This inspection was carried out on 13th July 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.
CARE HOMES FOR OLDER PEOPLE
Magnolia House 40-42 Morton Road Exmouth Devon EX8 1BA Lead Inspector
Michelle Oliver Announced 13 July 2005 09:30hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Magnolia House Address 40-42 Morton Road Exmouth Devon EX8 1BA 01395 264338 01395 275824 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashgrove Care Company Limited Mr Thomas Duncan Keough Care Home 25 Category(ies) of DE Dementia (25) registration, with number PD(E) Physical dis - over 65 (25) of places Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 14 February 2005 Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Magnolia House provides personal care for up to 25 older people who may also have a dementia type illness and/or a physical disability. It is situated close to the seafront and not far from the town centre of Exmouth.The property was formerly three large terraced houses, which have been converted and adapted. Parking is on the road. Accommodation is arranged over three floors. All rooms are singles and 12 of these have en suite facilities. There are two lounges and two dining rooms on the ground floor. A passenger lift accesses all floors. A small sitting area is available to the front of the building and a small courtyard area to the rear which has been made accessible to service users. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on Wednesday 13th July 2005 from 9.30am to 2.pm. The providers, Mr & Mrs T Keough and the manager, Mrs Andrea Keough were present throughout the inspection. The inspector spoke to 8 residents and two relatives on this visit. All members of staff on duty also took part in the inspection. The atmosphere in the home was warm, welcoming and friendly and residents were relaxed, content and spoke highly of the care they received in the home. The inspector looked around the home, a number of records were inspected, which included pre inspection questionnaire, comment cards, thank you letters from relatives, staff files and a recent service user survey and results. The manager and staff were very helpful on the day of the inspection and a lot of positive discussions, advice and suggestions took place throughout the inspection. What the service does well: What has improved since the last inspection?
The home continues to maintain and renew the decoration and furnishings at the home. All public areas and corridors at the home have been recarpeted since the last inspection and some furniture has been replaced to ensure that the home is always fresh and up to date. New profile nursing beds have been bought to replace some divans. This ensures that residents are more comfortable and that staff are protected when assisting residents with moving and positioning as the height and positions of the beds can be controlled electronically.
Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 7 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. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 &6 Service users benefit from good admission and assessment practice that ensures that the home is able to meet their needs. EVIDENCE: Care needs are well met through a comprehensive assessment process that is carried out before a resident decides to live at the home. Care plans are completed from this information. The assessment exceeds the elements listed in the standard. A comprehensive assessment was seen for a resident recently admitted to the home. The home does not admit residents for intermediate care. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 ,8 & 10. Resident’s health and social care needs are well met and promoted by good planning arrangements. Resident’s privacy and dignity are met and promoted by the staff and management team at Magnolia House. EVIDENCE: Records are properly kept for each resident. They include good guidance on help needed with mobility and risk of falls. Staff showed clear respect for residents’ privacy, for example they knocked on bedroom doors and waited to be asked in before entering. The home promotes residents’ welfare in cooperation with families and health care professionals. One resident commented “Very happy and very well cared for”, another “ I’ve been satisfied with the care”. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 14. Social activities and meals are generally well managed and provide daily variation and interest for people living in the home. Residents are encouraged to maintain their independence, exercising choice and taking control of their lives. EVIDENCE: Staff and management have worked hard to gain information about individual residents social and leisure needs and this is included in care plans. Some residents confirmed that they were asked what they would like to do daily but often they did not want to take part and enjoyed watching TV or listening to the radio. Many enjoyed the frequent and varied outings which are arranged by the staff at Magnolia House. One resident commented that they would like to go out on a trip. This was discussed with the provider who will look into this matter. Visitors said that they are encouraged to visit whenever they wish and that they are always made welcome at home. Residents are encouraged to maintain their independence in whatever way or manner is meaningful to them. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18. Residents and relatives are confident that they are listened to and their requests actioned. Arrangements for protecting residents are not currently satisfactorily protecting them from the risk of harm or abuse. EVIDENCE: Residents confirmed that their views are taken seriously, that their concerns are fully taken on board and that action is taken where needed. The home has received one complaint since the last inspection which the manager investigated. A resident commented that they had never had to make a complaint but they didn’t know the complaints procedure. A copy of the home’s complaint procedure is prominently displayed in the entrance hall for residents and visitors information. There was nothing to suggest that residents are anything but safe and protected at the home. Staff have not received training in the prevention of abuse and what they should do in the event of concerns for the safety of service users. All staff were able to describe bad practice and confirmed that they would not hesitate to report any concerns to the manager or providers. Training has been arranged to take place in August 2005. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The standard of the environment within the home is very good providing the residents with an attractive and homely place to live. Residents’ rooms suit their needs and have been personalised. Attention has been made to the safety of residents and staff. EVIDENCE: The property is well maintained, with homely and comfortable communal spaces. The home employs 2 maintenance persons and a record is kept of all routine maintenance requests. The home offers two lounges and a dining room. Residents’ rooms were personalised with sentimental items, photographs and small pieces of furniture and all expressed their satisfaction with the accommodation provided. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29. Staff are employed in sufficient numbers to meet residents’ needs. The home’s procedure for the recruitment of staff are consistent and provide safeguards for the protection of residents living in the home. EVIDENCE: The home aims to provide 5 carers between 8am and 2pm, 4 between 2pm and 8pm, and 2 between 8pm and 8am. There are also a cook, a laundry person and 2 domestics on duty during the day. The manager said that they are occasionally short staffed at weekends, but that she is always on call and has worked a shift at the home when needed. Residents were happy with the number and the efficiency of the staff on duty at any one time. A relative said that she felt that residents should have more “one to one” time with staff. They felt that their relative was not stimulated. This was discussed with the providers and manager who discussed the concerns with the relative at the time of the visit. Three staff files were looked at. All included the relevant documents including Police checks, two references and proof of identity. Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 &38 The manager provides clear leadership and guidance to staff to ensure that residents receive consistent care in a safe environment. EVIDENCE: The providers and manager give a clear lead and direction to staff. Residents and a visitor confirmed that the providers and manager are approachable and seek to ensure that all their needs are met. The systems for resident consultation are good with evidence that indicates residents’ views are both sought and acted upon. A Resident Association meeting is held monthly which covers subjects such as catering, personal care support and residents questionnaires and results. Safe working practices are employed and risk assessments are undertaken. Records show that staff undertake regular training in the prevention of fire. Fire alarms and emergency lighting are regularly checked.
Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Magnolia House D54 D06_s21974_magnoliahouseexmouth_v231660_130705 stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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