We carried out a review of the data available to us about Phoenix Homecare (Norfolk) Limited 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 Homecare (Norfolk) Limited, you can give feedback on this service.
Phoenix Homecare (Norfolk) Ltd is a homecare service that provides care and support to people in their own homes. Not everyone who used the service received the regulated activity of personal care. CQC only inspects where people receive personal care; this is help with tasks related to personal hygiene and eating. Where they do receive personal care, we also consider any wider social care provided.
People’s experience of using this service and what we found:
The service promoted an open and person-centred culture. People, relatives and staff told us the provider was approachable and supportive. The provider monitored the quality of care provided and acted to make improvements when shortfalls had been identified. However, they needed to develop their knowledge in some areas of legislation to ensure they were fully working within the necessary requirements.
Staff sought people’s consent and people were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, written consent had sometimes been obtained from people who had no legal authority to give such consent. We have therefore made a recommendation in relation to obtaining consent.
People received care that met their individual needs, and this included at the end of their life. At this time, staff worked closely with other professionals to ensure people’s wishes were met. However, people’s wishes regarding this area had not been routinely assessed whilst they were well. This would ensure they received the care they wanted should they become ill and their health deteriorate rapidly. We have therefore made a recommendation in relation to end of life care.
People told us they felt safe when the staff provided them with care. Risks to their individual safety had been assessed and staff had a good knowledge on how to support people to remain safe. People received their medicines when they needed them and there were enough staff to complete people’s care visits. When things had gone wrong, lessons had been learnt to prevent the issues from re-occurring in the future. The required checks had been made on new staff to ensure they were of good character and safe to work within the service although records regarding this had not always been kept as is required.
Staff had received enough training and supervision to enable them to have the skills and knowledge to provide people with good quality care. People received assistance with eating, drinking and their healthcare needs where this was part of their care package. The service alerted other professionals and worked with them when needed to ensure people were safe and received the care they required.
People and relatives told us staff were kind, caring and treated them and/or their family members with dignity and respect. People’s independence was encouraged. People were able to make decisions about their care and this was respected by the service.
Rating at last inspection:
The last rating for this service was Good (published February 2017).
Why we inspected:
This was a planned inspection based on the previous rating.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The service provided domiciliary care and at the time of our visit was supporting approximately 87 people with a range of different support packages including domestic support, help with personal care and overnight sits.
The service had two registered managers in post. 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.
The service was well managed with two registered managers both overseeing different areas. Together they formed an established team who knew their business well. They had worked within the care profession for many years and had extensive knowledge of the resources in the area and professional contacts. There were enough staff to deliver the care at the time they it was needed.
The feedback we received about the service was good. People using the service understood the role of the service and were positive about the care that they received and the management team. People knew how to contact the office and told us that they were kept informed if for any reason there was a change in the staff member providing their care or if staff were running late. People told us they had not had any missed calls and the agency provided a reliable service. People benefited from being supported by regular staff with whom they had established a strong bond and who were familiar with their needs.
Care plans were implemented quickly following an assessment of a person’s needs. Staff were familiar with people’s needs and referred to care plans to help inform their care practices. People told us care plans were not reviewed regularly and there was some discrepancy in how often they should be reviewed.
The agency had robust staff selection and recruitment procedures in place to help ensure only suitable staff were employed. Staff received excellent training and a thorough initial induction to help ensure they had the right competencies and skills to fulfil their role. The service also provided on going opportunities for staff to further develop their knowledge and skills. However, staff were not provided with regular formal supervision sessions and we were not assured that there were adequate systems in place to monitor staff competencies and practice
Some people required staff to administer their medication, whilst other people were able to take their own medication with staff prompting them when required. Training was given to staff and staff were observed by senior staff to ensure they were competent to undertake this task. However, we found that the auditing of medication records could be improved upon. We also had concerns about the processes that were in place to support a person who took their own medicines but were not consistently able to so reliably.
Staff knew how to safeguard people and protect them from abuse. Systems were in place to assess and manage potential risks to people. However, risk assessments needed to be more robust and the service were not adequately protecting people’s personal information. There were also systems in place to ensure risks were adequately managed. Risk assessments could be more robust. The service was not adequately protecting people’s personal information.
People gave their consent before care and treatment was provided. Staff had been provided with training in the Mental Capacity Act (MCA) 2015 and Deprivation of Liberty Safeguards (DoLS). People were supported in line with the legislation of the MCA and no unnecessarily restrictive practices were in place. The MCA and DoLS ensure that, where people lack capacity to make decisions for themselves, decisions are made in their best interests according to a structured process.
People were encouraged to eat and drink and staff kept detailed records showing how people’s needs were being met. These provided evidence that staff were acting upon concerns and changes to people’s health and ensured that people received timely medical intervention as needed.
The service took into account feedback from people to shape and improve the service. The service was responsive to people’s needs and communication was described as excellent by staff and people using the service.
Staff were caring and helped facilitate people’s independence and promote their well-being. Care was provided in a respectful, consultative way.
The service was well- managed which enabled it to provide effective care that was flexible and reliable. Staff felt well supported however, the systems in place to support staff needed further review.
The service had systems in place to monitor the service it provided and respond to feedback about the service.
We looked at four care plans for people who received support from the agency. Care plans contained detailed information that provided staff with enough information to meet the needs of people using the service. During our conversations with people using the agency and with family members, we were told that staff 'Are wonderful and support independence.' When asked, people confirmed that any changes to their needs were supported and implemented immediately in their care plan. This meant that people retained total control over what assistance they received on a daily basis.
The provider ensured that safety checks such as Disclosure and Barring Service (DBS) and identity checks were completed for all staff prior to their commencing employment with the service. People we spoke with told us that they thought staff knew their job and that they knew how to provide any assistance in an appropriate way.
People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider had taken steps to provide support and care from an environment that was adequately maintained.
The provider had an effective system to regularly assess and monitor the quality of the service that people received. Any necessary action was carried out and documents showed us that this was the procedure that had been followed.
We reviewed three people's care plans which documented personal information, emergency contact information, a safety inspection and manual handling risk assessment and saw copies of the person's personal plan.
We spoke to three carers (two over the telephone) who demonstrated a good understanding of safeguarding processes and told us what incidents or concerns they would report. They told us they were happy working for Phoenix Homecare (Norfolk) Ltd and felt supported by their managers and were able to discuss matters at any time.
The provider had systems in place to assess and monitor the quality of the services provided, including feedback from people using the service.