Background to this inspection
Updated
19 September 2019
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
The inspection team consisted of one inspector, one assistant inspector 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 homes.
The service has two managers registered with the Care Quality Commission who were the sole directors and the provider. They are legally responsible for how the service is run and for the quality and safety of the care provided. They will be referred to as the provider throughout this report.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider would be in the office to support the inspection.
Inspection activity started on 13 August 2019 and ended on 15 August 2019 when we visited the office location.
What we did before the inspection
Before the inspection visit to the office location, we reviewed the information we held about the service and the provider. This included any notifications the provider had to send us by law and information we had received from members of the public about the quality of care being provided. We also reviewed the information the provider had sent to us in their Provider Information Return. Providers are required to send us key information about their service, what they do well and improvements they plan to make. We obtained feedback from the local authority who were a commissioner of the service. We used all this information to plan our inspection.
During the inspection
We spoke with eleven people and six relatives about their experience of the care provided. We also spoke with ten members of staff including seven carers, the finance officer, and the two directors of the provider, one of whom was the nominated individual for the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included six people's care records and four medicine records for three people. Three staff recruitment and training records were also reviewed along with a variety of records relating to the management of the service including how the provider monitored the quality of care people received.
Updated
19 September 2019
About the service:
Phoenix Homecare (Norfolk) Ltd is a homecare service that provides care and support to people in their own homes. Not everyone who used the service received the regulated activity of personal care. CQC only inspects where people receive personal care; this is help with tasks related to personal hygiene and eating. Where they do receive personal care, we also consider any wider social care provided.
People’s experience of using this service and what we found:
The service promoted an open and person-centred culture. People, relatives and staff told us the provider was approachable and supportive. The provider monitored the quality of care provided and acted to make improvements when shortfalls had been identified. However, they needed to develop their knowledge in some areas of legislation to ensure they were fully working within the necessary requirements.
Staff sought people’s consent and people were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, written consent had sometimes been obtained from people who had no legal authority to give such consent. We have therefore made a recommendation in relation to obtaining consent.
People received care that met their individual needs, and this included at the end of their life. At this time, staff worked closely with other professionals to ensure people’s wishes were met. However, people’s wishes regarding this area had not been routinely assessed whilst they were well. This would ensure they received the care they wanted should they become ill and their health deteriorate rapidly. We have therefore made a recommendation in relation to end of life care.
People told us they felt safe when the staff provided them with care. Risks to their individual safety had been assessed and staff had a good knowledge on how to support people to remain safe. People received their medicines when they needed them and there were enough staff to complete people’s care visits. When things had gone wrong, lessons had been learnt to prevent the issues from re-occurring in the future. The required checks had been made on new staff to ensure they were of good character and safe to work within the service although records regarding this had not always been kept as is required.
Staff had received enough training and supervision to enable them to have the skills and knowledge to provide people with good quality care. People received assistance with eating, drinking and their healthcare needs where this was part of their care package. The service alerted other professionals and worked with them when needed to ensure people were safe and received the care they required.
People and relatives told us staff were kind, caring and treated them and/or their family members with dignity and respect. People’s independence was encouraged. People were able to make decisions about their care and this was respected by the service.
Rating at last inspection:
The last rating for this service was Good (published February 2017).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk