Inspection on 03/09/09 for Magnolia House

This inspection was carried out on 3rd September 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia House 20/03/09

Magnolia House 03/12/08

Magnolia House 24/11/08

Magnolia House 24/11/06

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Magnolia House 185 Rockingham Road Kettering Northamptonshire NN16 9JA The quality rating for this care home is: one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Catherine Perrins Date: 0 3 0 9 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 34 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 34 Information about the care home Name of care home: Address: Magnolia House 185 Rockingham Road Kettering Northamptonshire NN16 9JA 01536518689 01536513989 magnolia@consensussupport.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Caring Homes Healthcare Group Limited care home 19 Number of places (if applicable): Under 65 Over 65 19 0 learning disability Additional conditions: Only one service user over the age of twenty five (25) years may be admitted to Magnolia House. Only service users between the ages of eighteen (18) and twenty five (25) may be admitted to Lily House. Only service users between the ages of eighteen (18) and twenty five (25) may be admitted to Violet House. The Home is registered to provide personal care to service users as follows: Learning Disability (LD) - Magnolia House (10), Violet House (4), Lily House (5). Date of last inspection 2 6 0 3 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Magnolia House care home is made up of three properties, Magnolia House, Lilly House and Violet House. Magnolia House and Lilly House are next door to each other. Violet House is a newer building at the rear of Magnolia House. There is also a self contained flat for one person. Care Homes for Adults (18-65 years) Page 5 of 34 10 people can live in Magnolia House, four in Violet House and five in Lilly House Each person has their own room. No-one has to share. The home is in Kettering near to shops and buses. Fees range from 350 to 2,000 pounds per week. Care Homes for Adults (18-65 years) Page 6 of 34 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 34 How we did our inspection: This is what the inspector did when they were at the care home We did not tell the home we were going to visit. We talked to some of the people who stay at the home. We talked to some of the staff who work at the home. Care Homes for Adults (18-65 years) Page 8 of 34 We looked at people’s care plans. Care plans tell staff how to care and support people in the right way. We looked at other records that told us how the home is run. This included staff records and health and safety records. What the care home does well Care Homes for Adults (18-65 years) Page 9 of 34 Staff help people to communicate their needs and choices One person who cannot write uses a stamp when she goes to the bank to sign her name Some people have ‘person centered’ care plans. A visiting health professional told us that staff are good at following her advice. Care Homes for Adults (18-65 years) Page 10 of 34 People told us that they were involved in cooking their meals and that the food is good. The home followed the safeguarding adults procedure. Staff have a good understanding of the peoples needs. Care Homes for Adults (18-65 years) Page 11 of 34 What has got better from the last inspection The home has a new manager. Repair work and redecoration has started to improve the home. Water is being dispensed at a safe and comfortable temperature for bathing. Care Homes for Adults (18-65 years) Page 12 of 34 A new kitchen has been fitted in Magnolia House. What the care home could do better People who take medication should have their medication reviewed regularly. Care Homes for Adults (18-65 years) Page 13 of 34 People must be carefully assessed before they are given medication hidden in food. The lounge area in Magnolia House is not very big. The manager told us that he would look to see if he could make better use of the space available. If you want to speak to the inspector please contact Catherine Perrins Care Quality Commission. Citygate, Gallowgate, Newcastle upon Tyne. NE1 4PA Tel: 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 14 of 34 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 15 of 34 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 16 of 34 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good information about the home and have their needs assessed to ensure that the home is right for them. Evidence: The home has a statement of purpose and service user guide which give people information about the home and the services it offers. The Manager explained that the statement of purpose was being updated to reflect the recent changes to the home. The service user guide contains pictures and photographs to make it easier for people with learning disabilities to read. Records show that peoples needs are assessed before they move in to make sure that the home can offer them a service that is right for them. Staff explained that people are able to visit the home before they move in to help them decide if it is the right move for them. If they are not able to visit, their relatives or friends can do so on their behalf. There have not been any recent admissions to the home. Care Homes for Adults (18-65 years) Page 17 of 34 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs met and are supported to make choices. Evidence: Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to care for people in the right way. Each person has a goal plan which outlines the goals that they are trying to achieve. Information in the care plans informs staff how people should be supported to meet their goals. Care plans seen covered areas such as communication, eating and drinking, personal care, mobility, culture and religion, health and continence. They contained some detail about peoples preferences for example the care plan for one person stated that she should be given time to wake up slowly and that staff should talk to her whilst opening her curtains and putting away her laundry. Several people who live at the home have limited verbal communication. There was evidence of people being assessed by speech and language therapists and being Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: supported to use a range of different methods to communicate their needs and choices. For example staff used objects of reference, such as a coat to ask someone if they wanted to go out other people had communication boards with pictures and symbols on. A spot check of money held by the home on behalf of the people who live their showed all money to be accounted for. One of the people we case tracked was unable to sign her name so the home had arranged for her to use a stamp when she visited the bank to confirm her identity and to promote her involvement in managing her finances. Staff explained that they are in the process of developing person centered care plans with some of the people who live at the home which will detail their needs, preferences and aspirations in a way which is more individual and personal. People are supported to be safe without restricting their lifestyles by clearly documented assessments of the risks they face from the environment and the various activities that they do. These cover areas such as fire, finances, travel, community access, eating, mobility, behaiviour, infection control and water safety. One person, who was identified as being is at serious hazard of choking or harm due to her tendency to eat inedible items, had a risk assessment which outlined the steps that staff should take in order to minimise the risk of anything inedible being eaten. Observation of her staff support and her bedroom showed that this risk was being well managed however, the assessment did not state what action staff should take if they suspected that she had eaten something inedible. The evaluation of the risk stated that the potential effect of eating something inedible was a minor injury, this may not be the case as eating inedible items can be fatal. Staff spoken to said that they would seek urgent medical advice if they suspected that anything inedible had been eaten. Advice was given to the manager about the wording in a care plan for one person which described how staff should intervene if the person was physically aggressive. The manager agreed that this would be updated to ensure that any such intervention was appropriate. A visiting health care professional told us that staff follow the advice that she gives and support people in line with what is in their care plans. Care Homes for Adults (18-65 years) Page 19 of 34 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a range of different activities both within the home and in the local community. Evidence: Activities sheets were seen which contained a record of the activities that people had taken part in such as swimming, sensory room, visiting a local farm attraction, shopping, walking, music and bowling. Some of the people in Magnolia House attend day centres and college during the day. In Lilly and Violet House people do not attend any day service and all day time activities take place from the home. The home arranges some evening activities such as DVD nights, music, going to the pub and manicures. The home has a vehicle to make it easier for people to access different places. Menus were viewed in Magnolia House and appeared varied and nutritious. People told us that they were involved in cooking their meals and that the food is good. Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: One person who lives in Magnolia House spends most of her time in her bedroom. The home have requested advice from a learning disability nurse on how best to make sure that she is supported and given the option of going out and participating in other activities. There is however, no record to show how staff have encouraged her to try different activities either within her room or out. Care Homes for Adults (18-65 years) Page 21 of 34 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People generally have their health and personal care needs well met however systems to ensure the accurate administration of medication needs to be more robust. Evidence: Individual plans of care contained evidence that people attend health appointments with a range of health professionals such as dentists, General Practitioners, community nurses, podiatrists and opticians. There was evidence that people are supported to attend health checks and screening as determined by their health needs. One person however, who takes a medication that requires them to have regular medication reviews, had not had their medication reviewed for two years. Individual plans of care contained details about peoples preferences in relation to their personal care such as whether they liked to bath or shower and the time of day they preferred to do this. Staff spoken to were all aware of the need to check the temperature of bath water before supporting someone to bathe. Records show that people were being supported to bathe at temperatures that were safe and comfortable. The administration of medication is generally well managed, however, two entries on the Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: medication record were not signed to show that people received their medication as prescribed. Several entries on another sheet were made to show that a particular medication had been missed. Through discussions with staff it transpired that this medication had been refused rather than missed. One person receives their medication disguised inside food. There was no record on their file to say that this had been agreed by the persons general practitioner or pharmacist. There was also no evidence of the person giving consent to their medication being given in this way or an assessment that it is in their best interests is they are unable to consent. Care Homes for Adults (18-65 years) Page 23 of 34 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements to the homes procedures and practices ensure that people are safeguarded from harm. Evidence: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. The manager said that the home has received one complaint since the last inspection. This was dealt with under the homes policy and procedures and resolved to the satisfaction of those involved. One referral have been made by home to the Local Authority under the locally agreed safeguarding adults procedure. This incident is still being investigated but records show that the home is following the correct procedures and has taken steps to ensure that people are safeguarded whilst the investigation takes place. Staff spoken to knew how to raise any concerns that they may have and were aware of their responsibilities under the locally agreed safeguarding procedures. Care Homes for Adults (18-65 years) Page 24 of 34 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Violet House and the self contained flat provide a good standard of living accommodation. The people living in Magnolia House and Lilly House will benefit from the planned improvements. Evidence: The manager explained that quotes have been obtained and a schedule of work set in order to get the major repairs and maintenance work identified completed within eight weeks of the inspection. The manager explained that the company owner had visited the properties and agreed additional resources in order to finance the work required. Since the last inspection the new kitchen in Magnolia has been completed, window opening restrictors have been fitted to all windows except to the lounge in Magnolia House. These require a special type of restrictor which the manager explained were on order. No unpleasant odours were noted in any of the three properties. Magnolia House and Lilly House still show signs of wear and tear but the planned redecoration and refurbishment should address this. Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: The lounge area in Magnolia House is not spacious for the number of people who use it, particularly as some individuals are known not to have a good relationship with each other. The manager told us that he would review the available space with a view to making better use of the space available. Care Homes for Adults (18-65 years) Page 26 of 34 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and cared for by a committed and caring staff team. Evidence: The recruitment of staff is well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with older people. Staff told us that they had an induction when they first started working at the home which included working alongside an experienced colleague to make sure that they had all of the information that they need to do their job in the right way. Staff explained that they attend training courses such as food hygiene, safeguarding of adults, infection control, fire safety and moving and handling, health and safety, first aid, medication and challenging behaiviour. Some staff have also attended training relating to the specific needs of individuals living at the home. Staff were observed interacting with people in a positive manner which demonstrated an understanding of the persons needs. The manager told us that the quality of staff working in the home was high and that he had heard nothing but good about the newly recruited staff. Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: A visiting health care professional told us that there had been some changes to the staff teams which has impacted on the consistency of the care and support that people have received. Staff spoken to also commented on the changes. Care Homes for Adults (18-65 years) Page 28 of 34 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home manager is committed to developing and making improvements to the home. Evidence: The current manager has been in post for three months at the time of inspection. He is applying for registration with the Care Quality Commission to become the registered manager for the home. The manager explained that the home are in the process of sending out satisfaction surveys to the people who live in the home and to their relatives. The results of a survey recently sent out to staff were viewed and generally positive. The manager explained that the company carry out an annual audit against the National Minimum Standards, results of this show that their has been an improvement from 64 in July 2008 to 81 in September 2009. Records show that the necessary safety checks such as fire checks, checks on the water system and portable appliance testing have all been carried out recently. Hoists and lifting equipment has been serviced as per manufacturers recommendations. Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: The manager stated that he was committed to see the standards at the home improve and said that he felt supported by the Area Manager and the company. We made six requirements of the home at our last inspection. Five of these had been met and the sixth, relating to the environment, was in the process of being met. Care Homes for Adults (18-65 years) Page 30 of 34 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 24 23 Repairs and maintenance 01/10/2009 must be completed to ensure that the home is safe, clean and reasonably decorated and furnished. In order to meet the needs of the people who live there. Care Homes for Adults (18-65 years) Page 31 of 34 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 20 13 Arrangements must be made 28/09/2009 for the accurate recording, safekeeping and safe administration of peoples medication. To ensure that people receive their medication safely and as prescribed. 2 20 13 If anyone is to be 15/10/2009 administered medication covertly a full assessment must be carried to determine that doing so does not constitute a deprivation of the person’s liberty. To ensure that people’s rights are safeguarded. Care Homes for Adults (18-65 years) Page 32 of 34 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Risk assessments should accurately detail the potential impact of the risk and any emergency action to be taken should the risk occur. Where people chose not to participate in activities records should show what activities they have been offered. 2 14 Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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