Inspection on 25/09/08 for Phoenix House

This inspection was carried out on 25th September 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 19/09/07

Phoenix House 18/12/06

Phoenix House 15/03/06

Phoenix House 25/10/05

Phoenix House 14/02/05

Phoenix House 13/07/04

Phoenix House 01/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

CARE HOME ADULTS 18-65 Phoenix House 122 Bromyard Road St Johns Worcester Worcestershire WR2 5DJ Lead Inspector Christina Lavelle DRAFT REPORT: Unannounced Inspection 25th September 2008 1.20 – 6.40 Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 1 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 Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 2 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 Stationery 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 DS0000018670.V372606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Phoenix House Address 122 Bromyard Road St Johns Worcester Worcestershire WR2 5DJ 01905 426190 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Phoenixhouse122abtconnect.com Mr Nigel Hooper Mrs Susan Mary Jones Mr Nigel Hooper Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th and 28th of September 2007 Brief Description of the Service: Phoenix House was first set up as a care home in 1986. Mr Nigel Hooper is the sole registered provider and joint manager with Mrs Susan Jones. Mr Hooper also runs another care home that is situated next door called Cedar Gardens. The home provides accommodation and personal care for up to eleven adults. People living there must require care due primarily to learning disabilities. The stated aim of the home is to offer care to people who have moderate learning disabilities. Another aim is to provide a permanent and homely environment and to encourage the people who live there to be involved in household tasks. The property is a large, late Georgian, detached house located on a main road on the west side of Worcester. There are shops, pubs, a Church and various other facilities locally and the home is on a main bus route into Worcester city. The house has five single bedrooms and three shared bedrooms (none with ensuite facilities) and two are on the ground floor. The home has a sitting room, separate dining room, three bathrooms, two showers and three toilets for all residents’ use. There are garden areas at the front, side and rear of the house. Information about the home is provided in a statement of purpose and service users’ guide. The guide is in a format that is easier for people with learning disabilities to understand and is available from the home. The weekly fee for the service is as agreed with individuals’ funding authorities. Additional costs include for such as personal items and clothing, newspapers, telephone calls, hairdressing, chiropody, social activities, holidays, transport and college fees. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people using the service experience adequate quality outcomes. This is a key inspection of the service provided by Phoenix House. This means all the Standards that can be most important to people living in care homes are assessed. As part of this inspection a visit was made to the home without telling staff or anyone living there beforehand. Time was spent talking with some of the residents about the support they receive and their lifestyles. Two staff were also spoken with about their role and the support they provide. Mr Hooper discussed how the service is run and any changes made and planned. Surveys were sent to the home for eight of the residents and seven staff. Also to four care professionals who have involvement with the home, asking them for their views of the service. Ten surveys were returned and feedback from them, and from the discussions during our visit to the home, is referred to in this report. Various records that relate to residents’ care, staffing, menus and some other documents were checked and parts of the building looked at. Mrs Jones had completed an annual quality assurance assessment (AQAA), as is now required. This asks managers to say what they think their service does well and could do better, what has improved during the last 12 months and about their plans for further improvements. Any other information received by the Commission about the home since the last inspection is also considered. What the service does well: Most people have lived at Phoenix House for years and say they are happy and want to stay there. The home’s AQAA says the home “is a family orientated unit which has a friendly atmosphere”, which is also what our inspection found. Staff support residents well with their personal care. They also make sure they have routine health care checks and manage their medicines safely for them. Phoenix House offers residents a comfortable and safe home. It is near shops, pubs etc., which has helped them to become part of the local community. There is a small, stable staff team who work closely together. Residents know staff well and say they like them. They feel they can talk to staff and managers if they are worried about anything and know they will listen and take action. Staff have received training so they should know how to keep the home and people who live and work there safe. All the staff have also been checked out to help to make sure they are suitable to work caring for people. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents could be confident the home would be able to support them. This is because an assessment would be made of their care needs and the home would know their likes and dislikes from involving them and/or their representatives in their needs assessment and admission. EVIDENCE: No one has moved to Phoenix House for over three years but management had previously confirmed the assessment and admission procedures they would follow if a referral for a placement were made. They would first obtain a copy of a prospective resident’s community care assessment carried out by their funding authority. Managers would also visit them at their current residence to assess their needs. Introductory visits to the home would then be arranged and if successful they would move in for a trial stay. A review meeting would be held after this trial stay. Their family and/or representatives would be fully involved in the assessment, introductory and review processes. Prospective residents, staff and relevant others would then make a decision about if the home would meet their needs and they are compatible with existing residents. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents each have a plan showing their care needs and the level of support they require. They could take better control of their lives if staff supported them to identify and achieve more of their personal goals. If staff also enabled individuals to make more decisions and choices in their own lives, and to take risks, some people could move towards leading a more independent lifestyle. EVIDENCE: Some progress has been made since the last inspection to set up more “person centred” (PC) plans for residents. This should mean they are fully involved in drawing up their own plans and there is more focus on their personal goals and support needed to achieve them. The new plan format is user-friendlier with simple language and pictures and plans also include photographs of important people in residents’ lives and their weekday activities, outings and holidays. It is also good that some action planning meetings had been arranged to set up the PC plans. Meetings had involved residents, the manager, their keyworker from the staff team and other people they invited such as family and friends. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 10 Residents’ current lifestyle (and their view of it) and their likes, dislikes, wishes and aspirations had been discussed in their planning meetings. Whilst this is positive there are few personal goals identified in the plans seen and/or the support they need to achieve them. Goals identified are also quite general and include such as one person wanting to have a holiday. However there was no detail of the type of holiday they wanted and who with, who would help them organise it etc, which should all be in the action plan. Progress to achieve their goals, and actions taken, should then be reviewed regularly with the outcomes recorded. Development of person centred planning should therefore continue. Furthermore plans are only based on an assessment of their basic care needs and current situation and do not refer to individuals’ particular needs regarding their gender, age and/or disability. There is limited background information; in one plan seen the person’s “Life Story” and “My life Now” sections had not been completed at all. Whilst care reviews are being held regularly they seem to just reiterate the person’s initial needs assessment and current lifestyle. In addition specific risk assessments should be completed that aim to improve an individual’s life and not just, as most do, to address generic safety issues such as bathing, using the stairs and the management of their medication. keyworkers are allocated to individual residents from the staff team and should be able to spend time with them to get to know their needs and wishes better. They should also be more actively involved in helping them plan their care and in regularly reviewing their plans to make sure that their needs and goals are being met. Staff say they would like to offer residents some one to one input, but time is limited due to staffing levels. Residents spoken with are also not clear about their keyworker’s role and one hasn’t had a keyworker for a while. The more able residents who completed the surveys say that they can usually make decisions about what they do every day. However it is clear that people who rely on staff support have less opportunity to do so. It is also apparent that residents are not being supported to any extent to take more control in their lives, other than making some choices in their day-to-day routines and social activities. Opportunities for them to follow their individual interests are few and they are not involved in such as choosing menus. Whilst the AQAA states residents’ meetings are being held only one example was given about changes they have influenced, which was that the home has bought a minibus. . Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents take part in activities and are part of the local community, but would benefit from more individual support to follow their personal interests. Their independence and life skills could be better promoted if they were encouraged to take more responsibility in their daily lives. The home enables residents to maintain links with family and friends and staff aim to promote healthy eating. EVIDENCE: Residents’ activities are mostly based around their weekday attendance at day services, college and work placements. Unless they are able to go out without staff support their social activities are primarily with residents as a group. This includes a weekly social club for people with learning disabilities, a night out at a local pub and group birthday meals out, outings and holidays are arranged. It is good that residents mix and appear to be well integrated within the local community. The home has a minibus and another vehicle to provide transport. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 12 Plans record the weekday activities each resident currently takes part in. They include some of their personal interests but without specifying if and how they are being supported to take part in activities that address these. One person’s plan for example just states they like music and singing with no details as to how they (and/or if staff offer support) to take part in activities involving music and singing. It is also evident that the home is still not providing opportunities for more individual activities, which managers say is due to limited staff time and that his relates to the funding of the service. Staff reflect this in surveys commenting “If more staff were available then more 1 to 1 periods would be organised for service users” and “I feel more activities and a healthier lifestyle could be introduced so that service users could have a more varied life”. Generally the home recognises the need to support residents to develop their skills, including independent living skills. This process could be improved, as although the more able residents can make some choices in their daily routines and routines they all should be enabled to have more flexible and independent lifestyles. Residents could also take more responsibility for day-to-day running of the home such as menu planning, meal preparation and cooking. Currently they are expected to keep their own rooms tidy but are not all involved in the home’s domestic routines. Management acknowledge this, their AQAA stating “we should be supporting our clients more to aid them towards being more independent but this can be difficult to achieve due to the limited budget”. The ethos of the home is clearly still that of a more traditional care home with a family group living environment. This is what residents have become used to and whilst there is friendly atmosphere in the home currently accepted good practice for supporting people with learning disabilities emphasis is to promote individuality and independence. Efforts should therefore continue to provide a service that is as individual as possible, using staff and resources effectively. Residents are supported by the home to keep in contact with their relatives through telephone calls and visits and some people go out and stay with their family regularly. Their friends and visitors are made welcome in the home and are well known to the managers and staff. Social events for such as birthdays and Christmas are arranged and their families and friends are invited. Food provided by the home was discussed with staff and residents. Menus for main meals are made by one of the managers and include mostly traditional dishes. Some healthier foods and fresh fruit and vegetables are used although there were also quite a lot of tinned food and basic “value” makes seen. It is clear staff know what people like and the residents say their food is good. A choice of meals is not offered routinely and residents are not actively involved in menu planning. One resident was seen to make their packed lunch for the next day and attends cookery classes at college but doesn’t cook at home, only occasionally preparing vegetables. During our visit a meal had been prepared by the time most people got home (they eat at around 4.30pm). Greater input from residents in food provision is one of the areas needing to be developed. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are receiving good personal care and their health needs are met. Staff also manage their medicines safely in the home on their behalf. EVIDENCE: Plans show the support each resident needs with their personal care and risk assessments are carried out when supervision for such as bathing is needed. They could include more information about how their self-care is promoted, although the AQAA describes how an oral hygiene improvement plan had been put in place for one person and their dentist is now pleased with their hygiene. Residents were observed to be suitably clothed and well presented and staff encouraged and/or supported people going out tonight to wash and change. It is positive that progress has been made since the last inspection to set up health action plans (HAP) for individual residents, as had been recommended. The HAP format is in a simple language with pictures and two looked at had been completed by one of the managers with the residents, their keyworkers and families. All relevant health related areas are covered which should give a comprehensive overview of their individual health and requirements. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 14 Work needs to continue however for staff to include more detailed information in HAPs about residents’ medical conditions, specialist needs and treatments required. For example one person has epilepsy and although records are kept of seizures, and their records show that a nurse and Psychiatrist are involved, there is not specific guidance to staff about how they should deal with seizures and a description of their type and duration. A separate record sheet is also still being completed to record visits to GPs and for other routine and specialist health care input and appointments. This should be part of the HAPs and also reflect how residents are being encouraged to be independent and be involved in planning and monitoring their own health care. The section on lifestyle should also be more specific, as one just says the person should have a healthy diet, gentle exercise and not to go out on their own due to epilepsy. It is evident that staff do monitor residents’ health and well-being and take action when necessary to respond to any changes or problems. They ensure that routine and specialist health checks are arranged and provide support to attend them. One person has input from a Dietician to advise about their diet and exercise and relevant physical checks are carried out and recorded such as weight. It is good that the home is currently making arrangements for all the residents to have an annual well person check. Regarding medication prescribed for residents it was previously confirmed that the home has a policy and procedures for the safe management of medicines, which staff follow. A community Pharmacist visits the home regularly to check their system. The home has suitably safe storage for medicines. All staff who administer have received training relating to the safe handling of medicines. The home has a record of staff signatures and the records of medicines kept and administered in the home were seen to be maintained appropriately. Each resident has a medication profile detailing their prescribed medicines and any possible side effects. There is a self-medication assessment form available. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. If residents have any concerns they feel able to express them to staff and they know how to complain and are confident staff will listen and act on what they say. The home safeguards residents from abuse, neglect and self-harm. EVIDENCE: The home provides an appropriate written complaints procedure in a userfriendly format that is available to residents. There is also a record to complete if complaints are made with details of investigations, responses and outcomes. There was seen to be a good and open rapport between residents, managers and staff. Surveys and residents confirm that they know who to speak to if they are not happy. They say they could talk to managers and staff and would feel able to ask them for help and they would listen and act. Their relatives previously confirmed they know about the complaints procedure and although they had not needed to use it commented that staff are open and responsive. The AQAA states “We support our clients and respect their families points of view if there are points of concern”. Staff confirm in their surveys they would know what to do if anyone raised concerns with them about the home. One comments that “clear procedures are at hand for most conceivable situations”. There had not been any complaints made to the home or Commission about the service or referrals made under multi-agency safeguarding procedures for vulnerable adults. The home provides safeguarding guidance and procedures and staff have recently received training on abuse and safeguarding. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, clean and safe home. They would benefit from an updated environment that would also offer them more space and privacy. EVIDENCE: Phoenix House is located in a busy area on the west side of Worcester. The home is on a main bus route into the city with local shops, pubs, Churches etc. in walking distance. The house is large, detached and in keeping with the local community. It was extended to provide accommodation for eleven people. The overall impression of the environment is homely, but the home’s decor, furniture and furnishings are in need of updating. Furniture in one bedroom was also seen to be tatty and broken. The home’s AQAA does not describe any improvements made to the environment at all in the last 12 months. The plan discussed in the last inspection to extend the home in the next year has also not yet been started. The owner said it is still intended to build an extension, Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 17 which should provide another sitting room and single bedrooms. There should also be a planned renewal programme for the premises, with records kept. All areas of the house visited were clean, tidy and fresh. Residents indicate in their surveys that the home is always clean and fresh. In respect of hygiene and infection control it was previously confirmed that the home has all relevant policies and procedures for staff to follow and there are suitable soiled waste arrangements in place. Staff are provided with gloves and protective clothing and most of the staff team had attended training on infection control. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive safe and good personal support from suitably trained staff but would benefit from more individualised support and staff input. They can be confident in staff because checks were done to make sure they are suitable. EVIDENCE: There is a small and stable staff team. Most staff have worked at the home for years and the owner/manager and joint manager also cover direct care duties. This is positive in some ways because staff and residents know each other well and the care provided is consistent. Staff and residents clearly get on together and staff appear well motivated to providing a good home. One comments we “attend to service users’ individual needs as much as possible within staff numbers”. As already discussed in other outcome areas of this report, staff have limited time to offer individual support to residents with their activities or to carry out their keyworker role. Their focus is therefore just on covering the home; providing personal care, cooking and household tasks; transporting residents to their weekday activities and group social activities. It is also apparent that staffing arrangements include the owner’s other care next door. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 19 There has not been any new staff appointed since the last inspection. It was previously confirmed that new staff had not been allowed to start working with residents until a satisfactory criminal record bureau (CRB) check was obtained. The AQAA and staff surveys also confirm that all staff had CRB checks and references taken up before they were employed. Most staff confirm in the surveys that their induction covered everything they needed to know well. They all feel they receive training relevant to their role, although some comment that this doesn’t keep them up to date with new ways of working. Only four of the staff team have achieved an NVQ (National Vocational Qualification) in social care. Since the last inspection some staff have attended training sessions on abuse, epilepsy and autism. Whilst they have all completed all the mandatory health and safety training topics, some people need some of this training updated, in line with good practice. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Phoenix House is run by experienced managers but the ethos and approach of the home should be reviewed so residents can benefit from currently accepted good practice. An effective quality assurance system, based on what residents want, should result in an action plan for continual development of the service. EVIDENCE: The evidence shows there is caring and friendly atmosphere in the home and most people living there seem to have accepted that the style of the home is of a family/group living environment. This does not focus on and/or promote an independent lifestyle as the government’s plan “Valuing People” describes and is currently accepted as good practice. Despite funding issues the managers still need to review the service how they could implement a more individualised approach to care provision and continue to develop person centred planning. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 21 The home’s AQAA is brief and provides limited evidence of what the home does well and how this results in good outcomes for people using the service. Some aspects of the National Minimum Standards are not mentioned at all, such as management of medication, staff recruitment, training and quality assurance. Few improvements are detailed or any plans for future improvements. This should be part of an effective quality assurance system, using feedback from residents and other stakeholders, to plan to continually improve the service. Regarding health and safety in the home, training is arranged for staff covering the mandatory health and safety topics including fire safety, first aid, moving and handling, food hygiene and infection control. Staff have also completed training on abuse and the safe management of medicines. The AQAA confirms the home’s fire safety system is checked regularly and tests and checks on the fire system and equipment are being carried out. Also that gas and central heating services are maintained and checks on portable appliances and COSHH risk assessments are available. There were no safety hazards observed during these inspection visits and overall it is apparent therefore that the home pays due attention to promoting the safety and welfare of residents and staff. Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 X 2 X X 3 X Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered persons meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered provider must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to the National Minimum Standards and are seen as good practice for the registered provider to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations Work should continue to fully implement a “person centred” approach to care planning and delivery. This would help to ensure that residents are enabled to be involved (to the extent they can be) in planning their own care, and managing their health, and there is a focus on identifying and meeting their personal goals. Residents should have more opportunity for individualised activities and their responsibilities in their daily lives should be promoted to help them develop their life skills. The proposed extension to the home should be completed so that everyone living at the home can have the privacy of a single bedroom and there is more communal space. The home should draw up a planned renewal programme for the fabric and decoration of the premises to ensure that the environment is of good quality for residents. 2 YA16 3 YA24 Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 24 4 YA33 Staffing should be reviewed and consideration given to increasing staffing levels so that residents could benefit from more individualised and flexible support. The ethos and approach of the service should be reviewed and updated to ensure the home is run in a way that reflects currently accepted practice for supporting people with learning disabilities. This is based on people using the service being enabled to make decisions and move towards having a more independent lifestyle. The home should have ways in place to continually review and improve the service. This should result in an action plan for the continual development of the service, which will benefit the people living there. 5 YA37 6 YA39 Phoenix House DS0000018670.V372606.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000018670.V372606.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!