information about their care and support in formats they could understand. People did not always receive appropriate support to help them communicate and their independence was not always promoted.

There were not suitable arrangements in place to safeguard people from the risk of abuse.

Medicines were not always safely managed. Staff were not up to date with medicines support training and the provider had not assessed the competency of staff to give the medicines support being asked of them in a safe way.

Plans to reasonably mitigate risks to people’s safety and wellbeing were not being regularly reviewed and updated.

Staff had not received all the training they needed to enable them to support people and meet their needs safely and this could have an impact on people’s safety.

People's rights were not always being respected as they were not being supported in line with the principles of the Mental Capacity Act 2005.

The provider did not have effective systems to monitor the quality of the service and identify when improvements were required. There was no plan or strategy to develop or improve the service. There were no recorded systems in use for seeking feedback from people, their relatives and other stakeholders and using this to develop the service.

There were enough staff deployed to keep people safe. However, people were supported by a small team of support workers who sometimes voluntarily worked long hours. People were supported to access some activities in their local community.

Staff supported people to access mainstream health care services.

Staff felt supported by the provider who also regularly worked at the service to support people. Staff were confident they could raise any concerns they had with the provider.

We have made a recommendation about the management of complaints.

We identified six breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to safe care and treatment, person-centred care, staffing and good governance. Please see the 'action we have told the provider to take' section towards the end of the report.

Rating at last inspection:

We rated the service good at our last comprehensive inspection. We published our last report on 10 October 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Enforcement:

We identified six breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to safe care and treatment, the need for consent, safeguarding people who used the service from abuse and improper treatment, person-centred care, staffing and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check for significant improvements.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.