Inspection on 28/01/09 for Phoenix Care Centre

This inspection was carried out on 28th January 2009.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Phoenix Care Centre 30/01/08

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Phoenix Care Centre Ancaster Avenue Chapel St Leonards Skegness Lincolnshire PE24 5SN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ken Hague     Date: 2 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Phoenix Care Centre Ancaster Avenue Chapel St Leonards Skegness Lincolnshire PE24 5SN 01754872645 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Phoenix Care Centre Ltd Name of registered manager (if applicable) Mrs P Hoyes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service uses who can be aqccommodated is 39 The responsible person may provide the following category of service only: Care Home - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home fall within the following categories: Old Age, not falling within any other category - Code OP Physical disability - persons aged 47 years and over - Code PD (maximum number of places 3) Date of last inspection Brief description of the care home The Phoenix Care Centre provides accommodation and personal care for up to thirtynine older residents of both sexes, including up to three people with physical disabilities over the age of 47 years. The home is situated approximately half a mile Care Homes for Older People Page 4 of 27 care home 39 Over 65 39 39 0 39 0 3 Brief description of the care home from the sea front in the resort of Chapel St Leonards, in a suburban area within close proximity to the town?s shops, library, churches, holiday-maker?s and leisure facilities. It is situated on a bus route to the town centre. It is a purpose-built detached care home providing accommodation on ground and first floor levels, in thirty-one single rooms and four shared rooms. The ensuite facilities in all of the upper floor single rooms include showers; those in the ground floor have toilet and washbasins. All the shared rooms have shower facilities. Communally, there is a large lounge and conservatory, which is connected to a dining room. There are three toilets at each end of the building, two bathrooms on each floor and one shower-room on the ground floor. Residents and visitors are able to sit out in the garden. Residents can be taken to do their own shopping and visit the various leisure facilities. There is off road parking at the front of the home. At the time of the inspection the home confirmed that the weekly fees ranged from #348 - #500 depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, can be found in the home?s statement of purpose and service user guide. These documents are available in the reception area. An additional copy is kept in the home?s office. These documents are made available to all new potential residents. The care home does not offer a dedicated intermediate care service. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place over 7 hours. The registered manager and proprietor were given feedback at the end of the inspection. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of eight residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to this report being completed. This is a self- assessment Care Homes for Older People Page 6 of 27 document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. As part of the commissions inspection process an expert by experience is used on the number of key inspections. This is an independent person who has knowledge of the needs of people living in the care home through personal or professional experience of working with people with similar needs. They produce an independent report which is given to the Inspector. The expert by experience gives feedback also to the proprietor and registered manager of the home on their opinion of the service they are providing. The views of the expert by experience is reflected within the main inspection report. On the day of the site visit all residents were spoken to by the expert by experience or the Inspector. The views and comments obtained I reflected within this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive a full comprehensive assessment prior to then being admitted to the home. This ensures that residents needs are identified and can be met by the resources of the home. Evidence: The initial assessments were well structured and very detailed. Each resident had been assessed using the guidelines set out by the home procedures using internal documentation. The detailsl recorded within the assessments exceed that required by national guidelines. There are four sections to be completed at the initial assessment. The guidelines ask the assessor to consider 54 separate areas to ensure a comprehensive detailed assessment of need is established. Evidence was found that the resident and the family been involved in this assessment. All documents were signed and dated by the assessor and where possible signed by the resident. If a document had not been signed by the resident or relative the reason the resident Care Homes for Older People Page 10 of 27 Evidence: could not sign was recorded. Care records provided evidence that the comprehensive assessment is used to provide safe care to the resident on admission and to be used to generate a comprehensive detailed care plan. The registered manager stated that the initial assessment and care plan are reviewed daily for the first two weeks. The assessments were easy to follow were detailed and quickly enables the reader to understand the needs of each resident. The quality of assessment provided evidence that a significant time and effort has been given to each assessment to ensure every aspect is of the residents wishes had been recorded. A number of different assessments had been brought together to complete the final assessment demonstrating a number of skills used by the assessor. Residents confirmed that they wre provided with the information they would need to make an informed choice whether wished to stay at the care home. Residents confirmed that they have contracts with the care home and had been given details of their terms and conditions including the fees for their stay at the home. Residents being case tracked confirmed that assessments had been carried out in a sensitive relaxed manner ensuring that all the information had been documented. The quality of the record substantiated that the staff carryimg out the assessments are well-qualified and skilled in obtaining all information required to ensure all needs are identified and met. The registered manager stated that prospective residents can visit the home if they wish prior to admission. She stated that no one is admitted to the care home until the assessment process has been completed. Discussions with staff and the inspection of records substantiated the statement. The information pack given to prospective residents is comprehensive and includes photographs and a descriptions of the care home. All residents are given a copy of their assessment. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have comprehensive care plans which instruct staff how to provide safe care. Care plans state how the identified needs of each resident can be met while preserving their dignity and privacy. The updated medication procedure of the home ensures the safe administration and storage of medication. Evidence: The care records for three residents were sampled. Each resident had a current care plan which had been reviewed every four weeks. The care plan was written using information obtained at the initial assessment. Care plans contained social need, personal care needs, the wishes of the residents in respect of social activities and the provision of personal care. Care plans tell staff how to meet safely the personal care needs of individual residents. Including giving staff guidance how each task should be caried out but still ensuring that the safety dignity and privacy of residents is maintained. Care plans were written in clear English and were easy to follow and understand. Care Homes for Older People Page 12 of 27 Evidence: All care records were filed in a consistent manner with an index at the front of each residents file. Residents had signed their own individual care plans both when the initial one was written and at each following review. The care plans were very individualised and personalised. The reader can easily understand not only the needs of the residents but also have an insight into them as people and the way they would like to be supported and helped while staying in the home. Care plans identified the personal care needs and instructed staff how to provide safe care while respecting the wishes of each resident. The registered manger stated that personal care is discussed with each resident and they are provided with choices as to how much help they choose to allow care staff to provide. Staff stated that the dignity and privacy of the residents has to be preserved. We therefore give them choices as long as no risk is identified. They decide how much of the personal care we give to them in terms of practicle help and what parts of personal care they choose to carry out themselves with the support of staff. Care plans contained medical history and current medication being taken by residents. Residents confirmed that they had been offered opportunities to self-medicating should a risk assessment confirm that this is safe practice. Residents described their own choices of activities these corresponded with information found on their personal care plans. Any allergies or special dietary needs were recorded on current care plans. The company is developing a new person centered care plan with the aim of ensuring that services are always provided to residents in a manner of their own choice while preserving their privacy and dignity. The new plans are designed to ensure that the detail in respect of wishes in choices are expanded and to demonstrate the involvement of residents in planning the provision of the care being provided to them by the home. The home has a updated medication procedure which ensures the safe administration and storage of medication.The registered manager stated that all residents are offered the opportunity to self-medicating providing a risk assessment demonstrates that this is appropriate. Care records provided evidence that this statement is correct. There were agreements on sampled files in respect of residents who took their own medication which included risk assessments. Staff confirmed that they had been trained in the administration and storage of medication. No evidence was found of any malpractice in respect of medication during the site visit.There have been no notifications of maladministration of medication in the last year.The last pharmacy report was a positive one which contained no recommendations. Care Homes for Older People Page 13 of 27 Evidence: Staff were observed to provide care in a sensitive manner. they were seen not to enter private areas of the care home such as resident bedrooms without their permission. A resident stated I find staff are good here they do treat us with respect. A second resident said staff are courteous and helpful. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities is offered to residents which meets their social needs. The homes menu offers choice and meets in dietary needs of residents. Residents are encouraged to maintain links with their family and friends. Evidence: The menu offers choices to residents. Observations provided evidence that choices are offered to all individual residents and that special dietary needs are being met. Residents stated that they are happy with the quality and quantity of food. The Inspector took his lunch with the residents. All three residents who sat at his table stated that the food is of good quality there is plenty to eat. They stated our personal dietary needs are being met. The registered manager confirmed if there is a need for special diet this is recorded on the individual care plan and the cook informed. Care records demonstrated that staff obtained the likes and dislikes of the residents in respect of their diet and recorded this information on their individual care plan. The registered manager and staff stated that visitors are free to visit at any reasonable time. Resident stated they are encouraged to maintain links with their family. A resident stated my family are made very welcome if they choose they can have the Care Homes for Older People Page 15 of 27 Evidence: meal with me. The AQAA lists a range of activities offered to residents. The proprietor and registered manager stated that the range of activities are to be increased. The registered manager said that additional funding had been provided to purchase equipment to expand on the range of activities open to residents. Work is being carried out in the garden area to allow residents to take activities outside in the summer months. No negative comments were passed whatsoever regarding activities which were taking place on the day of the site visit. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place to protect residents. Staff had been trained to protect residents from potential abuse. Staff feel able to use the whistleblowing procedure if necessary. Evidence: The evidence from the inspection of the complaint procedures, records at the home and discussion with staff and residents is that the complaints procedure is accessible to all residents. This ensures residents can raise concerns or make a formal complaint. No complaints have been received since the last key inspection. Residents stated they were confident in being able to raise concerns with staff and the manager of the home. Residents and staff interviewed during the site visit stated the management are very approachable and would act immediately if any complaints or concerns were raised with them. There have been no notifications since the last key inspection that have raised any concerns. There has been no Adult Protection enquiries held at the home since the last key inspection. The inspection of training records and discussion with staff provided evidence that staff have received training in the identification and prevention of abuse. Staff were aware of the homes whistle blowing procedure and stated they would have no hesitation in using it if they had concerns. staff stated that they had every Care Homes for Older People Page 17 of 27 Evidence: confidence that the home managers will deal with issues without staff needing to use whistleblowing procedures. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean well maintained care home, which provides them with safe comfortable accommodation. The up-to-date infection control policy is followed and a safe environment is maintained. Evidence: The home has an ongoing maintenance program and action plan aimed at improving the homes environment put in place at the time of the change in ownership. The environment of the care home has been improved considerably since the last key inspection. There is a new safe outside area created for residents with new seating and raised gardens. Security lighting has been improved. The main lounge has been decorated and new equipment and fittings purchased. A new stair lift has been purchased. Areas of the home and been decorated including some residents bedrooms. New chairs have been purchased for use in bedrooms. The proprietor has started to create a second patio and sitting area on a balcony at first-floor level. A Residents stated the environment has improved a lot since the change of ownership. The chairs are much more comfortable we have a nice outside area to sit in now. The second resident said they keep the home spotless it is always clean and smells fresh. A third resident stated I stayed in another home recently but this is far better for me. I am very happy here. Care Homes for Older People Page 19 of 27 Evidence: No health and safety or infection control issues were identified at the site visit. The home was clean smellt fresh on the day and the site visit. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New staff are recruited safely using the updated recruitment procedure of the care home. Staff are well trained and sufficient staff are on duty at all times to meet residents needs. Evidence: A staff training plan is in place which is linked to appraisals and supervision.The training plan demonstrates that both essential and specialised training is being provided to staff. The registered manager stated that all staff are engaged in NVQ training. On the day of inspection 75 of staff held an NVQ two or equivalent in care. This exceeds the national guidelines. A sample of recruitment records for new staff were examined. They provided evidence that the registered manager had followed the recruitment procedure of the care home. All the information required under the Care Home Regulations had been obtained before employment had been offered to staff. The registered manager stated all of staff are provided with an induction. Staff confirmed this statement to be correct. Residents stated that they were confident that staff have the skills to be able to help them. A resident stated staff do know what they are doing they read my care plan and make sure they help me properly. A second resident said staff here know how to Care Homes for Older People Page 21 of 27 Evidence: help me they are kind. I feel very safe living here. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run, with good leadership. The health and safety and welfare of service users is promoted Evidence: The homes management team are said by staff to be very supportive. There is evidence of improvements in care records since the last key inspection. Staff retention is good with no staff leaving the home in the last 12 months. The numbers of staff holding a formal NVQ two qualification in care exceeds the national expectation. Records provided evidence that staff are being recruited safely and are receiving support appraisals and supervisions. The registered manager produced documents to evidence that inductions are given to all new staff. The home has not received any complaints since the last key inspection. There have been no investigations carried out since last key inspection. The registered manager has informed the commission for social care inspection of any incident which impacted Care Homes for Older People Page 23 of 27 Evidence: on the safety of the residents. The Expert by Experence made only positive comments about the quality of management and the manner in which to care home is being run on a day-to-day basis. No health and safety or infection control issues were identified at any time in the last year. The registered manager and proprietor demonstrated a commitment to continue improving the environment of the home and ensuring that good care practice is maintained. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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