Inspection on 20/09/05 for Phoenix House

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Phoenix House 16/10/07

Phoenix House 07/04/06

Phoenix House 15/04/05

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 Announced 20 September 2005 th 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 D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 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 Malcolm Johnson Care Home 9 Category(ies) of LD Learning Disability (9) registration, with number LD(E) Learning Disability - over 65 (1) (Male) of places PD Physical Disability (9) PD(E) Physical Disability - over 65 (1) (Male) Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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 15th April 2005 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 purpose built facility offering a good standard of accommodation. The bedrooms fully suit the needs of the Service Users and each bedroom is provided with a good size en-suite facility. The two communal rooms are suitable for the service user group. The garden is to the rear of the home which has been seperated into nine sections to provide each Service User with their own personalised garden. The home is situated in the village of Holt 3 miles south of Melksham in Wiltshire. The home is owned by Milbury Care and the Registered Manager is Mr Les Johnson. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection commenced at 10.30am and was completed at 3.45pm. The Manager and staff assisted the inspector throughout the inspection. The inspector toured the home and visited with Service Users and spoke with one family who was visiting at the time of the inspection who gave a positive response to the care provided at Phoenix House . Care records were reviewed as were the medications. What the service does well: What has improved since the last inspection? Due to clinical changing needs of a Service User the staff have had to increase their knowledge of infection control practices and caring for a Service User at high risk of pressure break down and using a PEG feeding system, all of which they have done well. The pressure area risk assessments are now reviewed three monthly as recommended from the last inspection. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 6 The communal room now has a new flooring which is more suitable to the daily activities of the Service Users. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 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 D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 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) The admission procedure was assessed at the previous inspection which was comprehensive and full assessments of Service Users needs were assessed prior to admission. EVIDENCE: The home has had no admission or changes to the Service Users group since the inspection conducted in April 2005, therefore these Standards were not assessed during this inspection. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 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 7 The individual care plans are comprehensive and where possible Service Users are involved with the care planning process. Service Users are supported with decision making by the home in line with communication skills. EVIDENCE: Individual comprehensive care plans are in place for each Service User, which are reviewed regularly and changed according to changing care needs. The nutritional risk assessment and pressure area risk assessments are now reviewed three monthly as required from the previous inspection, ensuring that all care needs of the Service Users are met. A daily diary is recorded for each Service User, which is inclusive of the days’ events and dietary information. A family informed the inspector how useful the diary was to the Service Users’ and the family as a means of communication and up to date information always being available. The families are not involved with the care planning process and do not sign in agreement to the care plans. Due to the complex needs of the Service Users group decision- making may be very difficult. However Service Users where possible are fully supported by the Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 10 home to make decisions in line with the communication skills of the individual Service User. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 11 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) 12, 13 and 17 The activities programme fully supports the social needs of the Service Users group. Service Users are supported to interact with the local community. The meals are of a good standard with a varied menu. EVIDENCE: The home has worked hard to develop the activities programme, which now provides a good range of activities appropriate to the needs of the Service User group. A very good detailed record is maintained of all activities. The activities programme is supported by appropriate staffing levels and transport, which is provided by the home. Service Users are supported by the home to participate in the local community. Phoenix House is situated within walking distance of the amenities offered in the village and Service Users can visit the local pub. Several Service Users attend local community clubs. The carers are responsible for cooking the main meal offered in the evening and a light lunch is served at around 12noon. The menus are now printed Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 12 photographs of the meals for those Service Users who are unable to read providing full information of the main hot meals. Service Users eat together in the main communal area where staff was observed fully assisting the Service User and interacting well with the Service Users. Where possible Service Users help prepare the meals. The kitchen is well designed for this with a large area for wheelchairs. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 13 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 needs of the Service Users are closely monitored and appropriate action taken when health care needs changed. The medication procedure is safe and the staff are provided with medication training. EVIDENCE: The home is not registered to provide nursing care, therefore nursing needs are addressed by the Community Nursing Team. However the care team closely monitor all health care needs ensuring that Service Users are provided with the care they require. A Service Users’ care needs have recently changed. The inspector visited the Service User. The home is to be commended for the level of care they have provided to the Service User. Clear records of care were also available to support the care provided by the team. The nutritional risk assessments and pressure area risk assessments are now reviewed three monthly ensuring that these areas of care are fully met. All Service Users are registered with a local GP. A family the inspector spoke with were complimentary of the care provided in the home. It would be inappropriate for the Service User to self medicate therefore all medications are administered by the care staff following training. The medications procedure was safe and all medication was stored correctly. An up to date medication reference book is needed. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 14 Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 15 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. A vulnerable adults procedure is also in place and staff are fully aware of the local procedures. EVIDENCE: There is a complaints policy and procedure in place, a copy of which is displayed in each bedroom for Service Users and families. The home has not received any formal complaints. The home has a copy of the “No Secrets” document, which is available to all staff. The staff has a clear understanding of the local vulnerable adults procedure. An organisational “Abuse” and “Whistle Blowing” policy is in place. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 16 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 and 30 The home is well maintained providing a safe and clean environment for Service Users to live in. The bedrooms fully support all needs of the Service Users. EVIDENCE: Phoenix House is purpose built which fully suits the needs of the Service Users group. The home is well furnished with domestic furnishings. The two communal rooms are light one being very spacious. New flooring has now replaced the stained carpeting in the communal room and is easy to clean following meals. The décor of the home is well maintained throughout. The inspector was able to visit all nine bedrooms, which were clean and very well decorated to suit the needs of the Service Users. Each room is provided with an en-suite facility, which are of a good size. Overhead hoists are provided in rooms. Each Service User has now been provided with their own garden to the rear of the building, which they have participated in designing. All areas of the home were clean and cross infection issues addressed. Due to an infection, which has now been resolved, the home have received training Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 17 and advice from the Community Nursing Team relating to cross infection. Clinical waste is dealt with appropriately. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 18 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) 35 and 36 The staff had not received the mandatory training required which may place Service Users at risk. The staff had been provided with appropriate supervision. EVIDENCE: The staff training records provided evidence that staff had not received all the mandatory training required, this was fully discussed with the Manager. Due to the physical needs of the Service User group it is important that the care staff are kept fully up to date with manual handling practices. The staff had been provided with regular supervision which is fully documented and kept securely. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 19 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) 39 and 42 Service Users views are listened to where communication is possible. Health and safety checks are made in the home providing a safe environment for Service Users to live in. EVIDENCE: Due to the communication skills of the Service Users group it would be difficult to gain the views of the Service Users. However the Manager has implemented simple tools to assist with gaining views of the Service Users. The care staff know the Service Users very well and are quick to recognise when something may be wrong. Fire records indicated that the weekly testing of the fire alarm system was taking place. The emergency lighting was tested monthly. Electrical equipment was tested annually and the hoists were regularly serviced. Appropriate safety checks are made through out the home ensuring a safe environment for Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 20 Service Users to live. Apart from the training that the staff had not received relating to health and safety. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 21 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. 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Phoenix House Score x 4 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 22 No 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 YA35 Regulation (1,c) Requirement The Registered Person will ensure that all staff receive all mandatory training. Timescale for action By 1st November 2005 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 YA6 YA20 Good Practice Recommendations The Registered person should consider involving families with the care planning process. The Registered person should ensure an up to date reference medication book is availabe to staff. Phoenix House D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 23 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 D51_D01_S28243_PhoenixHouse_V239225_200905_Stage4.doc Version 1.40 Page 24 - 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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