Inspection on 02/01/08 for Magna Nursing Home

This inspection was carried out on 2nd January 2008.

CSCI found this care home to be providing an Poor service.

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

Magna Nursing Home 12/06/08

Magna Nursing Home 03/07/07

Magna Nursing Home 22/01/07

Magna Nursing Home 05/09/05

Magna Nursing Home 01/06/05

Magna Nursing Home 26/10/04

Magna Nursing Home 22/04/04

Magna Nursing Home 24/07/03

Magna Nursing Home 16/10/02

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

CARE HOMES FOR OLDER PEOPLE Magna Nursing Home Long Street Wigston Leicestershire LE18 2BP Lead Inspector Debbie Williams Unannounced Inspection 10:00 2 January 2008 nd X10015.doc Version 1.40 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 Magna Nursing Home DS0000001918.V355282.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 Older People. 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. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magna Nursing Home Address Long Street Wigston Leicestershire LE18 2BP 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) 0116 2883320 0116 2812780 magna@schealthcare.co.uk/ osullibhan@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Care Centres Limited vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36), Physical disability (1) Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditional of registration apply. Date of last inspection 3rd July 2007 Brief Description of the Service: Magna is a care home providing personal and nursing care and accommodation for thirty-six older people. The Southern Cross Group, operators of a number of care facilities in the Midlands region, privately owns the home. It is a purpose built two-storey building with level entry access and both floors are accessible by passenger lift or stairs. Located near to the town centre of Wigston, close to shops, pubs, the post office and other amenities, the home is easily reached by private or public transport. The home has twenty-five single bedrooms sixteen with en-suite facilities. There are five double bedrooms without en-suite facilities. A choice of lounge and dining areas are sited throughout the premises for service users care and comfort. There is a well-maintained garden to the side of the building, which is accessible to all service users. At the time of this inspection the weekly fee ranged from £493 to £877. There was a copy of the last inspection report available at the home. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. A short observational focused inspection was also carried out as part of this inspection. This involved observing three residents in the communal areas for two hours and observing their state of being and the level and quality of staff interaction. This type of inspection was primarily designed to use with people suffering from dementia. The outcomes of this short observational inspection were extremely positive; the residents observed appeared to be in a positive state of being for the majority of the time and staff interaction was frequent and mostly positive. Evidence from the providers Annual Quality Assurance assessment was also used. Ten resident surveys were sent out prior to this inspection, three were returned with mostly positive responses to questions asked. This was a positive inspection with good outcomes for residents being achieved in most areas. One outcome area was assessed as poor and an immediate requirement was made regarding the administration of medicines. Residents and relatives spoken with were satisfied with the service provided. The inspection was unannounced and was facilitated by the nurse in charge and staff on duty. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Staffing levels have increased so enabling staff to meet the needs of residents accommodated. Staff training provided has been increased and improved; the majority of staff have received training in caring for residents with dementia. Staff have a better understanding of how to meet the specific needs of people with dementia, how to provide meaningful activities and how to manage challenging behaviour. All areas of the home seen were fresh and clean. A programme of refurbishment and redecoration has been commenced; lounges and corridors have been redecorated so providing a more comfortable and attractive environment. The providers plan to redecorate all bathrooms. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 7 Specialist equipment required for moving and handling which meets the needs of residents accommodated is provided. 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. The summary of this inspection report can be made available in other formats on request. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into the home are provided with the information required to make an informed choice and have their needs assessed before moving in. EVIDENCE: Three residents surveys were returned, these confirmed that enough information had been provided before moving into the home. A recommendation was made that that the service users guide be made available in formats which are more accessible to prospective residents. One person moved into the home on the day of this inspection, their relative was spoken with and confirmed that a full needs assessment had been carried out and that the information required had been provided. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 10 All residents have their needs assessed prior to them moving into the home. Assessment records were seen for three case tracked residents. Assessment records were mostly detailed and included risk assessments but one residents social profile did not contain any information. Information provided within the provider’s annual quality assurance assessment stated that –: ‘A Comprehensive & professionally presented brochure is provided. Further information regarding the home and what it would be like to live here is available to those making an initial enquiry’. ‘Staff Arrange home or hospital visits prior to admission and a full assessment of needs is carried out prior to admission by a competent member of staff, the information gained from the assessment is incorporated in the plan of care to allow development of the person centred care approach. Where possible advocacy is involved in this process. We also adhere to our policy admission of a new service user which can be provided on request. Residents are offered visits, respite stays and trials before becoming permanent. A minibus is available for use locally’. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Health and social care needs are met through good quality care planning and consultation with healthcare professionals. However, the lack of adequate recording of medications administered puts people who use the service at risk. EVIDENCE: Care plans were inspected and these reflected and addressed all assessed needs. A social profile is completed as part of the assessment and care planning process but these were not fully completed in two of the care plans seen. Evidence was seen of resident and relative involvement in the care planning process. Risk assessments were in place and evidence was seen of appropriate consultation with healthcare professionals. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 12 Care plans seen demonstrated that staff managed the risk and treatment of pressure sores appropriately and the required specialist equipment was provided. Two resident surveys returned indicated that residents ‘usually’ got the care and support they needed and the medical support needed. One survey indicated that this support was always provided. Staff spoken with said that one staff member had to be in the lounge area at all times in order to manage the risk of residents falling. Interactions observed between staff and residents were extremely positive, this was noted throughout the inspection but particularly during the two-hour observation that took place in the downstairs lounge and dining room, staff were respectful and interacted sensitively in order to meet the specific needs of these residents suffering from dementia. Evidence was seen in staff files that training had been provided regarding maintaining residents privacy and dignity. Medication administration records and storage areas were seen. Medication administered in the morning and at lunch time on the day of this inspection had not been signed for, an immediate requirement was made that the providers take urgent action to ensure staff follow safe handling of medication procedures and protect residents from harm. Medication is administered by trained nurses. Staff had access to the provider’s medication policies and procedures. None of the residents were self administering their medication at the time of this inspection. Information received within the providers annual quality assurance assessment stated that - ‘Healthcare professionals are involved with all resident care, a named nurse and keyworker system is in place. Staff have good relationships with GPs and healthcare professionals. All residents have an individual plan of care encompassing health, care and social needs, policies are in place to assess residents capabilities of being responsible for their own medication, all residents are addressed respectfully using their preferred name. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines of daily living are flexible in order to meet the individual needs and preferences of residents. EVIDENCE: Residents were seen moving freely around the home and appeared comfortable and relaxed. Staff spoken with described how they facilitated choice and autonomy for residents while also considering and managing risk; this was done in a respectful manner and promoted independence and autonomy. Residents seen during the two hour focused observation in the downstairs lounge were engaged in activities that appeared meaningful to them for much of the time. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 14 A list of forthcoming activities were seen on the notice board in reception. The providers had recently appointed two new activities organisers who were due to commence employment shortly. Social and recreational needs were addressed with individual care plans. Two of the residents surveys returned said that activities are arranged by the home some of the time but not always. One relative spoken with confirmed there were no restrictions on visiting times and they were always made to feel welcome at the home. The dining room on the ground floor was congenial and attractive. The lunchtime meal appeared appetizing and nutritious, and a choice was offered to all the residents. The atmosphere during lunchtime was pleasant and relaxed, some residents continued to move freely around the lounge and dining room and staff kindly encouraged them to return to the table to finish their meal. One resident asked for a second helping of lunch and this was provided, the staff member said they would ask for larger portions for this resident in order to satisfy his healthy appetite. Staff assisted residents with their meals when required to in a sensitive manner. Staff described the action they took to encourage residents with poor appetites, this included referral to a GP or dietician, nutritional supplements and providing residents with ‘finger foods’ to encourage appetite. Staff said they could be flexible with mealtimes to suit individual residents needs. The providers facilitated the provision of a cultural/religious diet for one resident. The three residents surveys returned said they ‘usually’ liked the meals provided at the home Information received in the provider’s annual quality assurance assessment stated that -: ‘a full and varied activities programme is available 24 hours a day for all service users. Care Planning includes a Social Profile. Good relationships are established with relatives and they are involved in social events. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by complaints and adult protection policies and procedures. EVIDENCE: The majority of staff had received adult protection training. Staff spoken with were aware of the correct adult protection and whistle blowing policies. Two of the residents surveys returned stated that they did know how to make a complaint and one said they did not. Information received within the annual quality assurance assessment said that complaints would be responded to within 28 days. The complaints procedure is displayed. The whistlblowing Policy is displayed for all staff. Adult protection training is provided for all staff, the relatives have confidence that if they bring a concern/complaint forward it will be taken seriously and addressed immediately. The majority of staff had recived management of challenging behaviour training. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable and well-maintained environment. EVIDENCE: Evidence was seen in staff files of infection control training. Alcohol based hand rub is provided in residents rooms and staff said they are provided with all the necessary equipment required to prevent cross infection. All areas of the home seen, appeared clean and hygienic and furnished in a homely manner to a good standard. The lounges and corridors had recently been redecorated. There was a new large flat -screen television in the downstairs lounge. The providers planned to refurbish all bathrooms in February of this year. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 17 The three relative surveys returned all indicated that the home was ‘usually’ fresh and clean’. Staff spoken with said they were provided with the specialist moving and handling equipment they required to meet residents needs. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by staff who are trained and competent to do their job. Residents are protected by recruitment policy and practice. EVIDENCE: Staffing numbers had increased since the last key inspection, staff spoken with felt there were enough staff on duty to meet residents needs and this had also helped to raise staff morale. Three resident surveys returned said that staff were ‘usually’ available when they needed them. Staff also said that more training had been provided since the last key inspection. The majority of staff had completed dementia awareness and challenging behaviour training. The staff-training matrix was seen and this outlined the ongoing programme of staff training in place. Staff spoken with confirmed they had received induction training on commencement of employment. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 19 Four care staff had completed a National Vocational Qualification in care. Two staff files were inspected, these contained all relevant checks and references. Information received within the providers annual quality assurance assessment stated that – ‘We operate a robust recruitment procedure to ensure that staff have the right experience, qualifications and personal qualities to provide a high standard of care. This is done adhering to our equal opportunities policy. Personnel files are complete and re audited on a monthly basis. The rota in the home is managed to ensure that adequate staffing are on shift and a training plan is in place to ensure that all staff are trained for their role and have ongoing development’. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of residents. EVIDENCE: Staff spoken with said the new manager was supportive and had lots of good ideas. Staffing numbers, staff training and as a consequence staff morale had increased since the last key inspection. A system of quality assurance was in place, this included regular audit from other home managers from within the company. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 21 Records were maintained of all transactions involving resident’s personal money and two signatures were maintained in order to safeguard the interests of residents. All mandatory health and safety training was included within the staff training programme. Staff spoken with confirmed they had received this training. Records of staff supervision were seen Information received within the annual quality assurance assessment sated that - ‘we maintain standards of practice and quality assurance throughout the home through a comprehensive system of monthly audits and regular consultation with the people who use our service. Our service specification is set out in our statement of purpose and service user guide. Health and safety is promoted through all practice. The annual quality assurance assessment stated that gas appliances had not been serviced or tested by the relevant authority; a requirement was made regarding this. All other maintenance of equipment and premises had been carried out. Magna Nursing Home DS0000001918.V355282.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 2 Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement All staff must follow safe administration of medication procedures. All equipment must be maintained and in good working order. Timescale for action 02/01/08 2. OP38 23(2)(c) 28/02/08 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 OP3 Good Practice Recommendations All assessment information should be fully completed within individual care plans. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 24 2. OP1 The provider’s service users guide should be made available in formats that are more accessible to residents. Magna Nursing Home DS0000001918.V355282.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Magna Nursing Home DS0000001918.V355282.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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