Inspection on 21/02/06 for Magnolia Cottage

This inspection was carried out on 21st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia Cottage 02/10/08

Magnolia Cottage 25/09/06

Magnolia Cottage 02/09/05

Magnolia Cottage 01/03/05

Magnolia Cottage 24/01/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Magnolia Cottage 26 Sydney Road Spixworth Norwich Norfolk NR10 3PG Lead Inspector Mrs Dorothy Binns Unannounced Inspection 21st February 2006 01:00 Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 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 Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 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 Adults 18-65. 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. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Magnolia Cottage Address 26 Sydney Road Spixworth Norwich Norfolk NR10 3PG 01603 897764 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) www.caremanagementgroup.com Care Management Group Limited Position Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd September 2005 Brief Description of the Service: Magnolia Cottage is a care home providing personal care and accommodation for up to 4 younger adults with a learning disability. The service users may also have a physical disability. Care Management Group Limited whose registered office is located in London owns Magnolia Cottage and four other small homes in the environs of Norwich. The home is located in a residential area in the village of Spixworth, and close to the city of Norwich. Local amenities, shops and pubs are also close by. The home consists of an adapted bungalow. All bedrooms offer single occupation. None of the bedrooms have en-suite facilities. There is ample communal space. There are gardens to the side and rear of the building, with parking available at the front of the home. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection lasting one and a half hours. The manager of the home was not available but the two staff on duty were able to assist the inspector. Service users were observed in the home though because of their disabilities were not able to be interviewed in any depth. Some records were examined and the requirements made at the last inspection were checked. Only some of the standards were inspected. The purpose of the inspection was to see what was happening on a normal day. What the service does well: What has improved since the last inspection? Little has improved since the last inspection with staff shortages still a problem. Requirements made at the last inspection about service users finances, the garden and staff supervision are still outstanding. The one improvement is the acquisition of a hoist for the bath which will help one of the service users. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 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. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 More care is now being taken to ensure that the home only admits service users whose needs can be met. The Home has an admission policy which allows service users to come and see first before moving in. EVIDENCE: Following difficulties with a recent admission and subsequent discharge from the home, more care is being taken to only admit service users whose needs can be met by the home. Staff confirmed that the current service users were able to be assisted and their needs met in a calm and constructive way and that the newest service user was blending in well to the home. There is a shortage of staff in this home and it has been agreed that a fourth service user will not be admitted until a stable staff group is in place. Recruitment is currently underway. Staff confirmed that new service users came for introductory visits before moving in and in the case of the newest service user, staff from a previous home came to stay overnight with him to show the home’s staff how best to assist him. This is good practice. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 7 The service users’ changing needs and choices are reflected in the care records and properly maintained. Service users are assisted with their money and staff accurately record what they handle. However the total money belonging to each service user is unclear and the accounts not transparent. EVIDENCE: The care record of the newest service user was examined and found to contain a lot of background information which was helpful to staff in knowing how best to support him. His daily routine was written in detail showing what the service user could do himself and how staff were to assist. The record showed how staff were to manage his behaviour as well as what he liked to do to and what made him happy. Staff wrote detailed daily reports on mood, activities and behaviour as they were monitoring the service user particularly to see how he settled. His keyworker told the inspector that they were getting to know him better and giving him as much choice as possible to see what he could cope with. This was a good record and clearly still being built up through good observation. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 10 Two finance records were checked of money belonging to the service users. The cash received into the home from a central office was correctly recorded and accounted for. Cash held was checked against the record and found to be correct. Requirements made at the last two inspections were to do with showing the total money collected in benefits and held on a service users behalf and what has happened to it. This information is now reported to be in place in the main home in Norwich owned by the organisation and was not available for inspection in this home. The inspector is aware of the debate being had at head office in regard to service users’ finances and has received correspondence indicating that improvements are being actively sought. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,15 and 17 Service users are supported to engage in leisure activities and are taken out as much as possible by staff. Service users are encouraged to stay in touch with their families and friends. Service users are offered wholesome food and enjoy their meals. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 12 EVIDENCE: Staff confirmed that they took the service users out most days even if it was just a short walk to the shops. They reported that they went out for a meal last Saturday and they have other activities which they attend. One person goes horse riding. They are still finding out what the new person likes. One staff thought that gardening might be an option for one service user and was hoping to have access to the garden in the better weather. They have access to transport so can go for outings some distance away. When they change shift they discuss with the coming on staff whether a person has been out or whether he needs to go out to ensure that things are attended to. In house service users have their own interests and listen to their own records, play their own games or are encouraged to do something with staff. Staff confirmed that contact with the family of the service users was encouraged and families were welcome in the home and to take out the service users. Staff were able to discuss the family contact of each service user and how they liaised with the family. One service user has no family but he has an advocate and attends a day centre where he has other professionals who are able to monitor him and see that he is well looked after. Service users know the service users in the other homes belonging to the same organisation and frequently visit the other homes for activities. One of the staff was preparing lunch as the inspector arrived. Pork pies and salad, sandwiches and yoghurt were being offered. Staff confirmed that they usually had home made meals though occasionally they had a carry out. The menu was monitored to ensure that a varied menu was offered and all staff were able to cook. There were no special diets. Staff felt the food was good and they took the service users to the shops to buy it. They felt they offered them a good quality and they had plenty of it. One service user was able to tell the inspector that he had enjoyed his lunch. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20 The health needs of the service users are monitored satisfactorily and there is good liaison with health professionals. Service users need help with their medication and the procedures of the home make sure they are protected. EVIDENCE: The care record of the newest service user was examined and found to have very good information about the health and learning disability of the person enabling staff to have a good understanding of his needs. Information was available from a hospital and there were psychology reports. There was also evidence that the service user was signed up with a local GP and had access to a chiropodist. Overall this home has good liaison with health professionals. The medicine for one service user was observed being given out by staff and this was satisfactorily carried out with staff signing the administration sheet following completion of the task. The rest of the sheets were examined and found to be satisfactorily completed. Medicines were stored in a locked cupboard. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion EVIDENCE: Not inspected on this occasion Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 29 The premises are suitable for their purpose and are comfortable though the garden still needs attention. There is poor attention to detail however with minor repairs required. The bathroom is improved by the installation of a hoist. EVIDENCE: The building is an extended bungalow in a residential area. All service users have single rooms and communal space is domestic in character. Everything is on the level. The premises are comfortable and cheerful with the sitting room having new furniture and carpet. A closer regard to detail would benefit the home however. For instance there were no lamp shades on the lights in the sitting room. The front door bell does not work and the inspector received no reply to her knock until she went round the back. The phone has wires trailing into the next hall because of the type of phone and location of the shelf it sits on. Staff reported that they had asked for an outside light for safety but this has not been provided. None of these things would remain unattended to in our own houses. They should be attended to here and the manager needs to ensure that they are. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 16 The garden remains untouched though staff said they would like to use it in the summer and perhaps encourage service users to garden. This was a requirement of the last inspection and the timescale for action is the end of March. This timescale remains. The bathroom was still without a hoist on the day of the inspection though staff confirmed that it was ordered. The manager phoned to say it arrived the next day. This will provide a good facility for staff and the service user who has difficulty in getting out of the bath. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 36 Service users are not yet supported by an effective staff team as too many agency staff are used. The supervision of staff is not carried out on a regular basis and needs to be implemented. EVIDENCE: There have been concerns for some time in this home about the lack of permanent staff and the need for agency staff. This has been mentioned and is the subject of requirements in the last two reports. The situation continues with only three permanent members of staff. On the rota for the week of the inspection, 18 shifts were filled by agency staff. However this was not 18 separate people but a few agency staff who keep coming to the home to work. One agency staff turned up for the afternoon shift and confirmed he had done several shifts in the home. The staff spoken to thought recruitment was taking place but were not informed about the progress. In terms of providing enough staff, they confirmed that there was always two staff on duty and this was sufficient for the needs of the service users. One service user is out during the week at a centre and the other two are able to be taken out by one staff. Staffing was therefore satisfactory in numbers for the three service users but a more permanent staff group is still required. The two staff on duty were males reflecting the gender of the service users accommodated. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 18 Staff confirmed that they had not received supervision for some time in any formal capacity though the manager was available and approachable to sort out any problems. This has been a requirement for the last two inspections and has clearly been delayed because of recruitment problems. However for the home to function properly staff need to be supported and supervised in a regular and formal way. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion EVIDENCE: Not inspected on this occasion Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 3 30 x STAFFING Standard No Score 31 x 32 x 33 2 34 x 35 x 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 3 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x x x x x x x x Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 21 Yes Are there any outstanding requirements from the last inspection? 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 YA28 Regulation 23(2)(o) Requirement The registered person must make the external grounds suitable and safe for the service users. The registered person must ensure that at all times suitably qualified and experienced staff are working in such numbers as are appropriate for the health and welfare of the service users. In addition the employment of temporary workers should be reduced to ensure the continuity of care. This is a repeat requirement. Previous timescales 31/10/05 and 31/01/06 The registered person must ensure that staff receive appropriate supervision. This is a repeat requirement. Previous timescales 31/10/05 and 31/01/06 Timescale for action 31/03/06 2. YA33 18(1a)& (b) 31/03/06 3. YA36 18(2) 31/03/06 Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 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 YA24 Good Practice Recommendations It is recommended that the premises are surveyed to ensure that attention is given to detail, for example, the doorbell, the lampshades, the phone wires. Magnolia Cottage DS0000027631.V285023.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 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. 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