Inspection on 26/09/06 for Phoenix House

This inspection was carried out on 26th September 2006.

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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Phoenix House 09/10/07

Phoenix House 15/11/05

Phoenix House 16/08/05

Phoenix House 11/02/05

Phoenix House 06/12/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Phoenix House 6 Lynn Road Snettisham Kings Lynn Norfolk PE31 7LP Lead Inspector Mr Roger Andrews Unannounced Inspection 26th September 2006 01:00 Phoenix House DS0000027534.V314168.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 DS0000027534.V314168.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 DS0000027534.V314168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Phoenix House Address 6 Lynn Road Snettisham Kings Lynn Norfolk PE31 7LP 01485 544415 NO FAX # 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) Mr John Bailey Mrs Valerie Bailey Mr John Bailey Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: Phoenix House stands in the middle of a square in the centre of the village of Snettisham. It sits between Hunstanton and Kings Lynn on the A149.There are shops, a pub and a church all close by. The home has 6 adults with learning disabilities who all have single bedrooms on the first floor of the house. There are two bathrooms, one with a standing shower and one with a bath and shower. There is a large lounge and large kitchen/dining room. Mr and Mrs Bailey, who are the providers, live in Phoenix House, running the home as a family unit. The home also has three dogs. Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from the providers, the service users as well as others who work at the service. This has included a recent announced visit to the service. This report gives a brief overview of the service and the current judgements for each outcome group. What the service does well: What has improved since the last inspection? What they could do better: The care plan for each resident needs to be kept up to date so that the information properly shows each resident’s support needs. Medicines must be locked away in a medicine cabinet when not in use to help keep residents safe. Now that they are employing a member of staff Mr and Mrs Bailey must make sure they have all the information they need on staff members to help make sure that the residents get support from people who will help protect them. Mr and Mrs Bailey need to look at what training the member of staff needs to help them offer a good service to the residents. As the residents do not smoke the areas they use must be a smoke free zone. Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 6 In order to make sure they get all the information they need Mr and Mrs Bailey could make their own list of things that they need to find out about when a new resident is about to move into the home. When they make a record of what each resident has spent their money on Mr and Mrs Bailey could number each receipt and entry so that it is easy to match them up when checking the records. 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 DS0000027534.V314168.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 DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality outcome for this area is Good. Relevant information is received about new residents, though the providers would benefit by developing their own admission assessment. EVIDENCE: No new permanent admissions have taken place for some time, though there is currently a vacancy following the sad death of a resident earlier this year. However, when admissions have occurred Mr and Mrs Bailey have received assessment reports and other relevant documents from the Social Worker. Prospective residents come on a trial basis with preliminary visits. From discussion with Mrs Bailey it is clear that a high degree of importance is attached to new residents being compatible with the existing resident group. Mr and Mrs Bailey should consider developing their own admission/assessment document. This will allow them to include issues and questions relevant to Phoenix House and to ensure consistency in the assessment process. See recommendation. In the past they have also used a questionnaire that prospective residents and their family can complete to tell them about their preferences and interests as part of the assessment process. This is good practice. Phoenix House DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 The quality outcome for this area is Adequate. Care plans are informative, but need bringing up to date and organising into easily accessible sections. Risk assessments are in place and residents have the opportunity to be independent. EVIDENCE: Three of the care plans were looked at. Each contains a resident’s profile written in the first person perspective along with a weekly routine. Risk assessments are also in place and include outside aspects such as road safety and domestic issues such as using the iron and self-medicating. Particular behaviours are noted including guidance on how to manage them. Care plans do need updating and organising into more easily accessible sections. See requirement. The residents continue to have opportunities to be independent and continue to, for example, use public transport, help in daily domestic routines and one resident looks after his own medication. Each of the residents has been Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 10 registered to exercise a postal vote at local and general elections. One service user participates in a local self-advocacy group. Phoenix House DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 The quality outcome for this area is Excellent. The residents have varied and interesting leisure, holiday and work opportunities. The residents are able to maintain contact with family and friends. The residents have a varied menu and like the food provided. EVIDENCE: All of the residents attend day services for at least part of the week and this includes work experience opportunities. For example, one resident helps twice a week at a visitors centre on the nearby Sandringham Estate, (for which she receives extra therapeutic earnings which she looks after and spends according to her own wishes), and another helps out in a bakery in a local town. One resident reported that she was starting an NVQ course at the local college. Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 12 Leisure activities include the theatre, outings, holidays, (the residents have been on two holidays this year to the Isle of Wight and a very recent one to Cornwall). The residents all said they enjoyed these trips. One resident reported that she had also been to visit her sister in Germany. Residents are able to use the local shops and there is a newsagent just a few yards away. There is a minibus for trips out if everyone goes together. One of the residents has additional funding for trips out on a one to one basis. A record of the day-to-day menus is kept and the food choices look varied. Residents’ likes and dislikes are noted in their care plans and are well known to Mr and Mrs Bailey who provide alternatives where one resident does not like the meal on offer. One of the residents described Mrs Bailey’s cooking as “wonderful”. Phoenix House DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 The quality outcome for this area is Good. Residents are encouraged to be responsible for personal care and to be independent, e.g. in managing their medication, though medication must be properly stored. The healthcare needs of residents are properly addressed. EVIDENCE: The personal care needs of residents are recorded in care plans and usually relate to assistance and/or encouragement with washing and bathing. One resident reported that she could no longer access the bath easily, but was able to use the shower room next to her bedroom without assistance. Residents are able to choose their own clothes and help in tasks such as ironing and putting their own clothes away. Healthcare needs are documented and evidence of visits to the G.P. and the hospital Consultant Psychiatrist were seen on individual care plan files. As written follow up letters are not provided about the outcome of these appointments it was suggested that Mr and Mrs Bailey make a note on the file. One of the residents reported that she had recently joined ‘Weight watchers’ and was attending their monthly meetings. Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 14 Medication is kept in the small downstairs office which is kept locked. Only one resident’s medication is looked after by Mr and Mrs Bailey and one resident looks after his own medication, a risk assessment being available on his support plan file. Although the medication is stored in a locked room it must be kept locked within the medication cabinet. See requirement. Phoenix House DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome for this area is Good. Residents know how to complain and who to talk to. EVIDENCE: There have been no complaints since the previous inspection took place. In their questionnaires all the residents reported that they had someone to speak to if they were worried and this was confirmed in discussion with some of the residents during the inspection visit. A complaints procedure has been produced for the residents and this is written in a plain English style. A vulnerable adults procedure is in place and this is in line with local agreed policies as developed by the police and social services. Mrs Bailey has attended courses run by social services on this topic. Phoenix House DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 & 30 The quality outcome for this area is Good. The environment offers a pleasant domestic atmosphere. Residents are able to personalise their own rooms and spend time there if they wish. EVIDENCE: The communal areas of the home, i.e. the lounge and large kitchen/dining room are on the ground floor. Each of the residents has their own bedroom on the first floor. These are nicely personalised reflecting individual preferences and styles. The residents have their own televisions and music equipment in their rooms along with various other items such as jigsaws, cuddly animals and certificates of merit for achievements at daytime activities. Each resident has a key to his or her own room. New carpets have been laid on the stairs and first floor corridor areas. The large kitchen/dining area tends to be the gathering place when residents get home and a large table is in place which will seat everyone. Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 17 All areas of the home are furnished in a pleasant and domestic style. All areas were clean and no obvious hazards to safety were identified during the inspection visit. Phoenix House DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 The quality outcome for this area is adequate. Mr and Mrs Bailey need to ensure their recruitment process is robust and that a training programme is identified for new staff. EVIDENCE: Traditionally Mr and Mrs Bailey have undertaken support of the residents largely on their own. However, they now employ one member of staff for approximately 20 hours a week to help with activities, some domestic tasks and records. This is a relatively recent appointment and a staff file needs to be compiled which contains all of the relevant information required by schedule 2 of the Care Homes Regulations 2001 and Standard 34 of the National Minimum Standards. This includes a full application form. Two written references were available, though one of these should be from the previous employer. A staff file is also required in respect of Mr and Mrs Bailey’s daughter who does some one-to-one work with a particular resident, though all family members have had Criminal Records Bureau checks undertaken. See requirement. A training profile also needs to be developed for the member of staff including copies of certificates of any qualifications already held. All members of staff should also be given a copy of the Code of Conduct produced by the General Social Care Council. See requirement. Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 19 Mrs Bailey has now successfully completed her NVQ 4 training. She has also attended other courses in the past on challenging behaviours, learning disabilities, food hygiene and emergency aid. Both Mr and Mrs Bailey have been offering support to adults with learning disabilities for a number of years and have built up a lot of experience. Phoenix House DS0000027534.V314168.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 The quality outcome for this area is Good. Fire checks are being carried out and financial records are in order. There is a homely atmosphere and residents and relatives are very satisfied with the service. A quality assurance process needs to be established. EVIDENCE: The fire records were checked and were in order. Weekly tests of the fire system are being carried out in line with a previous requirement and the fire alarm system has been serviced. Mr and Mrs Bailey have ordered some material which will allow them to carry out a fire risk assessment for the premises and individual residents. Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 21 The issue of smoking was discussed as Mr Bailey is the only smoker and he is aware that the residents must be provided with a smoke free environment at home. See requirement. Two of the residents’ financial records were looked at. Each resident has an individual record which documents expenditure and what items were purchased. Receipts are kept, though it was suggested that each expenditure be numbered and the receipt similarly numbered for easy retrieval when auditing the record. See recommendation. Residents also have individual bank accounts where excess funds are deposited. The residents handle their own money to varying degrees of independence depending on risk factors and personal wishes. The residents and their relatives spoke very highly of Mr and Mrs Bailey. Positive comments made by relatives of residents stated that: “I am very satisfied and pleased with my daughter’s placement. The staff are helpful and friendly” and “Mr and Mrs Bailey are most helpful with all my questions about my daughter. They are lovely people”. And “I have known Mrs Bailey for thirteen years and think she does a grand job looking after (the residents)”. Phoenix House DS0000027534.V314168.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 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X 3 3 X Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 23 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 YA6 Regulation 15 Requirement The care plan for each service user must be kept up to date and would benefit from having sections to make information more easily accessible. Medications that are looked after by the providers must be locked in the medication cabinet. All of the details required by Schedule 2 of the Care Homes Regulations 2001 must be in place in respect of each member of staff. A relevant training programme must be identified for all members of staff. Unless a suitable place is designated for smoking the home must remain a smoke free area for the benefit of service users who do not smoke. Timescale for action 01/12/06 2 YA20 13 26/09/06 3 YA34 19 01/12/06 4 YA35 18 01/01/07 5 YA42 13 26/09/06 Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 24 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 Refer to Standard YA2 Good Practice Recommendations It is recommended that the providers develop their own admission assessment form so that they can make sure that every admission is carefully assessed and meets their own criteria. It is recommended that entries in each resident’s expenditure record are numbered and these numbers correspond with the number entered onto the receipt. 2 YA41 Phoenix House DS0000027534.V314168.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 DS0000027534.V314168.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. 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