Inspection on 22/02/06 for Magnolia House, Exmouth

This inspection was carried out on 22nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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, Exmouth 18/08/09

Magnolia House, Exmouth 20/08/08

Magnolia House, Exmouth 15/06/07

Magnolia House, Exmouth 26/06/06

Magnolia House, Exmouth 13/07/05

Magnolia House, Exmouth 14/02/05

Magnolia House, Exmouth 13/07/04

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

CARE HOMES FOR OLDER PEOPLE Magnolia House, Exmouth 40 - 42 Morton Road Exmouth Devon EX8 1BA Lead Inspector Michelle Oliver Unannounced Inspection 22nd February 2006 14.00. 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, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 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, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Magnolia House, Exmouth Address 40 - 42 Morton Road Exmouth Devon EX8 1BA 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) 01395 264338 01395 275824 theashgrove@magnolia38-42.freeserve.co.u Ashgrove Care Company Limited Mr Thomas Duncan Keough Care Home 25 Category(ies) of Dementia (25), Physical disability over 65 years registration, with number of age (25) of places Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 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, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection began at 2 pm and lasted 3 hours. Several key standards were inspected. Those standards not assessed had been inspected at the last visit and all met the standards at that time. Many of the residents took part in the inspection and talked about their life at Magnolia House. Staff were also helpful and a lot of positive discussion took place about the ethos of the home and training. What the service does well: 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 contacting your local CSCI office. Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 6 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, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 7 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 the following standard(s): None of these standards were assessed during this visit. The key standards were met at the last inspection. EVIDENCE: Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 9. Medication is currently not being well managed, thereby potentially putting residents at risk. EVIDENCE: The home’s current procedure for ordering medication is delegated to the supplying pharmacy. It is considered essential for the designated person to see the prescriptions to check them against the items ordered. Staff who administer medication have not received appropriate training and have not been assessed as competent to carry out this task. The owner said that training was planned but a date had not been formalised. Generally, medicines are recorded when received at the home, however those medicines received out of the normal cycle were not. Hand written entries on the medication record charts often only had one signature and were not witnessed. Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 9 Not all medication was being administered in accordance with the directions made on the dispensing labels and it was not possible to find evidence to support this change. This puts residents at potential risk of not receiving the correct dosage of their medicine. Provision is not always made for residents to receive their medicine if they are not at the home at the time it is prescribed. The number of recorded doses administered did not always correspond with the quantity of medication having been recorded as being received. This is of concern as it questions whether records are being kept correctly when medication is given. Medication records had not been completed consistently when administered by staff. Once again this is of concern as a medication may be omitted or given again when already administered if a member of staff has not signed when it has been given. A separate fridge is available for the storage of medication. However, no records are made to demonstrate that it is kept within the appropriate temperature range and other non-medicinal items were kept within the fridge, which compromised infection control procedures. Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 13 & 15. Links with visitors and the community are good. Dietary requirements of the residents are well met. EVIDENCE: Residents are welcome to visit the home at any time, with the consent of the resident they are visiting. A visitor said that they are always made to feel welcome and that nothing is too much trouble for the staff. Residents said that they enjoy the meals provided at the home. A record is kept of the meals provided and of the diet taken by individual residents to ensure that any change in appetite is identified promptly. Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 11 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 the following standard(s): None of these standards were assessed during this visit. The key standards were met at the last inspection. EVIDENCE: Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 26. Residents enjoy living in a comfortable, clean environment. EVIDENCE: At the time of this unannounced visit the home was clean and there was no unpleasant odour. The home employs two domestics and care staff deal with any cleaning tasks necessary when the domestics are not on duty during the afternoon. The laundry was clean and well organised. Some wall tiles were loose and some missing. This will make cleaning of the walls effectively more difficult. This was discussed with the owner at the time of this visit. A dedicated laundry person has been employed since the last inspection. Staff said that the quality of the laundering and ironing of residents’ clothes had improved since their appointment. A visitor commented that more care is needed when residents’ clothes are sorted and put away. They described occasions when residents did not wear their own clothes. Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 30. Residents benefit from being cared for by staff who are trained and competent. This will be further assured as more staff complete training currently being undertaken. EVIDENCE: Residents said they had confidence in the staff. Staff talked of the different training they have received and that which is planned for the near future, which will keep them informed and updated. Two care staff are currently undertaking NVQ training, 3 are awaiting confirmation of this qualification and three have attained the qualification. The qualification confirms a certain standard of competence. Staff need to complete accredited medication training to ensure that medication is handled safely. [Refer to NMS standard 9] Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this visit. The key standards were met at the last inspection. EVIDENCE: Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 15 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 16 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 OP9 Regulation 13[2] Requirement Timescale for action 2. OP9 18[c] The registered person shall make arrangements for the recording, 21/03/06 handling, safekeeping, safe administration and disposal of medications received into the home. The registered person shall ensure that persons employed by the registered person to work at the care home receive training appropriate to the work they are 21/03/06 to perform [this relates to staff administering medicines not receiving accredited training] 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 OP9 Good Practice Recommendations A daily record of the medication fridge temperatures is kept. Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 17 2. 3 OP9 OP26 The designated person to see prescriptions to check them against the items ordered. Tiles on the laundry walls which are loose or missing to be replaced to enable the walls to be readily cleanable. Magnolia House, Exmouth DS0000021974.V273953.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Exeter 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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