Inspection on 01/12/06 for Magnolia House

This inspection was carried out on 1st December 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 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

Magnolia House 21/11/07

Magnolia House 13/02/06

Magnolia House 26/07/05

Magnolia House 15/10/04

Magnolia House 24/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Magnolia House 54 Salisbury Road Leigh On Sea Essex SS9 2JY Lead Inspector Ann Davey Unannounced Inspection 1st December 2006 09.00 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 Magnolia House DS0000015448.V320477.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. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magnolia House Address 54 Salisbury Road Leigh On Sea Essex SS9 2JY 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) 01702 712222 01702 712222 Magnolia House Nursing Homes Limited Valerie Daphne Gardner Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Number of service users to whom accommodation and personal care is to be provided shall not exceed twenty (20). Accommodation and personal care to be provided to no more than twenty older people over the age of 65 years (OP). 13th February 2006 Date of last inspection Brief Description of the Service: Magnolia House provides care for twenty older people. It is an older style building, which retains some of its original features. Accommodation is provided on two floors and there is a passenger lift to access both floors. The home consists of two lounges, a dining room, and single and shared bedrooms, some of which have en suite facilities. There is a small garden area with patio furniture. This area is used by residents who wish to smoke. There is limited parking at the front of the building. The home is situated in a residential area, within easy reach of local shops and a bus route. The range of fees provided by the manager was £350.00 - £500.00 per week. There are additional charges for items of a personal nature, chiropody and hairdressing. Copies of the Statement of Purpose and Service User’s Guide are available upon request. The home intends to display both documents in the main entrance hallway. Magnolia House DS0000015448.V320477.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 key inspection site visit. The inspection was undertaken over a 9-hour period and covered two days. At this inspection, all key standards (plus others as appropriate) were assessed, as well as the progress the home had made since the last inspection. A brief tour of the home took place. Staff and residents were spoken with. A random selection of records was selected and viewed, and care practice was observed. The home was warm, friendly and welcoming. The registered manager was available throughout the time in the home. In preparation for this inspection, the Commission had sent out some questionnaires. Complementary responses were received about the home from visiting professionals and relatives. In additional, positive responses were received from residents. As part of the home’s internal quality processes, the manager had sent out their own questionnaires. The response had been very positive and the findings had been incorporated within the home’s current Quality Development Plan. The majority of residents were spoken with at some stage during the visit. Some were spoken with in small group setting, whilst others were spoken with on an individual private basis. All spoke well of the home and their views have been incorporated within this report. Staff interacted well with residents and were very aware of individual care needs. As part of this unannounced inspection, the quality of information given to people about the care home was looked at. People who use services were also spoken with to see if they could understand this information and how it helped them to make choices. The information included the Service User’s Guide (sometimes called a brochure or prospectus), statement of terms and conditions (also know as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that the Commission is carrying out about the information that people get about care homes for older people. This will be reported on in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: The home has a number of strengths. The home presents as being warm, friendly and inviting. The manager continues to be committed to providing good care and this influences the whole ethos of the home. Residents are encouraged to express openly their feelings, views and comments. Residents Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 6 spoke freely about their experiences within the home. The rapport between staff and residents was warm, natural and in good humour. Personal care was seen to be carried out in a dignified, sensitive manner. The home enjoys a good relationship with health care professionals. What has improved since the last inspection? 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. Magnolia House DS0000015448.V320477.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 Magnolia House DS0000015448.V320477.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): 1,2 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate and current information about the home is available. Resident’s contracts and/or statement of terms and conditions require updating. Assessed care needs had been adequately recorded. EVIDENCE: The home has a current Statement of Purpose and Service User’s Guide. Residents spoken with were aware of the Service User’s Guide. On some occasions the next of kin or significant other had received the document on their behalf. The home intends to display both documents in the main hallway. The manager acknowledged that although all residents were in receipt of a contract and/or statement of terms and conditions, the documents were not current and did not provided up to date information about fees and charges in accordance with regulatory requirements. The manager wishes to address this as soon as possible and new documents will be issued. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 9 Assessment documentation regarding the most recent admission to the home was good in detail and content. The resident admitted was positive about her admission experience. Prospective residents are able to visit the home prior to an admission taking place. The home does not provided intermediate care. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 10 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. The care planning process is detailed, current and orderly. Medication practices are safe. Resident’s rights of privacy and dignity are respected and upheld. EVIDENCE: Four sets of care plan documentation and associated records were selected at random and viewed. The recording system was orderly, informative and current. Resident’s views, opinions and expectations were clearly recorded. Documentation demonstrated that residents are involved in the planning and delivery of their respective care. Risk assessments were current. Care plan reviews take place monthly. Resident’s spoken with about their care were generally very positive. Residents were honest and open about their views of the care provided, and acknowledged that the home provides care for a wide Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 11 variety of needs. It was clear from discussions that residents are consulted about the respective care needs. The home was able to demonstrate that it respects and facilities cultural diversity and religious beliefs. The home spoke of a good working relationship with all health and social care professionals. This was reflected within the questionnaires received back from the GP and social worker. Health care needs were recorded appropriately. The home uses a monthly dispensed monitored dosage system of medication administration (Mandrax). Staff are trained in safe medication administration practices. The storage of medication was tidy and medication administration records were in good order. Some containers of lotions/creams within bedrooms required labels identifying who they belonged to. Care practice was observed. Interaction between residents and staff was very natural, warm and friendly. Staff spoke to residents in a dignified, sensitive manner. There was a lovely sense of good humour around the home. Staff were seen to knock on bedrooms doors before entering and personal care tasks were seen to be undertaken with sensitivity and respect. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. The home continues to develop its social/recreational programme. There are established links with families. Residents are able to exercise choice and control. The home provides a varied and balanced diet. EVIDENCE: Since the last inspection, the home has worked hard at reviewing the social/recreational activities programme. The home now provides and/or facilitates a better range of activities or events. There is a notice board in the home providing information about this aspect of care. The home provides care for a wide range of care needs and this aspect of care provision clearly brings many challenges for the home. Some residents said that they prefer their own company whilst other prefer to use the main communal areas for most of the day. One resident who prefers to spend a lot of time in her respective room said that staff are always ‘popping in and out’ to make sure that nothing was needed. It was clear that individual hobbies or interests are fostered and encouraged. There is an established link with a local church. Significant Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 13 improvements have been made in this area of care and the Commission acknowledges this. The response from relatives within the questionnaires was positive. The main problem with this aspect of care is that the home does not have a designated visitor’s room where private meetings or visits can take place. Records demonstrate that where at all possible and practicable, residents are consulted about all aspects of their care and are afforded choice and control over what happens to them in the home. This is carried out on an individual basis and also through the regular residents’ meetings. Residents said that they have an input and can influence the planning of the daily menu and food provision. The menu was clearly displayed and records demonstrated that there is always choice and variety. Food being served looked very appetising and it was good to see that liquidised food is now ‘portioned’ on serving plates. The mealtime observed was unhurried by staff and residents were encouraged to take their time. The dining area is attractive and homely. Tables were attractively laid with silk floral displays, linen tablecloths and napkins. The more frail residents were provided with clean linen tabards. Residents needing help with their food were assisted by staff in a caring, sensitive way. From observation, the majority of residents have good appetites and mealtimes are clearly an enjoyable occasion. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 14 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. A complaints procedure is on display. Staff spoken with had an adequate understanding of adult protection procedures. EVIDENCE: A complaints procedure is clearly displayed in the main hallway. Residents spoken with about this matter said that they would either speak to the manager direct or speak to a relative. All were clear that they had a right to voice a concern and were confident that it would be dealt with appropriately. The home said that it had received no complaints since the last inspection. The manager, deputy manager and a member of the care staff were asked about their understanding of adult protection procedures. All were clear about what they would do within their respective role and responsibilities about a suspect or unexplained incident. It was however noted that the guidance within the home’s policy on adult protection matters was not in line with current government/local authority guidance. The document must be reviewed and brought in line with current guidance. If a member of staff was to follow the guidance within the document, it could be detrimental to the home and the resident involved. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 15 Magnolia House DS0000015448.V320477.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): 19,23 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have taken place to improve the physical environment. Other previous identified work remains outstanding. EVIDENCE: A brief tour of the home took place. The home is an older style design and therefore bedrooms are of different sizes, there are a number of corridors and accommodation is on different levels. As in keeping with this style of building, there are always improvements to be made, maintenance to be carried out and repairs to be undertaken. As it stands, the home does not meet the national minimum standards, but the home maximises what it has and is committed to making more improvements. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 17 Residents spoken with were satisfied with the standard of their bedrooms. One resident who spends considerable time in her bedroom through choice, said that she ‘had everything I need’. Since the last inspection there has been some significant improvements. These include some bedrooms have been redecorated, some new bedroom furniture has arrived, some new beds have been purchased, new windows are being fitted, a new washing and a new drying machine have been purchased and the kitchen has some new fitments. The manager said that other improvements and upgrades are planned to take place. General maintenance throughout the home has improved significantly following the appointment of a handyman. The lack of adequate storage facilities within the home is a problem for the home. Corridors are being used to house or store various items of equipment. It was pointed out to the manager that to store such equipment in corridors that are designated main fire escape routes, could present as an obstruction in the event of an emergency. It is recommended that the home consult with the fire service about how to manage the issue. In addition, the home has no designated visitors’ room. Those bedrooms seen were homely and comfortable. All were personalised. The communal areas in the home were warm, comfortable and homely. The kitchen and laundry areas were clean and orderly. There were no unpleasant odours anywhere in the home and all those areas seen were clean, pleasant and hygienic. Magnolia House DS0000015448.V320477.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): 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. Improvements have been made within this area of care and this has enhanced the quality of care provided. EVIDENCE: Since the last inspection, the home has worked hard in addressing the identified shortfalls. The home now has a stable core group of staff. Staff spoken with understood current residents needs and demonstrated commitment to providing a good quality of care to residents. The staff rota on the day was accurate and there were adequate staff on duty to meet the current residents assessed care needs. Since the last inspection the home has increased it’s staffing establishment by recruiting a handyman. In addition, care and domestic hours have increased. The home has reviewed staff training needs and records show that the level of training provided by the home has improved. The home has provided good opportunities for staff to undertake NVQ level2/3 qualifications. Records demonstrated that staff receive regular supervision and staff meetings were clearly recorded. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 19 The records of the 2 most recently recruited members of staff were viewed. Records were in good order and the home had an induction programme in place and ready to be implemented for these members of staff. Staff spoken with said that they were happy in their work. From observation, staff related well to each other and there was a good sense of teamwork. Residents were honest and open about their experiences with staff. Clearly for whatever reason, residents do have their ‘favourites’, but generally there was a sense that residents get on well with different staff members. Magnolia House DS0000015448.V320477.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): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a suitably experienced manager who provides sound leadership within the home. EVIDENCE: The manager said that she has completed her NVQ level 4 (Care & Management) and is now making enquiries about the Registered Manager’s Award. It was evident that residents are consulted on as many aspects as possible in connection with the daily management of the home and in particular how it impacts on the delivery of their own personal care. Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 21 Records relating to residents personal monies being held by the home were in good order. A random selection of safety and maintenance records were viewed and found to be in good order. These included lifting hoists/apparatus service checks, fire drills, emergency lighting, passenger lift service contract and fire alarms. The home has been active in sending out their own quality assurance questionnaires and has received some very positive responses. It was encouraging to see that the home has already produced and made available an Annual Development Plan. Magnolia House DS0000015448.V320477.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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 2 X X X 3 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 3 Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 23 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 OP2 Regulation 5 Requirement The registered person(s) must arrange for all residents to receive a current contract or a copy of the home’s statement of terms and conditions (as appropriate to their funding arrangements) The registered person(s) must ensure that the facilities within the home are compliant with regulatory requirements. In particular on this occasion specific reference is made to the lack of a private facility so that residents can receive visitors in private, and the lack of suitable storage facilities. Suitable arrangements must be considered and implemented. (The home is also aware of other facilities and shortfalls identified at previous inspections.) Timescale for action 15/01/07 2. OP19 23 31/01/07 Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 24 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 OP9 Good Practice Recommendations The registered person(s) should ensure that all containers of lotions and creams left within bedrooms are correctly labelled. The registered person(s) should ensure that the adult protection policy is amended to reflect current guidance. The registered person(s) should consult with the fire authority regarding the storage of equipment in corridors that are designated as fire escape routes. The registered person(s) should ensure that every opportunity is explored in order the manager can undertake the Registered Manager’s Award. 2. 3. OP18 OP19 4. OP31 Magnolia House DS0000015448.V320477.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Magnolia House DS0000015448.V320477.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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