Inspection on 11/07/05 for Magnolia House

This inspection was carried out on 11th July 2005.

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 03/09/07

Magnolia House 22/11/06

Magnolia House 22/11/05

Magnolia House 30/01/05

Magnolia House 27/07/04

Magnolia House 08/01/04

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 House 11 Station Road Biggleswade Beds SG18 8AL Lead Inspector Fiona Mackirdy Unannounced 11 July 2005 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 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 Stationary 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 I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Magnolia House Address 11, Station Road Biggleswade Beds SG18 8AL 01767 315562 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Community Care Solutions Ltd Sheira Plentie Care Home 5 Category(ies) of LD - Learning Disability (5) registration, with number SI - Sensory Impairment (5) of places Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. The CSCI is negotiating with the provider about categories and conditions of registration. Date of last inspection 27/1/05 Brief Description of the Service: Magnolia House was first registered in 1999 to provide residential care to 5 adults with learning disabilities. The home is a family house which has been extended to provide five single bedrooms, one of which is on the ground floor, a large kitchen/diner, lounge and conservatory. There are bathing and toilet facilities on both floors and a small office/sleep-in room on the first floor. The home is within walking distance of Biggleswade town centre, with its shops, library, pubs and places of worship. The current service user group are all between 25 and 50 years and all have learning disabilities. They also need varying degrees of support with behaviour that may be challenging. The home aims to enable people to live as independently as possible whilst receiving care and support to enable them to access the local community. Since the last inspection a two bedroomed bungalow has been built in the garden so that the home can offer more independent living for those service users who want to develop their skills in this area. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Magnolia House, which took place over three hours during the afternoon. The home has applied to increase its numbers to 7 and so the purpose of the visit was to check on the newly built bungalow in the grounds to make sure it was suitable. The care of two service users who plan to move to the bungalow was tracked, which included speaking with them and other service users, looking at care records, speaking with staff and a tour of the new bungalow. What the service does well: What has improved since the last inspection? What they could do better: The home needs to make sure it recruits staff promptly when it has vacancies and look at how it can encourage staff to stay working at the home. This is so that the home does not have to use agency staff so often. Service users commented that ‘we need more staff’. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 6 The home should update the care plans and risk assessments for the service users moving into the new bungalow so that they know how staff should support them in learning new skills. The home should also look at how it involves service users in updating their plans and should write them in a way that makes it easy for service users to understand what they say. 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 House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 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 standard(s) 1 & 3. The home provides clear information about what it aims to do and how it will support service users. EVIDENCE: The statement of purpose for the home had been updated to provide information about the new facilities and service to be offered in the bungalow. However, this information needed expanding to give more information about how the aims of the bungalow would be achieved and to provide specific information about the staffing of the unit. The home should also update the service user’s guide with this information and consider The provision of a separate unit within the home had been in direct response to the developing needs of the service users in the home, in recognition that they needed an environment in which they could further develop independence skills. The home continued to provide staff with training and support in the specific needs of service users. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 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 standard(s) 6, 7 & 9. The arrangements for planning service users’ care are thorough, but the home must now focus on involving service users more in this process. EVIDENCE: Two care plans were considered. These had both been updated to reflect the service users’ planned move to the bungalow, although did not give specific information about how staff should support service users to develop the new skills they would need, such as menu planning, managing their own finances and household budgeting. This information should be included at the earliest opportunity so that the service users and staff clearly understand how they will be supported with this change in their support needs. Plans were comprehensive in their detail and scope and showed evidence of regular review. The manager said that they had been reviewed in conjunction with service users or their representatives, although that was not always clear from the plan. Service users had signed their plans, although they were not in a format that was readily accessible to all service users in the home. Plans were linked to very detailed risk assessments, which had been regularly updated. Assessments of the risks for the service users moving to the bungalow had yet to be completed. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 10 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 standard(s) 11, 12, 15 & 16. Service users are supported to lead fulfilling lives in their local community. EVIDENCE: Service users were supported to use local community facilities, including shops, a local college and health and leisure facilities. They had a programme of planned activities which they enjoyed and which enabled them to develop and maintain new skills. The home had supported service users to go out from the home unaccompanied as part of a programme of independence. This had been appropriately risk assessed. Service users kept in regular contact with relatives and friends and the home liaised appropriately with them. The afternoon routine of the home was observed. Service users had unrestricted access to all parts of the home and made themselves drinks when they came back from day activities. The home must ensure that those service users who are moving to the bungalow have specific information about their responsibilities in relation to housekeeping. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 11 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 standard(s) 18 & 19. The home gives good support to service users with their health and personal care needs but needs to make sure that written guidelines are still relevant. EVIDENCE: Those service users whose care was tracked did not need significant support with personal care. However, they did need some support with behaviours or maintaining appropriate boundaries. Care plans gave some detail of how staff should support them and were linked to more detailed written guidelines. However, some of these guidelines had been developed a number of years ago, and it was not clear whether they remained relevant, as there was no evidence that they had been reviewed. Service users were being supported to receive regular health checks, including support from specialist learning disability services if appropriate. The home must make sure that, if service users smoke, that their care plans reflect this, including detailing the support they need for the health issues this raises. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 12 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 standard(s) EVIDENCE: Neither of these standards were assessed on this occasion. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 13 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 standard(s) 24, 25, 26, 27 & 28. The home is comfortable, homely and well maintained and provides a nice environment for service users. EVIDENCE: The new facilities provided in the bungalow were assessed in detail. The accommodation had been built and furnished to a high standard. Communal areas met the required standard but were compact, although service users bedrooms were large and had ensuite facilities. It was recommended that a small dining table be provided, and that the provider consider providing net curtains or blinds at the bedroom windows to ensure privacy, consider providing a shower over the bath and keep the regulation of the water in the kitchen under review to ensure that dishes could be effectively cleaned. Service users had chosen the colours in their rooms. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33. The effectiveness of the staff team is compromised by a shortage of staff, which affects the continuity of care for service users. EVIDENCE: The home had some vacancies for staff and the manager said that they were waiting for references and checks for new staff who had been interviewed. The home was using bank staff to cover vacancies. Although it was evident that the home tried to use the same staff to promote continuity for service users, some service users commented that these staff did not know their needs as well as permanent staff. It was noted that the manager was also working he majority of her time as part of the care staff rota; this should be kept under review to ensure she has sufficient time to attend to the management of the home. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 & 42 The home is being managed effectively and there are suitable arrangements for health and safety in the new premises. EVIDENCE: The manager had worked at the home for some time and had nearly completed her training to gain a care and management qualification. At the time of this inspection she was also overseeing the management of another home in Bedford, and therefore the senior carer had very recently taken on more day-to-day responsibility for the home. Service users and staff were clearly at ease approaching the manager and senior with issues and service users both said they would speak to the manager if there was something they were not happy about. The health and safety arrangements for the new bungalow were inspected. Suitable arrangements had been made to link the fire alarm system and call bell system with that of the main building to ensure appropriate fire detection. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 16 Risk assessments for the new environment and activities will need to be carried out as soon as possible. Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 x x 3 3 x Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Magnolia House Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 18 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 6 Regulation 15 Requirement Update care plans with how staff should prepare and support service users moving towards independence. This should also include updates to risk assessments Ensure care plans include information about health support for those service users who smoke Update the environmental risk assessments to include the new bungalow and, specifically, update the fire risk assessment and hot water risk assessment Timescale for action 31 August 2005 2. 6 & 19 13 & 15 31 August 2005 31 August 2005 3. 42 13 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. 2. Refer to Standard 1 6 Good Practice Recommendations Expand the statement of purpose to include how the aims of the bungalow will be achieved and the staffing arrangements for this unit Provide care plans in a format that is accessible and understood by service users and demonstrate how they are involved in the plans review I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 19 Magnolia House 3. 4. 5. 6. 16 18 & 19 33 33 & 37 Ensure service users are given clear information about their reponsibilities for housekeeping in the bungalow Review specific guidelines for aspects of service users support to ensure they remain relevant, and archive old information from the day-to-day file Develop a staff recruitment and retention strategy for the home Keep the managers rota under review to ensure she has sufficient time to attend to the management functions in the home Magnolia House I51 S14934 MAGNOLIA V222783 110705 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF 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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