Inspection on 14/09/07 for Magnolia House

This inspection was carried out on 14th September 2007.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia House 02/11/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Magnolia House Cripple Street Maidstone Kent ME15 6BA Lead Inspector Geoff Senior Key Unannounced Inspection 14th September 2007 10:45 Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 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 DS0000065344.V346055.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 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 House DS0000065344.V346055.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magnolia House Address Cripple Street Maidstone Kent ME15 6BA 01622 747677 01622 741140 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) CareTech Community Services (No.2) Ltd Miss Geraldine Cunningham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th August 2006 Brief Description of the Service: Magnolia House provides accommodation and personal care for six younger adults with a learning disability. The home is owned by CareTech Community Services Ltd, which is well established and provides a number of services in various parts of the country. Magnolia House is located in a Residential area of Maidstone and is within easy reach of the town centre, which is some two miles distance away. It is close to shops, pubs, public transport and Maidstone offers other usual town amenities. The home was first registered on 1st July 1999 and consists of a two-storey building that has six single bedrooms, three of which have en-suite facilities. There is a generously proportioned lounge/dining room with a patio door leading to the patio and a large garden area. There is a small parking area in the grounds and roadside car parking is also available to the front of the house. The home employs care staff, working a roster, which gives 24-hour cover. The home also provides a part-time maintenance person/gardener but does not employ specific staff for catering and domestic duties. The home’s current fees are £753.20- £1,202.33). Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Magnolia House included an unannounced visit to the home that was undertaken on 14/9/07. Time was spent talking with the Deputy Manager and with staff on duty. The opportunity to discuss with the service users, their experiences and opinions of the home was limited by their involvement in activities and their inclination and ability to communicate or not. Observations indicated that they were settled in the home, were comfortable in the company of staff and had plenty to do. Throughout the visit, the staff’s attention to the service users’ needs, their patient, friendly and respectful manner and their treatment of each service user as an individual were observed and noted. The premises were viewed and a range of records was inspected. The comments of family members, sought in telephone conversations after the visit, were generally supportive of the service offered. The comments include: ‘The home listens to what we (parents) have to say.’ ‘Very happy with the placement and our daughter’s progress.” “Positive staff attitude to service users and families.” “Best thing about the home is the staff, they all take time to listen” Family were invited to suggest any changes or improvements. None were suggested. Not all NMS were inspected at this visit. Unless noted, only the core standards were inspected in each outcome group. What the service does well: There is a well thought out range of activities available based on the individual needs of the service users. These include activities at home, trips out and attendance at the local centres. The staff work positively with the service users helping them to communicate their needs and develop their skills. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 6 Service users’ views and opinions are sought and considered wherever possible The home aims to be inclusive and enables service users to maintain appropriate links with families, friends and significant others 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 Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 8 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 House DS0000065344.V346055.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4. Quality in this outcome area is good, Prospective service users and their representatives may visit the home before admission and are provided with information to help them make a decision about moving in. Assessments are undertaken to ensure that the Home can support the service user’s needs The needs of the service users are regularly monitored to ensure that they adequately and appropriately supported This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current Service User group is well established and there have been no admissions to the home for some time. It was reported that any prospective service user would be subject to a protracted assessment and introduction period. This would be to determine the mutual suitability of the placement and to ensure that the individual’s needs can be appropriately supported. Written information about the Home is made available to assist in the decision making process. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 10 Staff and parents confirmed that prospective service users and their representatives are invited to visit the home prior to admission. They may use the opportunity to meet and spend time with the existing service users and staff, view the accommodation and find out about the routine and lifestyle they could expect to experience at Magnolia house. Input is welcomed from the service users and families and from relevant agencies and professionals. Support needs and aspirations are identified and, where possible and achievable, appropriate support is planned. The Home’s admissions policy aims to be flexible to accommodate the potential service user’s individual needs and idiosyncrasies. The reassessment of needs is on going and changes in support practices are made where necessary. There are good staff development opportunities ensuring that the team has the skills to deliver support Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is adequate. The care planning system is generally clear and consistent and provides staff with information and guidance when supporting residents. The care plan documentation would however benefit from additional ‘person centred’ information and guidelines relating to individual social, educational and therapeutic goals and aspirations. Risk assessments are undertaken in order that service users can participate in activities with the appropriate level of support and supervision . EVIDENCE: The home has developed reasonably well-structured and informative client files. Although cumbersome to use and reference, the content and detail provided enables new and existing staff to understand and effectively support Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 12 the needs of service users. Staff were observed filling in daily check list records that note the completion or otherwise of support tasks identified in care plans. They commented that they felt they are useful in ensuring “everything gets done”. The emphasis, in the samples viewed, was however on physical care of the individuals. The care plan documentation would benefit from additional ‘person centred’ information and guidelines relating to individual social, educational and therapeutic goals and aspirations. Service user family members confirmed that they are invited to contribute to the planning process and feel that their views are positively considered and acted upon. Service users are helped, as far as possible; to make day-to-day decisions affecting their lives with regard to activities, outings, routines and food choices amongst other things. Risks are viewed positively by the home and assessments are undertaken in order that service users can participate in activities with the appropriate level of support and supervision. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good, Service users are supported to participate in a variety of in house and community based activities. The meals in the home offer service users choice, variety and consider any special needs Service users are supported and helped to maintain contact with families and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users have a fairly well established pattern of activity. Some of the service users said they attend day’s centres and adult education centres. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 14 Each service user is encouraged to take part in activities and interests both inside and out side of the home. Use is made of the community facilities. The local centre, church and community social clubs seem to be very popular with the service users as are the monthly ‘theme nights’. Service users, family members and numerous invited visitors reportedly enjoy these. Daily record sheets note the nature of the activity and level of participation. On the day of the inspection there was an air of excitement and anticipation as the service users and staff were busy readying themselves for the first ever Magnolia Garden Fete to be held the following day. Visiting relatives also brought in items to sell on the stalls and despite the disruption to the house and routine all were eagerly anticipating a successful day. Visitors are encouraged and made to feel welcome at the home. Restrictions are placed only in accordance with the wishes of, and convenience to, the Service User. The staff keep in contact with families to update them on progress and changes. The Service User group is generally well established and the staff are aware of food likes, dislikes and preferences. Meals provided are mainly based on these wishes, but also take into account the need for a reasonably balanced diet. Service users weight is monitored. Mealtime arrangements are sufficiently flexible to take account of changes to routine. Service users are encouraged to eat together and help with the preparation of food and drinks. Service users weight is routinely monitored. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good, Staff endeavour to support the service user in a manner that is dignified and respects the individual’s privacy. Healthcare needs are monitored and addressed. Medication systems are supported by procedures and documentation This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the service users require assistance with aspects of their personal care and hygiene. The management ensures that the staff are instructed and supervised to provide this thoughtfully and sensitively. Staff were observed interacting with, and responding to, service users in a friendly, non-patronising and sensitive manner. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 16 Service user preferences for the way personal care is provided and support needs that are specific to the individual are documented in the care plans. The healthcare needs of service users are monitored and addressed. The home has developed positive relationships with the local healthcare agencies that provide support and advice. Specialist staff are consulted as required and the outcome of visits noted in case files. Medication storage and records are adequate for the needs of the home. Administration sheets were clear and up to date. The home has Company procedures in place for dealing with medicines. It was reported that the staff who currently administer medication receive training and are deemed competent by the Management. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good, Residents are protected because staff receive training in the protection of vulnerable people. Residents can feel confident that there are systems in place for the expression and resolution of concerns or complaints. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was reported that protection of vulnerable adults training is offered by the Organisation. It was understood that it is an area covered by the induction and foundation programme undertaken by staff and supplemented on NVQ training. Staff spoken to indicated an understanding of issues relating to the protection of vulnerable people. They are aware of their role in ensuring people living in the home are protected from abuse in all its forms and that they are the service users main key to having their views heard. In conversation with family members it was apparent that they had been made aware of the appropriate procedures and would happily approach staff and management if they had any concerns or complaints. . Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is adequate. The service provides a homely and comfortable environment in which to live and work. The premises appear to be generally well decorated, clean and hygienic. The kitchen however remains an area that would benefit from an upgrade and refurbishment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The décor and furnishings in the communal areas provide a comfortable and welcoming environment. Not all the service users’ own rooms were viewed at this visit but they are reportedly decorated and arranged to reflect their choice, interests, character and personality. The kitchen area was noted in a previous Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 19 report as being in need of refurbishment due to damaged units and cracked work surfaces. This was acknowledged by the management but there was no evidence of progress or change. Externally there is a spacious, mainly enclosed, garden laid mainly to lawn and shrubs with areas for sitting. Written confirmation was received that maintenance checks and certification are satisfactory and up to date. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good, Service users are supported by an enthusiastic and committed staff team. The care of residents is enhanced because staff opportunities for training and development are well established. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home benefits from a blend of youth and experience with a senior member of staff on duty at all times during the day. The rota pattern reportedly provides sufficient staff on duty for the needs of the resident group. Extra staff may be called in for duty to cover for annual leave, sickness and times of additional activity. There are no staff specifically employed for domestic and catering duties. Support staff and service users undertake this. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 21 Staff were observed interacting with the service users in a friendly and non-patronising manner. They were firm and assertive where necessary but not oppressive in their approach. They indicated an understanding of the service users’ needs and managed behaviours in a patient, calm and proactive manner. There is an induction and training programme in place. The manager reported that changes in the programme are to be implemented in Sept in line with current practice and thinking. The National Minimum Standards recommendation, that at least 50 obtain NVQ level 2 has been addressed. The recruitment procedure endeavours to ensure that the safety and well-being of vulnerable adults is protected by undertaking background and reference checks on potential employees. Relatives commented on how positive the staff always are and how they often do more than is required or expected of them. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good, The home appears to be well run in an inclusive manner that allows for service users and staff to contribute to the daily life and routine. The home is supportive, encouraging the ongoing development of the service users. There are systems in place to promote the well-being and safety of the service users and staff This judgement has been made using available evidence including a visit to this service. EVIDENCE: Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 23 The Manager was away on other duties at the time of this visit. The assistant manager facilitated the visit. It appears from discussion and observation that the Management is generally approachable and supportive. They operate an open door policy and frequently meet with staff individually and collectively on a formal and informal basis. An open and inclusive atmosphere appears to have been established within the Home. A representative of the organisation visits the home each month. It was understood that a newly formed Quality Assurance team is to undertake regular assessments and audits. Parents confirmed in conversation that they felt fully informed, involved and consulted on any matters that impact upon the experience and quality of life for their family members in the home The health, safety and welfare of service users, staff and visitors are addressed in induction and training and through written guidance. Confirmation that maintenance and safety checks are satisfactory and up to date was received prior to the visit. Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 24 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 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 25 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA30 Regulation 13(3) Timescale for action The registered person shall make 31/01/08 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. In that kitchen units are replaced where damaged and broken cracked surfaces identified Requirement (This requirement has been repeated from previous inspection on 30th Aug 2006, 21st July 2005 and 15th December 2004.). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000065344.V346055.R01.S.doc Version 5.2 Page 26 Magnolia House Standard Magnolia House DS0000065344.V346055.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000065344.V346055.R01.S.doc Version 5.2 Page 28 - 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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