Archived: Phoenix Care

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.

Phoenix Care provides a supported living service for up to 3 people with a mental illness or learning disability. The provider is registered with the Care Quality Commission (CQC) as an individual. The service does not require a registered manager as the provider is in day to day control of the service.

People using the service were safe because the provider had systems in place to assess and mitigate possible risks and staff had the training they needed to support people safely.

People were supported by staff who were suitable to work in the service because the provider ensured they carried out checks on new staff before they started work.

People's nutritional needs were met and they had a choice of freshly prepared food.

The provider ensured they assessed, monitored and met people's health care needs and people received the medicines they needed safely.

The staff who supported people using the service had the training, support and information they needed.

People’s relatives told us staff were kind and caring and the provider and staff respected people's privacy and dignity.

The provider assessed, recorded and reviewed people's care and support needs with them. People’s support plans reflected their individual preferences and included information about what was important to them. People took part in a range of social and leisure activities both within the service and the local community.

People had the opportunity to express their views and be involved in planning their own care and support. Other stakeholders were happy with the service provided and felt people's needs were met.

There were appropriate systems to audit the service and to ensure good quality care was provided.

Records were accurate, up to date and appropriately maintained.

We looked at the support plans for two people using the service and the pre-admission file for one person who was due to start receiving support shortly after our inspection. We saw support plans detailed people's needs and the support their care workers should provide. The plans were updated regularly and people were involved in reviewing the care and support they received.

The provider had policies and procedures for safeguarding people using the service. Care workers were trained to identify possible abuse.

We looked at the staff rotas and saw there were enough staff on duty at all times to meet people's care needs.

There were procedures in place for responding to complaints. Representatives of people using the service told us they knew how to make a complaint and they were confident they would be listened to. The provider told us there had been no formal complaints since our last inspection in November 2012.

People's comments included 'communication with the manager and care workers is very good. They make sure my [relative] is safe at all times'. 'The care is good, they look after people. I'd give them 101%.' 'I like it, it's quiet and I get on with everybody. I've made a few complaints, nothing major, but the manager sorted them out for me'.

We found that the care needs of people using the service were apprpriately assessed and clearly recorded in their care plans. Risk assessments had been completed to make sure that people were cared for safely. We saw that the agency had thorough recruitment policies and procedures to make sure that all required pre-employment checks were carried out. This meant that people using the service were cared for and supported by suitable staff.