It looks like the medium might need replacing but the problem is that you are heading into winter. Optimum temperature range 60 to 90F with bright light.

Lots of past threads you can read and be aware that the plants are not tidy-ness freaks and will grow roots all over the place, in fact new roots are a good sign.

Here are the AOS Notes. AOS Phalaenopsis notes

What type of mix is in the pot now?

Don't repot if it has a flower spike. let it bloom and once it's finished, you'll be closer to spring (assuming you're in the Northern Hemisphere) which is the best time to repot. Don't worry about the aerial roots - that's what they like to do. Maybe give them a mist once in a while so they get some moisture, unless your indoor climate runs above 60% humidity.

I would reccomend a mixture of pine bark, charcoal and perlite for repotting. Let the air be air roots. You just have to get used to them.