Inspection on 22/01/07 for Magna Nursing Home

This inspection was carried out on 22nd January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Magna Nursing Home 12/06/08

Magna Nursing Home 02/01/08

Magna Nursing Home 03/07/07

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 Lee West Key Unannounced Inspection 22nd January 2007 12:00p 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.V323997.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.V323997.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 Southern Cross Care Centres Limited Mrs Susan Brach 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) Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditional of registration apply. Date of last inspection 5th September 2005 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. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which began at 12:00pm on Monday 22nd January 2007. Another Inspector, Michael Wilson, accompanied the Lead Inspector, Lee West. The Registered Manager, Sue Brach was available and assisted with the process, until 15:00pm, when the administrator and other members of staff gave assistance. The method used was Case Tracking. That is, a number of service users were spoken with about their experiences and expectations of living at the home. Their care plans and other records, prepared and made available by the manager, including the pre-inspection questionnaire, were analysed. A tour of the premises was also undertaken to see the rooms used by service users case tracked. Staff, and visitors’ views were also sought to inform the judgements within this report. The service users in this home have a wide variety of mental or physical health issues. Those case tracked were representative of this diversity. What the service does well: What has improved since the last inspection? Medication procedures have been improved and medication is stored appropriately. Staff interviewed had knowledge of safeguarding vulnerable adults and training, including National Vocational Qualifications and No Secrets was evidenced. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 6 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.V323997.R01.S.doc Version 5.2 Page 7 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.V323997.R01.S.doc Version 5.2 Page 8 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): 3, 6, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A thorough assessment process is carried out to identify the needs of service users. EVIDENCE: The service users at Magna have complex mental health and physical needs and the assessments case tracked, were detailed and included risk assessments, but did not include medical or personal histories. Relatives spoken with confirmed that they were involved in the preparation of the assessment, but this was not evidenced in the care plans case tracked. They also confirmed they were given information to help make their decisions about the home being able to meet the needs of the service users. Intermediate care is not provided at Magna. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 9 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): 7, 8, 9, 10, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users’ care needs are set out in individual care plans, but some information was not evidenced. Service users are treated with respect. Medication procedures have improved and safeguard the service users. EVIDENCE: The service users at Magna have complex needs, which are set out in individual care plans. The plans case tracked though lacked information on medical and personal history, and identification of social and recreational interests. This has an impact on the service users’ care needs being fully met. Care staff spoken with said they read and follow the care plans and relatives of a service user said, “they do a really good job, in very difficult circumstances.” A service user said, “I am looked after very well, but sometimes I am left alone a long time.” Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 10 None of the service users case tracked was responsible for their own medication, in view of their dementia, or other mental disorder. The medication storage and recording was observed during the afternoon, and this was improved, with all medication appropriately labelled and stored. Correctly completed Medicines Administration Records were seen during the observation. Service users and visitors confirmed they were treated with respect and their privacy upheld. “They always knock on my door,” said one service user. Visitors spoken with said, “staff are helpful, polite and treat people here with dignity.” Many of the service users at Magna are not able to verbally communicate and their interactions with staff were observed to be positive and supportive. Carers were observed responding to their needs quickly and competently. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 11 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, 14, 15, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Activities for service users require further development to include individual preferences and needs. Family and friends are encouraged to be involved within the home and service users are helped to make their own decisions. The meals observed were appealing, wholesome and balanced. EVIDENCE: The Activities organiser was spoken with during this inspection and it was discovered that activities were being carried out spontaneously, “a set programme doesn’t work.” “We do painting, collages, progressive mobility and activities using old money.” The care plans case tracked did not identify the individual social and leisure preferences of service users, which could lead to lack of mental stimulation, which is an important aspect of care for service users with dementia. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 12 Service users who were confined to bed, or who preferred to be in their own rooms, said they felt “isolated” and a relative said, “my relative is alone for the majority of the day and evening.” There were a number of visitors present who were interacting in a positive way with the staff and service users were observed being given choices about what to have for their meal and supported with mobilising and where they wanted to sit, and what they wanted to do, following the meal. The meal served was wholesome and appetising, served in pleasant dining areas. Service users commented how much they enjoyed the food prepared for them, “I’ve put on a couple of stone since I’ve been here, because the food is so good.” Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 13 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): 16, 18, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously. Staff awareness of adult protection procedures has been improved to help ensure service users are safe from risk of harm. EVIDENCE: Magna has robust complaints procedures and records showed all concerns were taken seriously and dealt with quickly in accordance with the procedures. Visitors spoken with said they were satisfied that they would speak to the manager if they had any issues. Staff spoken with, were able to discuss their role in safeguarding vulnerable adults and confirmed there had been training within the National Vocational Qualification work covering this topic. They also had an understanding of the “whistle blowing” policy. Certificates were seen in the staff files, which evidenced an improvement in the area of protection from abuse. Visitors spoken with said they were satisfied their, “relatives were in safe hands.” Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 14 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, 20, 21, 22, 23, 24, 25, 26, Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The lounges and personal rooms in general were clean and comfortable, but corridors on both floors, and other areas, have a strong, unpleasant odour. There are insufficient useable bathroom facilities for service users to have a choice of when and where to bathe or shower, with broken equipment stored in the upstairs bathroom. EVIDENCE: The home is generally clean and comfortable, with service users’ own rooms containing personal possessions and service users spoken with said “I like my room as I have everything I need in here.” The carpets on both ground and first floor corridors have a strong, unpleasant odour, as does the first floor shower room. Visitors spoken with said, “this is perhaps one of the biggest problems, the odour, but you get used to it.” Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 15 The paintwork on doors along the first floor corridors require maintenance, particularly the toilet near room 15, which had a large hole which had been poorly patched and painted. This toilet also had a non-functioning light. As the room had no windows, it is constantly dark, putting service users at risk of injury. The bathroom on the first floor was used as a storage area for large and broken equipment, including a broken hoist, indicating this room has not been used for some time. This has the effect of reducing the opportunities for service users to have choices as to frequency of bathing and whether to choose bath or shower, particularly for those without en-suite facilities. There are nine single and 5 double rooms without en-suite facilities. It also impacts on the staff, who have reduced facilities to assist service users with bathing. The lounges and dining areas and serveries were clean and hygienic and comfortably furnished. Service users and visitors spoken with said they were satisfied with these areas. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 16 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): 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The skill mix and numbers of trained and competent staff are sufficient to meet the needs of service users. The home’s recruitment practices support protection of service users. EVIDENCE: There was one qualified nurse on each floor, plus three carers on the ground floor and 2 plus a floater on the first floor, reflected on the duty rota and staff spoken with, said, “we usually have this number and it is enough to carry out our jobs, it gets difficult when someone is off sick.” Service users spoken with said they were happy there were enough carers and “they always come when I need them.” Some visitors felt there were not always sufficient numbers, especially for service users with complex needs, or nursed in bed, and service users were often left for long periods because of pressure of work. Staff files examined contained relevant Criminal Records Bureau checks and references. There was evidence of induction in one file tracked, but not the others, and some had no evidence of identification or photograph. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 17 Evidence of training in Moving and Handling and No Secrets were seen in one file, but files of some night staff had no evidence of training, supervision or photograph in place. The “National Minimum Standards file”, containing evidence required by the Commission, had evidence of the Personal Identification Numbers and dates of birth of the qualified nurses, which were regularly checked and up to date. This information could easily be accessed and would be safer, and meet Data Protection requirements, if kept in individual staff member’s personal files. Staff commented, “I feel well trained for my role, I’ve done First Aid training, Basic Food Hygiene, Moving and Handling, Infection Control and Dementia course.” Others said, “staff get on well together and support each other. We enjoy doing the National Vocational Qualification.” Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 18 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): 31, 32, 33, 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The Registered Manager has an open leadership style, but her absences have an effect on the running of the home, although there is a continued effort to run the home in the best interests of the service users. EVIDENCE: The Registered Manager is currently assisting another home within the group which does not have a manager. This is having a detrimental effect on the home, as she is not always available to make managerial decisions. There is now a deputy, who is working at Magna and covers when the Registered Manager is unavailable to try to reduce the impact of this on the service users. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 19 Visitors said, “its difficult now to get hold of Sue,” others said, “its just not the same with Sue away so much.” Interactions between the Registered Manager, visitors, service users and staff were observed and these were supportive, one said, “when Sue is here she has time to listen to me if I have any concerns about my relative.” There was no evidence seen of formal supervision of staff, but carers said they had supervision. Staff said they felt supported and the manager was always encouraging. Service users would benefit from properly supervised care staff, as any issues requiring training, or development could be identified and dealt with. All the mandatory health and safety checks were appropriately carried out and recorded, to protect the health and safety of service users and staff. But, there are areas of maintenance, which require improvement to reduce risks to service users. The Registered Manager is aware of these areas and has started negotiations with the group to begin the work, which has been outstanding for some time. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 3 3 3 2 2 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 2 2 X X X X 2 Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? none 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 OP7 Regulation 15(1)(2) Requirement Timescale for action 31/03/07 2. OP12 16(2) 3. OP19 23(2) 4 OP21 23(2) Care plans to include all aspects of health, personal and social care, and kept under regular review to reflect any changing needs of the service user. Service users, including those 31/03/07 who are nursed in bed, or choose to remain in their own rooms, must be given opportunities for mental stimulation through leisure and recreational activities, which take into account their preferences and personal choices. The home must be kept in a 31/05/07 good state of repair, in particular, the problem of odour in the corridors to be dealt with, and repairs to corridor doors and light in the toilet carried out. The bathroom and shower 30/04/07 facilities to be brought up to standard and made useable, with equipment stored in the bathroom removed. Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 22 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 OP31 Good Practice Recommendations The Registered Manager to be responsible for no more than one registered establishment, to protect the standards of care for service users at Magna Nursing Home. Supervision sessions with staff to include all aspects of care practice and career development needs. The sessions must be recorded and records retained in staff files. Records of Personal Identification Numbers and Dates of Birth of Qualified nurses at Magna Nursing Home, must be kept confidential and secure, in line with the Data Protection Act. 2 3 OP36 OP37 Magna Nursing Home DS0000001918.V323997.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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.V323997.R01.S.doc Version 5.2 Page 24 - 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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