Phoenix Care & Support Services 24/7 Ltd

Phoenix Care & Support Services 24/7 Ltd is a domiciliary care and supported living provider delivering personal care and support to people in their own houses and flats. At the time of our inspection there were 32 people receiving a 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

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.

Right Support:

Risks to people were assessed and regularly reviewed. Since the last inspection risk assessments had been improved to make them more specific to people’s individual risks. Positive risk taking was encouraged. People told us they felt safe. Their relatives and professionals agreed. People appeared calm and happy in staff company.

A familiar and consistent group of staff meant they knew people well and understood their specific needs. People and relatives knew how to complain should they need to and were confident timely and appropriate action would be taken to resolve issues. People were supported to maintain contact with family and friends and take part in activities of their choice.

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 Care:

Recruitment procedures had improved since the last inspection and were now robust. Staff demonstrated a good understanding of how to protect people from poor care and abuse. People received their medicines on time and as prescribed. Accidents and incidents were reported and follow up action taken including sharing learning to prevent recurrence.

Since the last inspection sensitive discussions had taken place with people to help ensure their preferences about end of life care were known and documented. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right Culture:

Since our last inspection improvements had been made to the governance systems and oversight of the service. This helped to ensure and maintain care quality and safety. There was an open and supportive culture at the service. Staff got on with their colleagues, felt valued and enjoyed their work. Staff were supported and encouraged to take on new skills and qualifications.

Surveys were used to gather feedback from people, relatives and staff. Feedback was positive and all felt listened to. The management team were seen as approachable and very supportive. The service worked well with other organisations and recognised the benefits to people of establishing and maintaining links with the wider community.

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 this service was requires improvement (published 4 February 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

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

Phoenix Care & Support Services 24/7 Ltd is registered to provide personal care to people living in their own homes. This includes support with personal care, such as assistance with bathing, dressing, eating and medicines. We call this type of service a 'supported living' service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care. At the time of the inspection 22 people were receiving a service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

Whilst people using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. The service didn't always apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. We found some examples of choice and control being restricted. Since the inspection the provider has reviewed their monitoring of the service to ensure people have full choice and control in their homes in the least restrictive way possible.

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

People's rights to make their own decisions were not always respected. People’s tenancy agreements were not independent of the care provided which restricted their choice and control. We visited one home where there were restrictions in areas of people’s home due to locked doors. Following the inspection, the registered manager told us they had reviewed their tenancy agreements and issued new ones where required.

Although the service was run from the providers office, staff told us they received supervisions and staff meetings at the homes they were working from. The practice of holding meetings for staff in people’s homes does not reflect good practice or the model of supported living.

People told us they received safe support from staff they knew well. However, there was a risk that some people may not always receive the correct numbers of staff to support them’. Some people had the support of a live-in care worker but were also funded for the support of a second care worker to move them safely. There were occasions when only one staff member was on duty, or the second care worker had to be called from their home.

Risk assessments covered care needs such as mobility, their home environment and other individual health conditions. However, they did not always take into consideration the least restrictive option. Staff told us they did not complete incidents and accidents forms but did contact the office if there had been any. This meant there was a risk that any learning which may help prevent reoccurrence may be missed.

People told us they were pleased with their care and that they felt involved in decisions. They had effective caring relationships with staff who provided their care and support. Staff could explain how different support worked for different people.

People were encouraged to remain independent and safe. People and their relatives told us they had good community networks which were personal to them. This included work opportunities, day service and supporting people to use technology to connect with family and friends

Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards enabling people to learn essential life skills.

The service had a complaints process in place. People and their relatives told us they knew how to complain if they needed to. There were mixed comments about how people and their relatives would be confident to make a complaint.

People received support to take their medicines safely. Staff had completed training in medicine administration and were assessed as competent. Care plans contained information about health conditions and appointments with professionals. Information was kept updated with changing needs. Appropriate referrals to external services were made to ensure needs were met.

The service was managed by a registered manager who had a clear vision about the quality of care they wanted to provide. Staff were aware of their roles and responsibilities. We received positive feedback regarding the leadership and management of the service.

The registered manager and manager were receptive to feedback throughout the inspection and responded quickly to address concerns and improve the service. They informed us they would be addressing the issues raised in regards the audits of the service.

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 this service was Good (published 5 May 2017 ).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Phoenix Care & Support Services 24/7 Ltd is registered to provide personal care to people living in their own homes. At the time of our inspection the service provided personal care and support for 16 people.

There was a registered manager 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 were positive about the care and support they received. They told us staff treated them with kindness and we saw people were comfortable with staff in their homes. Staff were consistent in their knowledge of people’s care needs and spoke with confidence about the care they provided to meet those needs. They were motivated to provide the best care they could and told us they felt supported in their roles. They had received training that provided them with the necessary knowledge and skills to do their job effectively. Staff kept accurate records about the care they provided.

There were enough safely recruited staff to ensure people were supported in ways that met their needs. People were mostly supported by live in staff and told us this worked well. People were positive about the care they received and told us the staff were friendly and compassionate. Staff treated people and each other with respect and kindness throughout our inspection. We saw they were supported to make choices and these choices were respected by the staff.

People felt safe. They were protected from harm because staff understood the risks they faced and how to reduce these risks. Staff knew how to identify and respond to abuse; including how to contact agencies they should report concerns about people’s care to. People’s medicines and creams were administered safely.

People had access to health care professionals and were supported to maintain their health by staff. Staff understood changes in people’s health and shared the information necessary for people to receive safe care. People chose and when possible prepared their food with support from staff.

Management were committed to making continual improvements to the quality of care. There were systems developing to ensure this as the service grew.