Archived: St Anne's Community Services - Phoenix Court

Phoenix Court is a residential care home providing personal care for up to 7 people with a learning disability and autistic people. At the time of our inspection there were 5 people using the service.

People’s experience of the 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 assessment 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 not always identified, assessed or mitigated. Medicines were not always managed safely. Staffing arrangements need to be reviewed as although there were enough staff to keep people safe, additional duties impacted on the level of support staff could provide. Thorough recruitment processes were not always implemented. Quality assurance processes were not robust as some issues we found at inspection had not been identified or addressed. However, the provider acted promptly in taking action to address the issues and made improvements during the inspection. 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:

People were comfortable and relaxed around each other and in the company of staff. Staff knew people well and had developed positive relationships with individuals. The management team were in the process of updating support and care documentation. Some records contained person-centred information, but others lacked detail and did not accurately reflect people’s needs. Systems were in place to safeguard people from abuse.

Right Culture:

People were supported with social activities and accessing the community. Staff involved and encouraged people with daily living activities such as preparing and serving meals. People were supported to keep in touch with relatives and friends who could visit at any time.

A new manager started in post on the first day of the inspection. Apart from the manager, no senior staff were employed which meant staff roles were not clear in terms of who took responsibility and was in charge when the manager was off. The provider had an action plan in place to make improvements to the service and was working with external stakeholders to implement the changes.

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 on 9 December 2020. There were no breaches of regulations, however, we made a recommendation in relation to medicines.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for St Annes Community Services – Phoenix Court on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to regulations 12 and 17.

Please see the action we have told the provider to take at the end of this report.

Follow Up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The environment was clean, hygienic and well ventilated.

The provider had arrangements in place to test people and staff for COVID-19.

Staff supported people to keep in touch with family and friends through telephone and video calls and provided individualised support to maintain people’s wellbeing and prevent social isolation.

Signage around the home promoted the use of personal protective equipment (PPE) and good hand hygiene practices

Further information is in the detailed findings below.

This inspection took place on 14 March 2018 and was unannounced which meant the provider did not know we would be visiting.

A registered manager was 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.

Staff told us people were safe and understood safeguarding and whistle blowing procedures. People lived in a safe environment and risks to people had been identified, assessed and managed through the support planning process. The same workers provided support so people received consistent care. We have made a recommendation about the management of some medicines.

Staff received training and support which enabled them to do their job well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People received a balanced and varied diet, and accessed services which ensured their health needs were met.

Throughout the inspection we observed staff were friendly and caring in their approach. They knew people well and talked about things that were important and relevant to the person. The provider promoted people’s rights and had systems in place to ensure people were not discriminated against.

People received person centred care. Support plans were comprehensive and reviewed regularly. Annual review meetings were held which involved the person and others who were important to them. People had opportunity to engage in varied in house and community activities. They were supported to maintain relationships. Relatives we spoke with said they knew who to speak with if they wanted to discuss anything or to raise concerns. They said staff were approachable and had “time to listen”.

The registered manager had good knowledge of the day to day running of the service as well as their overall responsibilities. Relatives and staff we spoke with told us the service was organised and well managed. The provider had systems and processes in place to make sure safe quality care was being provided.

Further information is in the detailed findings below.

Phoenix Court is a care home registered to provide personal care with nursing for seven adults with learning disabilities. The home is a detached property located in a residential area of Todmorden close to the town centre. The accommodation is provided in single rooms on two floors. Each floor has a kitchen, a lounge and communal bathrooms and toilets.

The last inspection was carried out on 13 November 2013. At that time we found there was one breach of regulation relating to the safety of the premises. The provider sent us an action plan with details of the actions they planned to take. During this inspection we checked and found the provider had taken appropriate action.

The registered manager had been in post for approximately a year at the time of the inspection. 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 living at the home were safeguarded from abuse. Staff were trained to recognise and report abuse and understood their responsibilities in this area. There were enough staff to meet people’s needs and all the required checks were carried out before new staff started work. This helped to protect people from the risk of receiving care and treatment from staff unsuitable to work in a care setting.

People’s medicines were managed safely. There were processes in place to check medicines and we saw when errors had occurred actions had been taken to ensure people were safe and reduce the risk of it happening again. However, we found the Commission had not always been notified about these incidents.

The home was clean, well maintained and there was evidence of on-going redecoration and refurbishment. People living at the home were involved in choosing the décor for their bedrooms.

The home was working in accordance with the requirements of the Mental Capacity Act 2005 which meant people’s right were protected.

People were supported to have a varied and nutrition diet which took account of their individual needs and preferences.

People needs were assessed and planned for; people were supported to have access to the full range of NHS services.

Person centred care was promoted by a model of care called Positive Behaviour Support (PBS). PBS is promoted by BILD (British Institute of Learning Disabilities) as the preferred approach when working with people with learning disabilities who exhibit behaviours described as challenging.

People’s care and support plans provided detailed information about how each person preferred their care and treatment to be delivered.

People were supported to maintain relationships with family and friends and to take part in leisure activities in the home and in the community.

The complaints procedure was made available to people who used the service.

The home had a warm and friendly atmosphere and we observed a lot of positive interactions between the people who lived there and staff. The registered manager was enthusiastic and open and staff told us they were well supported and enjoyed working at the home.

The provider had systems in place to assess and monitor the quality of the services provided.

Our observations of the service showed that care staff spoke with and interacted with people who used the service in a patient and pleasant manner. Care staff supported people in a sensitive way using differing methods of communication to ensure that people understood what was going to happen.

The people who used the service appeared happy and comfortable with the surroundings. They appeared to be relaxed with the staff in their interactions with them. We noted that people who used the service had access to a wide range of activities which were personalised to their individual needs.

Relatives we spoke with after our visit were very satisfied with the care. They told us 'staff chat to us' and 'we are comfortable with the way things are.' Another relative said 'It's lovely where he is' and 'staff are good.'