Phoenix Care Centre is situated in the seaside resort of Chapel St Leonards in Lincolnshire. The home can accommodate up to 39 people with personal care needs, some of whom lived with memory loss associated with conditions such as dementia. When we undertook our inspection there were 28 people living at the home.

The home was run by a company who was the registered provider. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. In this report when we speak both about the company and the registered manager we refer to them as being, ‘The registered persons’.

At the last inspection on 23 July 2015 the home was rated 'Good.'

This inspection was carried out on 25 July 2017 and was unannounced. During the inspection we found some areas in which improvement was needed to ensure people were provided with care and support that was safe and the registered person’s regulatory responsibilities were being met in full.

This was because the registered persons had not ensured the arrangements in place for the maintenance of the building were consistently being planned for so that any required maintenance could be responded to and addressed quickly.

In other areas, the registered persons were meeting people’s needs effectively.

People were supported by staff who knew how to recognise abuse and how to respond to concerns. Risks in relation to people’s daily life were assessed and planned for to protect them from harm.

People were supported by enough staff to ensure they received care and support at the times they needed it. Medicines were managed safely and people received their medications as prescribed.

Care staff had received the training the registered persons had identified they needed to ensure they could meet people’s needs in an effective way.

People were supported to make decisions for themselves. When people needed help with some of their decisions the registered persons had processes in place which ensured, when needed, they acted in accordance with the Mental Capacity Act 2005 (MCA). The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards (DoLS) under MCA and to report on what we find. These safeguards are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to deprive them of their liberty. This is usually to protect themselves. At the time of this inspection four people living at the home were subject to an authorised DoLS.

People were supported to maintain their nutrition and staff worked closely with community health professionals in monitoring and responding to people’s health conditions.

People’s emotional needs were recognised and responded to by a staff team who knew and cared about the individuals they were supporting. People had also been supported to maintain their interests and hobbies..

People were involved in giving their views on how the service was run and the registered manager had developed and maintained a range of checks and audit systems to monitor and improve the quality of the services they provided.

Phoenix Care Centre provides care for up to 39 older people, some of whom may experience needs related to memory loss associated with conditions such as dementia. There were 28 people living in the service at the time of our inspection.

The registered provider had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered provider had processes in place which ensured, when needed, they acted in accordance with the Mental Capacity Act 2005 (MCA). The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards (DoLS) under MCA and to report on what we find. These safeguards are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to deprive them of their liberty. This is usually to protect themselves. At the time of the inspection no one living at the home was subject to an authorised DoLS.

Background checks had been completed by the registered provider before new staff were appointed to ensure they were safe to work there. Staff knew how to recognise and report any concerns they had so that people were kept safe from harm.

Staff understood people’s needs, wishes and preferences and they had received training in order to enable them to provide care in a way which met people’s individual needs. People were treated with kindness, compassion and respect.

Staff provided the care as described in each person’s care record. People had access to a range of healthcare professionals when they required more specialist help. There were clear arrangements in place for ordering, storing, administering and disposing of medicines.

People were provided with a good choice of nutritious meals. When necessary, people were given any extra help they needed to make sure that they had enough to eat and drink.

People were able to see their friends and families when they wanted. There were no restrictions on when people could visit the service and visitors were made welcome by the staff in the home. People and their relatives had been consulted about the care they needed and were offered the opportunity to pursue and maintain their interests and hobbies.

There were systems in place for handling and resolving complaints. People we spoke with and their relatives were aware of how to raise any concerns they may have. The home was run in an open and inclusive way that encouraged staff to speak out if they had any concerns. The registered manager had systems in place to enable them to continually assess and monitor the quality of the services they provided.

When we visited Phoenix Care Centre there were 32 people living at the home. We spoke with six people and watched how staff provided care and support to others. This was because some people had problems with their memory and could not tell us their experiences of the care they received.

A single inspector carried out this inspection. During the visit we also spoke with two relatives who visited the service, the home owner, the manager and eight staff members.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.

If you want to see the evidence supporting the summary please read the full report.

Is the service caring?

Throughout our visit Staff were polite and friendly in their approach to people. People told us things like, "The staff are very caring” and “I know all the staff well and it’s good to know who is caring for you.” A relative we spoke with told us, “The staff are a caring team and they get to know about people so they can gear the care to needs better.”

Assessments and care plans included people's likes, dislikes and preferences. Staff encouraged people to make decisions and choices for themselves. We found the provider ensured people had a choice of suitable and nutritious food and drink in sufficient quantities to meet their individual needs and preferences.

Is the service responsive?

People were involved in an assessment before they moved into the home and when they had moved in. Care plans were developed with people based on the assessment information. This included people's individual choices about how they wanted to be cared for. Assessments and care plans were up to date and regularly reviewed.

Is the service safe?

We saw the provider had made the required environmental improvements to the issues we highlighted during our last inspection of the service completed on 18 October 2013.

People told us that they felt safe living at the home. We saw safeguarding procedures were in place and that staff understood how to safeguard the people they supported. People were protected against the use of unlawful or excessive control or restraint because the provider had made suitable arrangements.

Is the service effective?

People knew how to make a complaint if they were unhappy. One person said, “The boss is easy to talk to and she always comes round to check things out with us.” A relative we spoke with said, “If there are ever any issues and I raise a concern the manager and staff get it sorted.”

We spoke with the manager who confirmed any concerns raised had been addressed straight away and found responses had been open and timely.

People could therefore be assured that informal concerns were addressed and systems were in place to make sure more formal complaints would be investigated in the right way.

Is the service well led?

People who lived in the home were consulted about how they liked their care to be delivered and were asked for their views about how the home was run.

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a quality assurance system and records seen by us showed that shortfalls were addressed in the right way.

When we visited the service in May 2013 we told the provider they must make improvements. This visit was to look at those improvements.

During the visit we spoke with the deputy manager, the gardener and a service user.

We found the systems for dealing with the control of infection had been improved. A new sluice machine had been installed. Sluice machines are pieces of electrical equipment that clean and disinfect items such as commode pots.The area downstairs which had been used as a sluice previously had appropriate flooring in place.

Improvements had been made internally and externally to the premises although further work is required.

Recruitment processes had been modified to ensure applicants were required to provide a full employment history when applying for a post in the service.

Twenty-seven people were living in the home when we visited. The manager was not present during our visit but we spoke with another senior member of staff as well as people living in the home, care staff and relatives.

We spoke with people about their experiences of giving consent to care and treatment in the service. One person told us, “I never feel anything’s done to me without my permission, including taking pills and having a bath.”

People told us they felt well cared for and staff were always kind to them. One person told us, “The care is great, all my needs are met. The carers check on me all the time.”

We found the home was not taking care to protect people from the risk of infection because of the lack of robust processes for disinfecting some personal equipment.

People liked the home. One person told us, "I love my room and it's got all my pictures in it." However, people who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises because of the lack of maintenance both internally and externally.

Recruitment and selection processes were not robust. We found staff application forms did not contain a full employment history including any gaps in employment they may have had.

When we looked at records kept by the home we found people were protected from the risks of unsafe or inappropriate care and treatment.

During our visit we looked at records. These included care plans and minutes of meetings. We also spoke with care staff and a relative.

We also sat and watched care staff delivering care to people in the home. This helped us to understand the needs of people who could not talk with us.

We found people were respected and involved in their care.

People we spoke with told us the home was a nice place to live. They told us the care staff provided the support and care they needed. One person said, “They couldn’t be better, they’re so kind.” People liked the food they had and said they always had a choice at mealtimes. They also appreciated the activities that were put on for them to take part in.

People told us they felt safe in the home and if they didn’t they felt the manager would do something about it. Care staff knew how to protect the people in the home and who to contact if they had concerns.

We saw evidence that care staff were receiving training and support to do their jobs although during our visit we saw some poor care practices.

People felt they were asked about their opinions in the running of the home by the manager and felt confident taking any concerns directly to her.