Pheonix Healthcare

Updated 14 April 2022

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 checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are 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 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on 4 March 2022 and ended on 8 March 2022. We visited the office location on 4 March 2022 and completed telephone calls to people and relatives on 7 March and 8 March 2022.

What we did before the inspection

We reviewed information we held and had received about the service since the time of registration. We sought feedback from the local authority, safeguarding team and other professionals who work with the service. We checked information held by Companies House and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. Due to technical problems, the provider was not able to complete a Provider Information Return (PIR). A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people and six relatives about their experience of care and support provided by the service. We spoke with the nominated individual about their oversight of the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with a care worker and the care coordinator. We contacted the local authority safeguarding and commissioning teams. We reviewed a range of records. This included eight people’s care records, medicines administration records and eight staff personnel files. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We requested and received further care records, quality assurance documents, and were provided with a variety of additional evidence for consideration.

Updated 14 April 2022

About the service

Pheonix Healthcare is a care at home service providing personal care. The service provides support to older adults, some of whom may live with physical disabilities. At the time of our inspection there were 13 people using the service.

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

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

People said their support visits were always completed. However, there were multiple instances where the visits did not last for the scheduled period of time. Visits were sometimes not carried out at the planned time. Risk assessments such as premises, food hygiene and moving and handling were completed however some without much detail. Staff personnel files required improvement. There were conflicting start dates against when criminal history checks were obtained and some missing staff employment references. There was, however, evidence of remedial actions to try and fill some of the gaps and omissions made historically. There was sufficient personal protective equipment (PPE). Investigations of incidents and accidents were satisfactory.

The quality of the information in people’s care documentation was not consistent; the templates used were satisfactory. Tasks written in people’s daily notes were included within their care plans but for some people the information was not recorded, for example a task of applying a skin cream. The training matrix did not list training about mental capacity, and there was no evidence of catheter awareness training. Consent forms were in place and were signed. Some staff competency assessments were missing. There were satisfactory supervision records.

People and relatives said staff were kind and caring. There were some compliments recorded by the provider. The care records indicated whether people and relatives contributed to the care plans or care plan reviews.

Person centred language was not always used in people’s daily notes. We made a recommendation about care plans. Most of the notes were focused on the tasks that were completed with little to no information about the person's physical, emotional or social wellbeing Examples included pads being changed and creams being applied. Complaints management was satisfactory and there were good investigations. Information about do not resuscitate orders in the electronic care system required review. There was no record of people’s end of life preferences.

There was no manager registered with CQC. The provider was carrying on the service from a location that was not registered, but had submitted applications to CQC. There were some people, staff, and relatives’ surveys but they did not have analysis completed to understand key themes and trends. Staff meetings were held, however where there were actions to be taken there was action plan and not always a due date or named staff member responsible. A service or continuous improvement plan was not in place to capture actions where the provider found improvement was needed. Audits had taken place on personnel files, care files and staff training. However, audits were not completed on a regular basis and did not always follow up what was found at the previous audit.

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 however did not support 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

This service was registered with us on 13 January 2021 and this is the first inspection.

Why we inspected

This was a scheduled inspection based on the date of the provider’s registration.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.