Membership review for Phylward House

 

The contents of this review are intended to cover some of the subjects and issues which an individual, their relatives or their placement officer might ask. This review has been published with the written agreement of the home owner, or an authorised representative of the company.

 

I found Phylward House to be really homely with a dedicated staff team. I found the Registered Manager and staff to be very focused, knowledgeable, open and helpful. Although not an autism specific placement, there are individuals with autism currently being successfully supported at Phylward House. 
 

I would see the service as being suited to individuals with autism and additional physical and  learning disabilities with complex additional health or medical needs, but not challenging behaviour.
 

The information set out in the Phylward House profile was also found to be correct as stated.
 

Phylward House is situated in a very tranquil suburb of Harrogate. It is a nine bedded residential home for adults with physical and learning disabilities, autistic spectrum conditions and complex health needs between the ages of 16 and 65. 
 

The latest inspection from the Care Quality Commission found the service to be compliant in all areas with no recommendations.
 

Phylward House although slightly set back from the road is clearly signed. There is space for parking at both the front and the rear of the home. I was greeted at the door by The Registered Manager, Nicola Spencer. Once inside the house there is no reception area; you just walk into a porch area where the signing in book is located and this then leads into the main hallway. Despite individuals living at Phylward House having significant and complex needs around their health care the atmosphere was not in any way clinical, but very homely.

 

 

There is a large well organised garden to the rear of the property with areas for sitting out. At one end of the garden there is a large pond which was appropriately fenced off. Sadly it did not seem to be fully working in terms of water pump etc to help maintain a habitable environment for fish, but, apparently, is a great environment for newts.

At the time of the visit, the garden was ready for the annual spring tidy up. The Wilf Ward Family Trust has no maintenance team or gardener, thus the staff at Phylward House source assistance locally. The home itself is situated on a very quiet road in an attractive area.

 

The house felt very homely and comfortable. There was a large lounge area with a soft sofa and chairs. The majority of individual living spaces and bedrooms are located on the ground floor and thus suitable for those individuals with a physical disability as there is no lift. There are a couple of rooms upstairs and these would have to be occupied by individuals who could make it up and down stairs safely. Particular attention was given to lighting and Nicola, the Registered Manager, was knowledgeable with regards to sensory sensitivities not only in terms of autism, but also epilepsy. Overall the environment felt quite spacious and light. There were no areas of damage or particular maintenance problems observed.

 

There are good transport links to Phylward House with a train station only half a mile away. Nicola stated that public transport is only occasionally used by people living there. There are two individuals at Phylward who have their own mobility vehicle and there is a large minibus/people carrier that is used as the main transport vehicle for the home.

 

Individuals living at Phylward House do tend to have a number of hospital appointments and Phylward is within walking distance to hospital.
 

There is a school playground in quite close proximity to the rear of the property so it might not suit someone who is noise sensitive to the chatter of schoolchildren.

 

As mentioned in the introduction, not all the individuals living at Phylward House are on the autistic spectrum. One individual has a diagnosis and there are another two people who Nicola felt likely to be on the spectrum as they displayed some autism characteristics. There is a lot of focus on communication with the majority of staff trained in ‘Intensive Interaction’. This is an approach to teach the pre-speech fundamentals of communication to children and adults who have severe learning difficulties and/or autism and who are still at an early stage of communication development. Nicola recounted how one individual living at Phylward communicates by tapping and how the use of ‘Intensive Interaction’ has enabled staff to interpret each individual’s mode of communicating. Phylward House receive a lot of input from the Community Speech and Language team. 

 

I looked at one of the revamped care plans which includes a specific section on communication.

 

Some members of staff had received specific training with regard to autism and Nicola the Registered Manager demonstrated she had significant knowledge in the area particularly around sensory issues.

 

Staff support several individuals at Phylward House with some very complex medical conditions. The hospital where many individuals have regular appointments is within walking distance which is very helpful. Nicola (Registered Manager) also mentioned that Phylward House has a good relationship with the local General Practitioners surgery. 

 

All staff receive significant training to meet the health needs of individuals particularly in terms of epilepsy. Staff need to be able to undertake tube feeding and be able to administer Buccal Midazolam. Menu’s are changed on a regular basis and take into account a number of dietary requirements related to medical conditions.
 

The Wilf Ward Family Trust does not have an in house clinical team or any Dietician or Nutritionist to call upon; however, support from the local health services appears to have been very positive.

 

At the time of the visit, there were 8 people living at Phylward House. Individuals have a variety of disabilities and some quite complex medical needs. Despite this, as I alluded to in the introduction, the feeling I had was that although the health needs are taken very seriously staff do not allow them to rule the individuals’ lives. Some of the activities that people are supported to be involved in within the community again shows that every effort is made to give individuals as many life experiences as possible. As well as swimming and walking individuals have been involved in a local drumming group, wheelchair cycling and visits to the riding stables at a local village for carriage riding.

 

It is commendable that at mealtimes even those individuals who preferred to eat alone or were unable to sit at the table to eat were still all in close proximity and aware of each other. I thought that this was really thoughtfully achieved. Where possible individuals will become involved in preparing their own meals and other daily chores; however, the extent they are involved naturally depends on their abilities. 

 

No individual residing at Phylward House at the time of the visit managed their own finances. The Wilf Ward Family Trust acts as appointee for some individuals, whereas some people have chosen to have family members as their appointees. 

 

A number of Independent advocates have been accessed by Phylward House to assist with varying issues and Harrogate has its own advocacy service for adults.

 

There are group meetings involving Service Users and staff members advocate for individuals so that everyone has a chance for input. Nicola (Registered Manager) gave several examples of how the cultural needs of individuals who had previously resided at Phylward House had been met. 

 

Phylward House maintains a staffing ratio of 5 staff to 9 individuals in the morning, 4 staff to 9 individuals in the afternoon with a cook and management time. These ratios are adapted in line with the life choices the individuals make. At the time of the visit, there were 23 staff employed by Phylward House. No member of staff is allowed to work at the home without a Criminal Records Bureau check although they can start their induction if they have had a recent check performed. 
 

Staff are issued with a staff handbook upon commencement of employment and can access the Wilf Ward Family Trust intranet site to keep up to date with any changes in policies etc. Staff members receive formal supervision every 6 to 8 weeks. 
 

Staff retention appears to be very good and there also appears to be good opportunity for internal progression. Nicola, the Registered Manager, began working with the Wilf Ward Family Trust as a Support Worker 12 years ago.
 

As previously mentioned Nicola Spencer is the Registered Manager at Phylward House and she is supported by a Deputy Manager.
 

All staff undertake ‘Complex Needs and Behaviours’ training as part of their induction. This includes some ‘breakaway’ techniques and low level physical intervention; however, no individuals residing at Phylward House at the time of the visit had any physical intervention element written into their Care Plan. I saw a copy of the newly reworked Care Plan document and was impressed by the detail it incorporated, but also its simplicity. I imagine in practice it would allow quite quick and easy access to key information.

 

The staff team have a number of ‘Champions’; these are individuals who have a particular role or some expertise in particular areas like Health and Safety for instance.
 

Phylward House has a complaint procedure for the individuals residing there and this is available in several formats including picture form.

Phylward House has a really homely and comfortable environment. I found the Registered Manager and staff to be very focused with a particularly caring ethos. Although not an autism specific placement, there are individuals with autism and additional needs being successfully supported at Phylward House. I would see the service as being best suited to individuals with autism and potentially physical and learning disabilities with complex additional health or medical needs, without the element of particularly challenging behaviour.

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Visiting Officer - Craig Godding
Director of Compliance and Client Liaison, Living Autism