Inspection on 07/04/06 for Phoenix House

This inspection was carried out on 7th April 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 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 20/09/05

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 Unannounced Inspection 7th April 2006 9.45am Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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 DS0000028243.V288435.R01.S.doc Version 5.1 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 DS0000028243.V288435.R01.S.doc Version 5.1 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 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) londonroad@tiscali.co.uk Milbury Care Services Limited Mr Leslie Malcolm Johnson Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (1), Physical disability (9), of places Physical disability over 65 years of age (1) Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only the named male service user referred to in the application date 27 October 2004 maybe aged 65 years and over. 20th September 2005 Date of last inspection 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 divided 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 DS0000028243.V288435.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this key inspection commenced 6th April 2006 when the inspector toured the building, observed staff interacting with service users and attending to their care needs. The inspector visited with all nine-service users. The care of three service users was cased tracked through the inspection process. This was inclusive of observing the care provided whilst on site. Reviewing the care records of the three service users and the medications. Following the site visit, written contact was made to the three families to gain their views of the service provided at the home. Verbal response was received from the families who were positive about the care provided at Phoenix House. The inspector returned to the home on the afternoon of 10th April 2006 to complete the site visit, which included reviewing staff records and health and safety records. The inspector following a discussion with the manager left twoservice user survey record at the home with the aim of gaining the service users view regarding the service provided at the home. Only 1 survey was returned to the inspector on the 19th April 2006, as it was not possible for another service user to give their views due to communication skills. The survey received was positive about the service provided by Phoenix House. The Community Nursing Team who regularly visit the home on a weekly basis were contacted by letter, again the response was very positive to the standard of care provided at the home. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 Page 6 The staff had been provided with all mandatory training. A training programme has now been put in place ensuring that staff will be kept up to date with all mandatory training. 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 DS0000028243.V288435.R01.S.doc Version 5.1 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 DS0000028243.V288435.R01.S.doc Version 5.1 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 admission procedure is inclusive of a pre admission assessment-taking place conducted by the Manager. All social and care needs are assessed ensuring the home is able to meet the needs of the service user. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service EVIDENCE: The inspector assessed the admission process for the most recently admitted service user to the home. Both the Manager and Deputy Manager visited and assessed the service user prior to the admission-taking place. A detailed written assessment was seen which provided information relating to the service users’ social and health care needs. Prior to the admission taking place the service user was provided with an opportunity to visit the home, as was the family of the service user. Information was also obtained from the care manager, providing the home with further information about the care needs of the service user. The service user was visited during the inspection, however communication was very limited. Through observation during the inspection the service user appeared to have settled well into the home. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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 and 9 The care team fully support service users with decision-making in line with their communication skills. The care records address all aspects of care and are regularly reviewed in line with changing needs. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user is provided with a comprehensive care plan. Three care plans were assessed all of which were regularly reviewed by the care team. Nutritional risk assessments and pressure area risk assessments are in place which are now reviewed three monthly or monthly according to the outcome of the risk assessment and changing needs to the service user, ensuring that these areas of care are being fully met. Short-term care plans are recorded, again to ensure any immediate care need is identified and providing a record of what treatment is being provided. To support the care records each service user has a daily diary, which is recorded by the care staff providing details of the service users’ activities for the day and dietary intake. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 Page 10 Due to the complex needs of the service users and very limited communication, personal decision making could be consider as hard to achieve. However through observing the interaction between the staff and the service users, it was evident that the staff fully supported where possible service users with making their own decision. The service users due to high care needs are unable to take risks as part of an independent lifestyle. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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, 15, 16 and 17 The activities programme fully supports the social needs of the service users. The dietary needs of the service users are closely monitored. A varied and balanced diet is provided. The home supports family and friends to freely visit with service users. Quality in this outcome area is judged to be excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities programme provides a range of activities appropriate to the service users social needs whilst taking into account their individual care needs. The home has its own transport with staffing levels that can accommodate trips out. The day following the inspection the male service users and male carers were spending a “boys day out” at Yeovilton Air Museum. Service users are supported to participate in local community events. Three service users had been to the local fair the evening prior to the inspection. The service users also enjoy evening at the local theatre. Family and friends are able to visit the home at any time to visit with service users. Two family Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 Page 12 members have been able to confirm this and the visitors book provided evidence of visits taking place at various times of the day. Through observation of the interaction between the service users and staff it was evident that service users rights are fully respected. This was also verbally confirmed by a health professional that visits the home on a regular basis. The health professional expressed how well the staff managed to ensure that service users rights were always respected and the dignity of the service user maintained at all times. The dietary needs of the service users are closely monitored, as are the weights of the service users. The main hot meal of the day is in the evening, when service users eat together with the support of the care staff. The menu’s are provided with photographs of each meal, inclusive of the lunch time meal, providing service users with full information regarding their meals and choosing another meal if the main meal of the day is not what they wish to eat. Two service users were observe in the kitchen prior to lunch enjoying the time with the carer who was preparing lunch. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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, and 20 The home provides a good standard of personal care. The health care needs of the service users are closely monitored and appropriate action taken when health care needs change. The medication procedure is safe. Quality in this outcome area is judged to be excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to provide a good standard of personal care to the service user, which was observed being provided in the privacy of the service users’ bedroom or bathroom. The home is not registered to provide nursing care, therefore all nursing needs are addressed by the Community Nursing Team. The Community Nursing Team visit the home weekly or on requested. The District nurse was contacted by letter following the inspection that gave a very positive responds regarding the care provided at Phoenix House. The care records provided evidence of how physical and emotional care needs are assessed and addressed. It was evident by observing the care staff with service users that the care staff fully understood the care needs of the individual service user. All service users are registered with a local GP. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 Page 14 The care staff are responsible for the administration of all medications, as it would not be appropriate for service user group to self medicate. The medication procedure was safe and all medication was stored correctly. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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): 22 and 23 A complaints policy and procedure is in place with a pictorial complaints procedure for service users. An “Abuse” policy is in place supported by the local vulnerable adults procedure. The care staff had not recently received training in abuse awareness. Quality in this outcome area is judge to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedure is clearly provided in each bedroom, which is easily available to friends and family. A pictorial complaints procedure is in place for the service users due to the limited communication skills. The complaints log was seen. The home has not received any complaints since the previous inspection. An organisational “Abuse and Whistle Blowing” policy is in place. Through conversation with the Manager and Deputy Manager it was evident that they were fully aware of the local Vulnerable Adults procedure and of their responsibility to report any allegation of abuse. However it is recommended that all staff receive an up date in “abuse awareness” training, which is mainly provided during the induction period of employment. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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 and 30 The home is well maintained and provides a safe, clean and homely environment for service users to live in. Infection control measures are in place and the staff had received infection control training. Quality in this outcome area is judged to be good. This outcome has been made using available evidence including a visit to this service. EVIDENCE: Phoenix House is a well-designed purpose built home suiting the physical needs of the service user group. Two communal rooms are provided both of which are furnished in a homely fashion. The kitchen is well designed for the service users enabling them to assist with meals and spend time one to one with staff members. The home provides all single room accommodation with large en-suite facilities. The bedrooms are very personalised and homely to suite the individual service user. Each service user has now been provided with a garden area, which the service user has participated in with the design of the garden where possible. A tour of the building took place during the site visit. The home was generally clean throughout. Infection control measure was in place apart from in a Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 Page 17 laundry area where soiled laundry was seen on the floor increasing the risk of cross infection. Clinical waste is dealt with appropriately and the staff was up to date with infection control training. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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): 34 and 35 Recruitment procedures protect the service users as much as possible from harm. All mandatory training has now been provided. Service users care needs are being supported with staff being trained to meet their changing needs. Quality in this outcome area is judged to be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The employment files of three members of staff were reviewed to ensure that service users were protected as much as possible from harm by the homes’ recruitment procedures. The employment files contained all required documentation, and evidence of appropriate police and POVA checks. Since the previous inspection the management team have worked hard to ensure that all mandatory training has been provided. A system is now in place listing all staff and when training is required. The Manager informed the inspector that the staff will now ask for training in line with the changing needs of service users, which is also being provided. It is recommended that a copy of the homes’ induction programme, which is provided to each member of staff is kept within the employment file. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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 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 and 42 Mr Les Johnson is competent and manages the home well with putting the needs of the service users first. Service users views are listened to where possible. The home is well-maintained and all appropriate health and safety checks made. Quality in this outcome area is judged to be good. This outcome has been made using the available evidence including a site visit. EVIDENCE: Mr Les Johnson is the registered manager of Phoenix House. Mr Johnson has worked with this client group for a long period of time and fully understands the care needs of the service users. Mr Johnson is supported by a deputy manager, which it appears makes a good working partnership and provides a well run home. Mr Johnson is currently working towards level 4 NVQ managers award. Communication skills of the service users are limited therefore gaining there views may be difficult. However a simple but effective tool has been devised by the manager to gain the views of the service users. The inspector was able to Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 Page 20 gain the views of one service user using the “Have your say” tool provided by the commission, which provided positive comments about the care provided. Fire records indicated that the weekly testing of the fire alarm system was taking place. The staff had been provided with fire training. It is recommended that a copy of the fire training listing the staff members name be kept with the fire log. All accidents are fully recorded and audited monthly. All mobile and over-head hoists are serviced six monthly ensuring the safety of service users. Appropriate safety checks are made throughout the home, which is also a wellmaintained building provides a safe environment for service users to live in. Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 x 4 X 3 X X 3 x Phoenix House DS0000028243.V288435.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action 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. 3. 4. Refer to Standard YA20 YA35 YA35 YA42 Good Practice Recommendations A copy of the homes’ drug error policy and procedure should be kept with the medication administration records. A copy of the record of the induction programme should be kept with the employment file. The Manager should provide further training in “Abuse Awareness” inclusive of local procedures. The Manager should keep a list of all members of staff who have received fire training in the fire log. 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