Inspection on 21/11/07 for Magnolia House

This inspection was carried out on 21st November 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 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 01/12/06

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 Jane Offord Unannounced Inspection 21st November 2007 12:00 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.V355177.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.V355177.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.V355177.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). 1st December 2006 Date of last inspection Brief Description of the Service: Magnolia House is a detached property situated in a residential area of Leigh on Sea close to shops and the seafront. It is an older building that retains a lot of original features such as fireplaces and panelling. The accommodation is over two floors with a passenger lift for access by residents with limited mobility. There are two lounges, a dining room and a mix of individual and shared bedrooms, some of which have en suite facilities. There is a small patio area with wheelchair access and garden furniture for use in good weather. The fees range between £375.00 and £525.00 per month. These do not cover hairdressing, chiropody, newspapers and clothing but basic toiletries are included. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection looking at the core standards for care of older people took place on a weekday between 12.00 and 16.00. The manager and deputy were available throughout the day and assisted with the inspection process. This report is compiled from information available prior to the inspection and evidence found on the day. During the day a number of residents and staff were spoken with and a tour of the home was undertaken. The serving of the lunchtime meal and medication round were seen and care practice was observed. A selection of documents were inspected including three residents’ files and care plans, two new staff files, the policy folder and records of residents’ personal finances. The home was clean and tidy with no unpleasant odours noted. Residents were relaxed and spending time in the lounge or their own rooms as they chose. Interactions between residents and staff were friendly and appropriate. The meal at lunchtime looked and smelled appetising and help was given to residents who needed support, sensitively. What the service does well: What has improved since the last inspection? The service has implemented a much fuller activity programme and some staff have trained in armchair exercise techniques to take sessions with the residents. A number of residents’ rooms have been redecorated and had new carpet laid. A new industrial washing machine with sluicing programmes has been purchased and installed. Work was in progress on the day of inspection to replace tiling over the cooker in the kitchen that had become unsafe. A new refrigerator and freezer have been purchased for the kitchen. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Magnolia House DS0000015448.V355177.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.V355177.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, 3, 6. Quality in this outcome area is good. People who use this service can expect to have adequate information to make an informed choice and have an assessment of need undertaken prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an up to date statement of purpose and service users guide that contain all the required information about the service offered by Magnolia House. They are on display in the entrance hall of the home together with the most recent CSCI inspection report. The documented admission procedure offers prospective residents the opportunity to visit the home before making a final decision to live there. The service does not offer intermediate care. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 9 The manager said that if the placing agent is the local authority they always have an assessment of need from the social worker but the home staff always complete a further one before accepting a new resident. The files of three newly admitted residents were seen and each one contained a pre-admission assessment. Areas that were covered included mobility, communication, personal hygiene, continence and diet. The assessment looked at the person’s mental state, their social needs and family involvement. One resident had requested a shared room for the company and to feel safer. Another had made a request for personal care to be delivered by same sex carers. The manager and resident confirmed that this happened. Magnolia House DS0000015448.V355177.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. People who use this service can expect to have their health needs met and be protected by medication practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of three fairly recently admitted residents were seen and contained a good depth of information about the residents and their health and care needs. Each file had contact details of the resident’s GP and any other health professionals involved with them. There was a list of visits to or by health professionals and a record of any treatment given or prescribed such as foot care from a chiropodist or a change of medication by the doctor. There were risk assessments for falls and a Waterlow score for tissue viability. A manual handling care plan for each resident was very detailed about the way each resident was to be transferred from bed to chair, in bed and generally around the home. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 11 Care plans covered all aspects of daily living from communication to personal hygiene needs, level of mobility to eating and drinking. It was clear from residents spoken with that they are consulted about the way they wish to be supported and care plans are reviewed at least monthly. The manager said the home has a good relationship with the local surgery and very good service from the doctors and community nurses. Surveys sent to health professionals as part of the quality assurance procedure showed the professionals think the staff of the home make correct use of their expertise to support the residents. The medication administration round at lunch was observed. The home has a monitored dosage system (MDS) so medicines are supplied by the local pharmacy in pre-prepared blister packs. Medication is stored in a purpose made trolley locked to the wall in the dining room. The carer said they had had medication administration training updated recently. Records seen later confirmed this. Administration practice was safe with all charts having an identification photograph of the resident attached to them. The carer correctly washed their hands before starting and after administering eye drops. The medication administration records (MAR sheets) were inspected and no signature gaps were seen. Some eye drops and antibiotic syrup that required storage at a low temperature were kept in a plastic container that was not locked in the domestic refrigerator in the kitchen. The controlled drugs (CD) register and stock were checked and amounts tallied with the records. Care practice was observed during the day and interactions between staff and residents were friendly and appropriate. There was a good deal of laughter and humour. Residents were spoken to in a respectful manner and offered support sensitively. Carers spoken with were able to give relevant examples of the ways they would maintain residents’ privacy and dignity during personal care and people were observed knocking on doors prior to entering rooms. Magnolia House DS0000015448.V355177.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. People who use this service can expect to be encouraged to maintain contact with their family and be offered meaningful pastimes and a healthy diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three new residents’ files were seen and they all contained contact details for the next of kin and friends of the residents. The daily records showed when residents had visitors or went on an outing. The initial assessment records included details of family involvement with the resident. Visitors were seen to come and go during the day and spent time with residents in the lounges or the resident’s own room. The manager is aware that the home has no facility for residents to meet visitors in private apart from their own room. They would always make the office available if necessary but as the building is old and not purpose built there are no other spare rooms. The home employs a part time activities co-ordinator who works mainly over weekends. During the week carers organise some activities and some have had specific training in armchair exercises. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 13 One wall in the dining room is used to place notices of forthcoming entertainment and events. A pat dog visits the home regularly and the residents enjoy that. External entertainers are booked monthly and an inhouse church service takes place weekly. Some residents have visits from their chosen priest and some go out to church services on a Sunday. Arrangements have been made to access satellite television to allow one resident from an ethnic minority to receive programmes in their room from their own background and language. The menus were seen and showed there was a choice of meals at lunch and teatime such as chicken Korma or sweet and sour chicken. A hot light meal is served at teatime such as cheese on toast or ravioli. Lunch on the day of inspection was roast lamb, Yorkshire puddings and a selection of fresh vegetables or sausages and dessert was tapioca or fruit and custard. The meal looked and smelled appetising and residents spoken with said they had enjoyed it. The kitchen was visited and store cupboards inspected. There was a wide range of dry goods and frozen stocks. The temperatures of the refrigerators and freezer are recorded and showed that they are functioning within safe limits for food storage. After the lunch had been served a workman was replacing tiles that had come loose over the cooker. The manager said the owner had organised a tiling specialist to come and do the work. The extractor fan over the cooker was noted to be very dusty and in need of cleaning. Magnolia House DS0000015448.V355177.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. People who use this service can expect to have concerns taken seriously and be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints have been received by CSCI since before the last inspection and the manager said they have not had any complaints at the home either. There is a robust complaints policy that is displayed in the entrance hall and residents spoken with said they were comfortable raising any concerns with the manager or staff, ‘but there is nothing to complain about’. Training records showed that protection of vulnerable adults (POVA) training has taken place at least twice in the last year. The manager and deputy manager were both aware of the new ‘safeguarding adults’ initiative and the changed referral system. Staff spoken with were clear about their duty of care and were able to give examples of issues they would consider needed to be brought to the attention of the manager. The policy in the folder needs updating to offer the latest guidance to staff. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 15 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, 26. Quality in this outcome area is adequate. People who use this service can expect to live in homely surroundings but cannot be assured that the décor always looks fresh. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All areas of the home were visited during the day and were found to be clean and tidy. No unpleasant odours were noted. Individual bedrooms were furnished to suit the resident with personal items of furniture, ornaments and photographs. One room that had clearly just been redecorated looked very attractive and the resident said they had chosen the colour scheme and were pleased with the result. In some rooms the décor did look ‘tired’ and dark. Some comments on surveys of relatives that were seen commented on the need to brighten up a number of their relative’s bedrooms. The carpet in the entrance hall is worn and can no longer be properly cleaned in places. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 16 The laundry was visited and contains a large industrial washing machine with sluicing programmes that has recently been purchased. One new carer spoken with was not clear about the management of soiled linen and this was brought to the attention of the manager who agreed to go over the policy with the carer. Red alginate bags are used to transport soiled linen to the laundry and they are placed directly into the machine. The policy seen in one folder for managing soiled linen was out of date and needed to be replaced to give correct guidance to staff. Hand washing equipment and protective clothing were in evidence throughout the home. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 17 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. People who use this service can expect to be supported by correctly recruited and trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files for two newly recruited staff were seen. They contained evidence that a POVA 1st and criminal records bureau (CRB) check had been undertaken. Both files had two references and a full work history of the member of staff. As the CRBs had been applied for identification documents had been seen but no copies were taken to keep in the files. The manager said that normally they do keep copies but the home had recently changed the umbrella agency for applying for CRBs and copies had been overlooked. One recently employed carer was spoken with about their induction. They said they had done a number of shadow shifts with more senior carers and received instruction about fire awareness, care practice, health and safety, manual handling and POVA issues. The home employs fifteen carers and six have achieved an NVQ 2 or over and a further seven have signed to undertake the course. When they have completed the home will more than meet the 50 of standard 28. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 18 There is a commitment to training staff in all areas of care and understanding the aging process. Training sessions offered in the last few months included promoting continence, care of elderly skin, fire awareness, infection control, an overview of the Mental Capacity Act, POVA and pressure area care. Certificates of attendance for individuals were seen and staff spoken with confirmed they had attended some of the sessions. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 19 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. People who use this service can expect to have their opinions sought and their welfare protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has a number of years experience in care home management and been in post at Magnolia House since 2003. They have achieved an NVQ award at level 4 in care and intend to enrol to do the registered managers award (RMA). Staff and residents spoken with said they found the manager supportive and clear in the leadership and expectations of the service. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 20 The home has a system for consulting residents, relatives and other stakeholders about the service being offered. It was clear from residents’ care plans and files that they are included in the care planning process and the reviews. The manager showed a number of surveys that had been returned by professionals who help support the residents. They were complimentary about the staff, ‘staff are always helpful and welcoming’ but a number made comments on the poor décor in some of the rooms. Meetings between staff and residents are held and minutes are made available. Those seen showed a wide range of subjects were discussed from health issues to maintenance and menus. The home also has contact with an advocacy service and the advocate holds surgery in the home for any resident to access every few months. Some personal monies belonging to the residents are managed by staff. They are securely locked in a filing cabinet in the office. All transactions are recorded and receipts kept. Some wallets at random were checked and they tallied with the records. A number of maintenance records and service certificates were seen and showed that the home had a food hygiene inspection in February 2007. The lift was serviced in the same month and fire extinguishers, emergency lighting and fire exit signs were tested in March 2007. Hoists, slings and the gas supply were all tested in October 2007. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 21 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13 (2) Requirement A system must be established to store securely any medication that requires refrigerated temperatures to make sure residents are protected and receive medicines that have not deteriorated from being poorly stored. All staff must receive training in the management of soiled linen to protect residents and staff from possible cross infection. Documentary evidence that new staff have had identification checks must be held in staff files to make sure the recruitment process is properly followed to protect residents. Timescale for action 15/12/07 2. OP26 13 (3) 15/12/07 3. OP29 19 (1) (b) (i) Sch 2. 21/11/07 Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 23 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. 3. Refer to Standard OP15 OP18 OP19 Good Practice Recommendations Cleaning the extractor fan in the kitchen should be included in the cleaning regime to ensure good levels of hygiene are maintained. A review of the policy folder should be undertaken to ensure staff have correct and up to date guidance available. Consideration should be given to a more robust redecoration and carpet renewal programme to ensure residents live in attractive surroundings. Magnolia House DS0000015448.V355177.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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.V355177.R01.S.doc Version 5.2 Page 25 - 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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