Background to this inspection
Updated
7 October 2023
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 was carried out by 2 inspectors on site and 2 Experts by Experience off site. 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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post; the previous registered manager left several months prior to the inspection. The nominated individual was acting as the manager and intended to apply to become the registered manager.
Notice of inspection
We gave the service short notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with nine staff, six people that use the service, and seven relatives. We reviewed a range of records including care plans, recruitment files, training records, audits and safeguarding records. We spoke with the nominated individual and another director. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
Updated
7 October 2023
About the service
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.