Background to this inspection
Updated
19 March 2020
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 Care Act 2014.
Inspection team
This inspection was undertaken by one inspector.
Service and service type
Phoenix Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they 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 4 hours’ notice of the inspection on the 30 January 2020. This was because the service is small, and people are often out and we wanted to be sure there would be people at the service to speak with us. We told the provider we would be returning for a second day on 11 February 2020.
What we did before the inspection
We looked at information we had received about the service since the last inspection. We asked for feedback from professionals who work with the service. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke briefly with three people who lived at Phoenix House about their experience of the care provided. We spoke with four members of staff including, one of the providers, the registered manager, the deputy manager and a member of care staff
We looked at a number of records. This included two people’s care records, two people’s medication records.
Updated
19 March 2020
About the service
Phoenix House is a residential care home providing personal care to seven people who are living with a learning disability at the time of the inspection.
Phoenix House accommodates seven people in one adapted building over two floors.
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. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The service was not well managed, and the registered manager lacked oversight of staff training, recruitment processes, medicines management and there was not a system in place to monitor the quality of the service.
Risks had not all been identified and minimised to ensure people were kept safe. Staff had not received regular training to ensure their skills and practice was being kept up to date.
There were enough staff available to ensure people’s needs were met at all times. Staff had time to support people with their interests and activities.
Staff did not have clear guidance in place that detailed what medicines people were prescribed and to ensure they were administered in line with the prescriber’s instructions. We have made a recommendation to seek further guidance from National Institute of clinical Excellence (NICE) in managing medicines in care homes.
Care plans did not all provide enough guidance to ensure staff had the detail one how to provide care and support to people in line with their needs and choices. We have made a recommendation to seek further guidance from NICE on best practice.
People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; although the policies and systems in the service were limited.
Staff felt well supported although they had not received any refresher and up to date training.
Staff were caring in the way they supported people with their needs.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 4 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified three breaches in relation to medicine management, recruitment and good governance at this inspection.
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.