Phoenix Care

Phoenix Care is a service providing personal care to people in their own homes. This included older people, people with physical disabilities, people with dementia, people with mental health conditions and people with a learning disability. At the time of inspection 29 people were receiving the regulated activity of personal care. Not everyone who used the service received personal care. The Care Quality Commission only inspects where people receive personal care. Personal care is help with tasks related to personal hygiene and eating, we also consider any wider social care provided.

People’s experience of using this service and what we found

People told us they were happy with the care provided. One person told us; “the staff are amazing; they work at a pace which makes me feel confident”. People we spoke with had not had any concerns and knew who to contact if they did. Feedback from relatives was also positive. One relative described care staff as “very patient and kind”, and another felt staff were “pleasant, approachable and friendly”.

We received mixed feedback from staff. Some staff told us they did not feel training was effective because this was mostly online. We found there was not always oversight to ensure staff had completed relevant training before supporting people. We found some improvements were required around recruitment of staff. This included ensuring all staff had a full employment history and checks on people’s identity.

Care plans were written in a way that promoted people’s dignity, respect and independence, and these were detailed. Audits and spot checks had taken place, but these did not always occur on a regular basis and were not always effective in identifying areas for improvement.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 06 August 2021) and there were breaches of regulations. At this inspection we found the provider remained in breach of regulations for regulation 12, regulation 17 and regulation 19.

At our last inspection we recommended that the provider sought guidance on how to improve their safeguarding processes, how to ensure care plans contain adequate information in line with current best practice, and how to ensure people's communication needs were met. We found some improvement in relation to care plans and people's communication needs. However, we found safeguarding allegations were not always notified to the CQC.

Why we inspected

The inspection was prompted in part due to concerns received about clarity of care plan guidance for staff, infection control procedures, and concerns around staff working excessive hours. A decision was made for us to inspect and examine those risks. We did not find these concerns to be substantiated at this inspection, however we did find breaches of regulation in other areas.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to people’s safety, recruitment and management systems at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Phoenix Care is a service providing personal care to people in their own homes. This included older people and people with mental health conditions. Small teams of staff were allocated to each person. At the time of inspection 69 people were receiving the regulated activity of personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. Personal care is help with tasks related to personal hygiene and eating, we also consider any wider social care provided.

People’s experience of using this service and what we found

People and their relatives were positive about the care they received from staff. Comments included, “They are very, very good”, “My carer is very helpful to me”, and “It is excellent, it really is.”

However, we found improvements were required in several areas which placed people at risk of receiving poor and potentially unsafe care. Care plans lacked details, when regular staff were not available there was limited guidance for new or agency staff to follow. Risks had not always been assessed or mitigated. Medicines were not always managed in line with current best practice.

People, their relatives and staff felt staff were not rushed and had time to travel. Systems were in place to monitor missed calls and provide an on-call service for staff. However, recruitment of staff was not always in line with current legislation to protect vulnerable people.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

Management systems were currently not effective to drive improvement and identify concerns as they arose. Reliance had been placed on external organisations and the structure of staffing needed to be embedded.

We made two recommendations around safeguarding and person-centred care planning.

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

Rating at last inspection

This service was registered with us on 20 December 2019 and this is the first inspection.

Why we inspected

This inspection was the first inspection based upon the registration date and was prompted in part due to concerns received about safe care and treatment, medicine management, recruitment and leadership and management. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well led sections of this full report. You can also see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to managing risks to people, recruitment of staff, decision making for people who lack capacity and management of the service at this inspection.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.