Archived: Phoenix Healthcare & Recruitment

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by the Care Quality Commission (CQC) which looks at the overall quality of the service.

This was an announced inspection, we gave the provider 48 hours notice prior to the inspection to ensure we had access to senior staff and information. Phoenix healthcare provides care and support to people in their own homes. They provide this to adults and children with learning disabilities, physical disabilities and to older people living with dementia. At the time of our inspection they were supporting 19 people.

At our previous inspection in March 2014 the provider was meeting the requirements of the law in relation to consent to care and treatment, care and welfare of people, safeguarding people from abuse and how the quality of the service was monitored.

The service did not have a registered manager in place at the time of this inspection. The previous registered manager had not been working at the service for the two months prior to the inspection. The deputy manager had been covering in their absence. They had not registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. At the time of the inspection the people we spoke with and the staff were unclear of the management structure within the service.

We had difficulty accessing information about people’s care and how the service operated at the time of the inspection and afterwards. This was because the acting manager was not fully aware of what information the provider held or where to locate it. After the inspection the acting manager failed to respond to requests to send us further information. Not all information we requested was provided.

People told us contradictory things about the service they received. While some people were very happy, others were not. Our own observations and the records we looked at did not always match the positive descriptions some people had given us.

People’s safety was being compromised. One relative told us staff had not turned up on time for calls and some calls had been missed. Other people told us the staff turned up regularly on time and the service was good.

Risks identified in people’s care plans had not all been assessed. Training for staff in relation to risks and promoting some people’s health had not been provided. For example, how to protect people’s skin from pressure damage. Staff said the online training that was provided in other areas was not effective or helpful. Staff did not recognise and take preventative action when a person’s health deteriorated. Their relative felt the delay in the staff response meant the person’s recovery was prolonged.

Senior staff did not know how to identify possible abuse or how to report it. People’s mental capacity to make decisions and choices for themselves had not been assessed. This meant the provider could not show if they were acting in the person’s best interest. Staff did not always have access to the detailed guidance they needed to safely and effectively support people whose behaviour could be challenging.

Staff cared about the people they supported. They had formed relationships with people and told us they knew how to provide care and support in the way the person wanted. However, care plans were not reviewed at regular intervals which meant they may not be up to date or effective. Where people or their relatives had been given the care plan to approve, their comments or changes had not always been taken into account.

There was no evidence the provider regularly requested feedback from staff or people or their representatives on how the service could improve. The provider failed to meet their legal obligation of sharing information with the CQC regarding events that occurred within the service. This was because they did not know how and when they had to do this.

The provider had in place a complaints procedure. People and their relatives told us when they had made complaints the provider had listened and taken action to improve the service. They told us they were satisfied with the service they were now receiving.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.