Inspection on 15/04/05 for Phoenix House

This inspection was carried out on 15th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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 House 16/10/07

Phoenix House 07/04/06

Phoenix House 20/09/05

Phoenix House 20/10/04

Phoenix House 05/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Phoenix House 318 Station Road Holt Trowbridge Wiltshire, BA14 6RD Lead Inspector Karen Mandle Unannounced 15th April 2005 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Phoenix House Address 318 Station Road Holt Trowbridge Wiltshire BA14 6RD 01225 783127 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Milbury Care Services Limited Mr Leslie Johnson Care Home Only 9 Category(ies) of LD Learning Disability (9) registration, with number LD(E) Learning Disability - over 65 (1) of places PD Physical Disability (9) PD(E) Physical Disability - over 65 (1) Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Maximum number of service users who may be accommodated in the home at any one time is 9 2. Only the named male service user referred to in the application date 27 October 2004 maybe aged 65 years and over. Date of last inspection 20th October 2004 Brief Description of the Service: Phoenix House is registered to provide personal care for 8 younger adults and 1 named person over the age of 65 years, with Learning Disabilities and Physical Disabilities. The home is a new purpose built facility offering a good standard of accommmodation. All bedrooms are of a good size which are single with an en-suite facility. The home offers two communal areas and a good size garden to the rear of the home. The home is situated in the village of Holt 3 miles south of the town of Melksham. The home provides transport for Service Users to attend outside activities. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced at 9.40am and was completed at 1.45pm. At the commencement of the inspection the inspector was assisted by the Deputy Manager and the Registered Manager joined the inspection at 12.10pm. The inspector was able to freely tour the premises and visit with all of the Service Users. Several members of staff were spoken with during the inspection. Care records were inspected, as were medication records. What the service does well: What has improved since the last inspection? The home is now operating with two waking night staff each night, providing further support to the Service Users night care needs. The activities programme has now been increased and a delegated Day Service Co-ordinator is now in post who has worked hard towards providing appropriate activities to suit the individual needs of the Service Users. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 A clear admission procedure is in place and all needs are fully assessed prior to admission, ensuring the home is able to meet all care needs. Prospective Service Users visit the home prior to admission to ensure that this is the right home for them. EVIDENCE: Admissions to Phoenix House rarely take place as the Service Users remain at the home for a long period of time. However the home has recently admitted a new Service User who was assessed prior to admission by the Registered Manager and the Deputy Manager. The documented assessment was detailed and comprehensive. The assessment process ensures that the home can meet the personal care needs and social needs of the Service User. The prospective Service User was able to make two daytime visits to the home before admission took place to see the home and meet with other residents and staff. The home also seriously considers the current Service Users living at the home to ensure any new person coming to live at the home will not have any negative effect towards their current living arrangements. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Where possible (due to complex needs) Service Users are involved in all aspects of developing their individual personal plan. Where this is not possible the home works closely with families and care managers in developing individual plans, which are realistic to the Service User’s needs. Where possible the home will support independent lifestyles. EVIDENCE: Individual care plans are in place, which are comprehensive. Regular care reviews take place and records are changed in line with reviews or changing needs. The nutritional risk assessment and pressure area risk assessment will need to be more frequently reviewed. A daily diary is recorded for each Service User, which is inclusive of dietary information and a night record of events is recorded. Due to the complex needs of the Service Users independent lifestyle and taking any form of risk is very limited for this Service Users group. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14, 15 and 17 The activities provided are appropriate to the Service User group. Service Users maintain links with families and friends. Dietary needs are very well supervised by the home. EVIDENCE: The home has recently developed the day care services to provide a larger choice of arranged activities within the home and outside of the home, which are appropriate to the Service User group. The home provides its own transport to enable Service Users to attend community activities and events. Service Users are fully supported by the home to retain links with families and friends, who are able to visit the home at any time. A healthy diet is provided and Service Users and staff use meals times as a social event with good interaction seen between care staff and Service Users during meals. Dietary needs are very closely monitored through observation and monitoring weights of Service Users. Any changes to a Service Users’ ability to take a healthy diet is appropriately addressed. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Healthcare care needs of Service Users are closely monitored and appropriate action taken when health care needs change. The care plans fully address all aspects of care. Medication procedures are safe and the staff have a good understanding of the responsibility they have to the Service User when administering medications. EVIDENCE: Individual health care plans are in place and health and emotional needs are clearly identified in the care plan record and addressed appropriately. The home is not registered to provide nursing care, therefore nursing needs are addressed by the community nursing team who have a good relationship with the home. This was reported to the inspector directly from the community nurse who also commended the home for the level of care that the home provides. Two risk assessments that are used; Pressure risk assessments and nutritional assessments need to be more frequently reviewed to ensure any changes to Service Users needs are monitored and addressed. All medications are administered by the care staff who receive appropriate training. It would not be appropriate for this Service User group to administer their own medication. Examination of the medication records produced evidence that the method of medication administration was safe and all medication was stored correctly and recording of medication was satisfactory. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 12 Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 There is a complaints policy and procedure in place. A vulnerable adults procedure is also in place and staff are fully aware of the local procedure and how to use it. EVIDENCE: There is a complaints policy and procedure in place, a copy of which is displayed in each bedroom. Due to the limited communication skills of the Service Users it would be difficult for a Service User to voice or express a complaint. However the manager has devised a quality assurance tool appropriate to the communication needs which could also be used if a Service User needed to make a complaint or if staff had concerns that a Service User was not happy. The home has not received any complaints regarding the service provided. The home has copies of the “No Secrets” document, which is available to all staff. The staff have a clear understanding of the local vulnerable adults procedure. An “Abuse” organisational policy and procedure is in place as is a “Whistle Blowing” policy. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 29 and 30 The home is well maintained providing a safe and clean environment for Service Users to live in. The bedrooms are well equipped to support the complex physical needs of the Service Users whilst retaining a homely environment. EVIDENCE: Phoenix House is a purpose built home, which is well furnished with domestic furnishings. The communal rooms are light and spacious which are used by the Service Users for meals and general daily activities. The larger communal room will need the carpet to be replaced which as become badly stained, with a more suitable flooring to suit the daily living needs of the Service Users. The décor of the home is generally well maintained. All bedrooms are single which are homely with many personal items and furnishings around. The decor of the bedrooms is very much in line with the Service Users needs and choices. Over head hoists are in each bedroom and the call bell system in each room has been moved to the side of the bed within reach for the Service User to use or for care staff to call for assistance in an emergency situation. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 15 All areas of the home were clean and cross infection issues were addressed. The care staff were observed using plastic gloves and aprons whilst attending to Service Users personal care needs, and using appropriate hand washing methods, reducing risk of cross infection between Service Users. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The home is able to meet the needs of the Service User group with the staffing levels in operation. The training provided is relevant to the changing needs of the Service Users. EVIDENCE: With the admission of a ninth Service User night staffing levels have increased from one waking night member of staff supported by a sleep in member of staff to two waking night staff, ensuring all Service Users care needs are fully supported at night. Service Users care needs are fully supported by the current staffing levels available during the day. The atmosphere of the home is busy but calm with lots of interaction seen between Service Users and staff. A stable core team of staff is in place who have worked at the home for a period of time and know the Service Users needs well and provide stability and continuity of care to the Service Users. Training needs are identified through any changing needs of a Service Users’ care such as care staff using a gastric feeding system. The home offers a good size garden to the rear which has been personalised for Service Users’, however further gardening support is needed to ensure the garden is maintained and that the grass is regularly cut. Eight of the bedrooms Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 17 look directly out to the garden therefore visual appearance of the garden is important to the Service Users. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 There is leadership from the management team, ensuring that all staff are able to fully support the care and social needs of the Service Users. Training for staff and health and safety checks made in the home provide a safe environment for Service Users to live in. EVIDENCE: Through observation and conversation with the Registered Manager it was evident that the Manager has a good understanding of the Service Users personal needs and social needs. The Registered Manager is supported by a Deputy Manager, one of which, is always available to the home providing continuity of care to the Service Users. The Manager is currently working towards The Registered Managers Award Fire records indicated that the weekly testing of the fire alarm system was taking place and that staff had received fire training. Emergency lighting was tested monthly and all fire exits were accessible. All hoists are regularly Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 19 serviced ensuring safety for Service Users. Appropriate safety checks are made through out the home ensuring a safe environment for Service Users. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 4 x x x 3 x Standard No 11 12 x x Standard No 31 32 33 34 Score x x 2 x Version 1.20 Page 20 Phoenix House CS0000028243.V205131.R01.doc 13 14 15 16 17 x 3 3 x 3 35 36 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA 24 Regulation 23 Requirement Timescale for action By 1st July 2005 2. YA 33 23 (2,b) The carpet in the main communal room will be replaced with a suitable flooring that is easy to clean. The registered person will ensure By 1st July that the maintenance needs of 2005 the building and garden is attended to. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA 19 YA 19 Good Practice Recommendations The Waterlow risk assesment should be reviewed three monthly or when needs change. The Nutrional risk assessment should be reviewed six monthly or when needs change. Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 22 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Phoenix House CS0000028243.V205131.R01.doc Version 1.20 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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