We carried out a review of the data available to us about Phoenix Bespoke Support 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 Bespoke Support, you can give feedback on this service.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
Staff supported people exceptionally well to live as independently as possible and be in control of their daily lives. Innovative uses of social stories and communication enabled people to achieve goals that would ordinarily have been very challenging for them. Staff and management used a range of communication strategies and accessible materials to ensure people were able to fully express their views and have full involvement in decision making that affected them. People were provided with consistent choice and involvement in all their decision-making and families were involved where they wanted to be. People were supported by staff to take up voluntary employment which helped them to maintain their independence. People’s risks in relation to their care were managed well. Staff understood how to maintain and improve people’s independence, including taking positive risks. There were sufficient staff to meet people’s needs and we were assured that the service was following good infection prevention and control (IPC) procedures to keep people safe. People and their relatives felt respected, valued and listened to.
Right Care:
People and their relatives told us they felt supported by staff in a kind, caring and dignified way. People’s differences were respected by staff and they had undertaken relevant training to effectively support people. People told us that the care they received was consistent and that staff knew them well. Managers matched people with care workers of their choice, who understood them and enhanced their care experience. People were able to choose their meals with appropriate support from staff. People’s right to privacy was respected and staff encouraged people to regularly provide feedback about the care provided. Care plans were personalised and included information on people’s healthcare needs, preferences, challenges and hobbies. People’s preferences and abilities in relation to oral care were recorded clearly in care plans.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Culture:
The culture of the service was open, inclusive and empowered people to live independent lives. People and their relatives were complimentary about the service and felt their ideas and concerns would be listened to by management. Relatives told us they felt that staff had helped their loved ones become more confident and independent. Management had undertaken regular audits to look at ways of improving the service and identifying issues. Staff were complimentary about the management of the service, felt valued and told us they were able to raise concerns with the manager. Staff were encouraged by management to undertake training. Staff treated people equally in line with their beliefs, opinions and preferences. Meaningful relationships had been developed between people, their relatives and staff. People felt comfortable and trusted the care workers. Caring for people’s wellbeing was an important part of the services philosophy. People had a regular team of care workers and felt they had become part of the extended family.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service was outstanding published on 9 May 2018. At this inspection, the rating has changed to good.
Why we inspected
The inspection was prompted in part due to concerns received about care delivery. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
At the last inspection in September 2015, the service was rated as good in the areas of Safe, Effective, Caring and Well Led. The service was rated as outstanding in Responsive and received an overall rating of good.
At this inspection, we found the service had improved and was now outstanding in two areas and good in three areas. The overall rating had improved to outstanding.
This comprehensive inspection took place on 8 & 9 February 2017 and was announced. There were 10 people receiving care from the service. Their hours of care delivered ranged from 15 hours a week to full time 24 hours a day.
There was registered manager in post. A registered manager is a person who has registered with the 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.
The care people received was outstanding. Staff treated people with respect, dignity and compassion. They were motivated, passionate and proud of their jobs. Outstanding and innovative care practices were delivered by staff to maximise people’s independence and help them achieve significantly positive life experiences. People were at the heart of the service. Staff knew what mattered to people the most. They recognised how important it was for families and friends to be involved in people’s care, support and wellbeing. They were supported to lead as good a quality of life as possible, and experienced close, trusting relationships with staff who were highly motivated, exceptionally caring and who knew them well. Staff and management demonstrated their empathy and compassion for people in their consistent willingness to go the extra mile.
The strong person centred culture within the service empowered people, enabling them to live full, vibrant lives and achieving exceptional outcomes for individuals. People received a bespoke package of care and support, reflecting their diverse needs and requirements. Personalised support plans emphasised people’s strengths, abilities and what was of greatest importance to them. Through adhering to these staff provided consistent, person centred support that enhanced people’s health, wellbeing, and independence. People’s involvement in their local community was actively encouraged, along with their access to a wide range of work opportunities and leisure activities.
Staff treated people equally in line with their beliefs, opinions and preferences. Meaningful relationships had been developed between people, their relatives and staff. People felt comfortable and trusted the care workers who came into their home. Caring for people’s wellbeing was an important part of the services philosophy. People had a regular team of care workers and felt they had become part of the extended family. People and their relatives felt respected, valued and listened to. Staff and management used a range of communication strategies and accessible materials to ensure people were able to fully express their views and have full involvement in decision making that affected them.
Staff received the training, supervision and ongoing support needed to fully succeed in their roles and to continually improve their knowledge and skills. Respect for people’s privacy, dignity and human rights was at the heart of the service. Staff had a good understanding of equality, diversity and human rights.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice. Staff had received training on the Mental Capacity Act 2005. They ensured people were asked for their consent before they carried out any care or support.
People were cared for by staff who were aware of their safeguarding responsibilities. Staff had received training in how to safeguard people from potential abuse and knew how to identify the risks associated with abuse. Staff were safely recruited, trained and supervised in their work.
Each person had risk assessments and a care plan in place. People and their families were involved in the planning of their care and these were regularly reviewed. When changes in care and support were required, these were carried out in a timely way.
Staff had been trained to give people their medicines safely and ensured medication administration records were kept up to date. Staff supported people to eat a nutritious diet with food and drinks of their choice and culturally appropriate diets and requests were catered for. People were encouraged to express their views and had completed surveys. They also said they felt listened to and any concerns or issues they raised were addressed. Technology was used to assist people’s care provision.
Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where managers were always available to discuss suggestions and address problems or concerns. The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.
We inspected Phoenix Bespoke Support on the 25 September 2015 and it was an announced inspection.
Phoenix Bespoke Support is a domiciliary care agency providing personal care for a range of people living in their own homes and supported living environments in the Croydon area. People using the service may have a learning disability, mental health issues, emitted challenging behaviour and may have autistic spectrum disorder. At the time of our inspection, the service was supporting eight people and employed approximately nineteen members of staff.
A registered manager was 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.
People and staff spoke highly of the service. One relative told us, “We are very happy with the care my [relative] is receiving”. Another relative said, “I am really very happy with the care provided”. A further relative told us, “[My relative’s] dream was always to live independently. My [relative] is really happy living independently and Phoenix Bespoke Support have been instrumental to that”.
People told us they received their care calls consistently and always received the care they needed. Risks to people were assessed and monitored to ensure action was taken to avoid accidents and the deterioration of people’s health. The service had recruited a sufficient number of suitably qualified staff to meet people’s needs. Recruitment practice was robust and protected people from the risk of receiving support from staff who were unsuitable. People received the support they required with their medicines.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. Staff commented they felt valued and enjoyed working for Phoenix Bespoke Support.
The service was very flexible and responsive to people’s individual needs and preferences, and found innovative and creative ways to enable people to live as full a life as possible. People told us that staff had an excellent understanding of their social and cultural diversity, values and beliefs. A relative told us, “[My relative’s] care workers share the same beliefs as our family. The choice of care workers was particularly important. They support [my relative] to go to the library, and go swimming and shopping”. People were supported to access the community and follow diverse hobbies and interests. They said that staff assisted them to achieve their goals and ambitions, such as attending college, living independently and organising a boat trip. The support people received promoted positive care experiences and enhanced people’s health and wellbeing.
Staff were able to accommodate changes to care calls or requests for urgent care. Staff regularly fed-back concerns to the registered manager. Where people’s health had deteriorated, the service responded in a timely manner and people were supported to access healthcare services.
Staff knew how to support people and help maintain their safety. They understood their responsibility to protect people from harm and abuse and they felt able to report any concerns appropriately.
People confirmed staff respected their privacy and dignity. Staff had an excellent understanding of respecting people within their own home and providing them with choice and control. The service had identified people’s needs and preferences in order to plan and deliver their care. The provider was innovative and creative in how they enabled people to be as independent as possible, achieve their goals and meet their needs.
People were asked for their views of the service and said they knew how to make a complaint about the service if they needed to.
The ethos, values and visions of Phoenix Bespoke Support was embedded into everyday care practice. The organisation had a strong vision on providing care calls which promoted people’s wellbeing and ensuring they and their families were supported appropriately.
We reviewed this outcome in October 2013, looked at information we had asked the provider to send to us, and spoke with the registered manager of the service.
We saw that the provider had implemented a system to ensure that effective recruitment and selection processes were in place, and that required checks were undertaken before staff began working with people who used the service.
The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us 'I get on great with them they sort out all my finances and help me out'. The relative of a person who used the service told us 'They provide a very good standard of care, it's really professional'. Staff we spoke with had a good understanding of the support needs of people who used the service. One member of staff we spoke with told us 'We are there for them. We give them choice and plenty of support'.
Staff we spoke with said that they had undertaken training for safeguarding vulnerable adults and children. We saw systems and accessible information in place in respect to safeguarding. We also saw that the service had systems in place to monitor the quality of the service provided, and to gain the views of the people who used the service.
However, during our inspection we did not see evidence that appropriate pre-employment selection and suitable checking of staff had routinely taken place.