Inspection on 25/01/06 for Magnolia Lodge

This inspection was carried out on 25th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia Lodge 13/08/07

Magnolia Lodge 20/06/06

Magnolia Lodge 04/10/05

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Magnolia Lodge 42 Hollow Lane Shinfield Reading Berks RG2 9BT Lead Inspector Lucy Martin Unannounced Inspection 25th January 2006 9:35 Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 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 Lodge DS0000065611.V276622.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Magnolia Lodge Address 42 Hollow Lane Shinfield Reading Berks RG2 9BT 01707 652053 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Caretech Community Service Limited Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 Brief Description of the Service: Magnolia Lodge is a care home providing personal care to up to six adults who have learning, physical and emotional/mental health difficulties. There are currently five male service users in residence, four of whom have physical disabilities and use wheelchairs. Magnolia Lodge is a large detached house set back on a main road a few miles from both Reading and Wokingham town centres. It is a two-storied building with the first floor accessible via an internal passenger lift. There are five single bedrooms on the first floor and one on the ground floor. None of the bedrooms have en-suite facilities. There are local community facilities nearby and the home has its own transport as well as being on a public transport route to the local town centres. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection which started at 9.35am and finished at 1.05pm. The inspector spent time with the current Manager and spoke to other members of staff on duty as they carried out their duties. All of the five service users were seen and spoken with informally. A variety of records, including service user’s files, were seen. What the service does well: What has improved since the last inspection? What they could do better: There is sill much work to do at this home. There is an urgent need to redecorate and refurbish the home which should be undertaken when the new extension is built as the building work will include most of the house. It is anticipated that the work will commence in March or April 2006. Out of the 9 requirements made at the last inspection 6 remain unmet. These unmet requirements must now be met within the new timescales given. There continue to be serious mistakes made in the administration of medication. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 6 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 Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: Standard 2 is a key Standard which has not been assessed during the last 12 months. This is due to no new service users moving into the home in the last year. It is anticipated that a large extension will be built adding a number of en-suite bedrooms and this Standard will be assessed at the next inspection when new service users will have been admitted. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 There were some improvements noted in the contents of the service user’s files but they still do not contain all the required information. Much work has been undertaken clarifying the complex financial arrangements for each service user but this information needs to be recorded in their file. EVIDENCE: It was an unmet requirement at the last inspection that the service user’s plans are reviewed to ensure that they contain all the required information and are up to date. This had not been met but some improvements have been made. Two service user’s files were seen and there was more detailed information regarding their individual support needs. However, the information is minimal and there is no photo of the service user or details of their financial situation. In addition, each service user has two files and there is still uncertainty about what information should be recorded in each file. This issue still needs clarification. It was a recommendation made at the last inspection that the behaviour and activities of service users are recorded on a day-to-day basis at the end of Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 10 each shift. This has been done and each service user now has a daily diary where these details are recorded. Much work has been undertaken since the last inspection attempting to clarify the complex financial arrangements in place for each service user. This is commendable and the arrangements are now more transparent. However, the requirement that there is written information for each service user regarding how their finances are managed has not been met as there was no information in the files seen. The home has no safe or secure place to store money and the all the financial information was off site. This is not ideal and it is a requirement that the home has a secure place to store money. A number of risk assessments are in place regarding individual service users. The risk assessments were found kept in different places, some in the kitchen and some in service user’s files and one service user had five separate risk assessments covering the same area of concern. All the information regarding risk and its management should be in the service user’s file and it is a recommendation that this area is reviewed. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 There has been much work undertaken in reviewing the activities available to service users. The menus seen appeared varied and meals were chosen by service users. EVIDENCE: The five service users take part in a variety of daily activities. One service user goes independently to work five days a week and another goes to a day centre twice a week. Since the last inspection, the daily activities available to service users has been reviewed and a new timetable drawn up. This has been a good piece of work. All the service users have a programme of activities and the records need to be kept up to date regarding their participation. The service users also take part in a range of leisure activities and recent trips out have included going to the cinema, shopping, trips to the pub and out for lunch. Family and friends are made welcome at the home and some of the service users have strong friendships. Service users are free to choose where they spend time and one service user spends most of his time in his room. The staff Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 12 on duty were seen to interact with service users but this is an area which could be improved within the house. The Manager was aware of this and was looking at ways to encourage relationships to develop. The food menus were seen and were varied in content. The service users are involved in choosing the menus and can have alternative meals if they wish. Meals are not eaten all together round a table as some service users prefer to eat in their rooms. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 Personal support is given in a sensitive manner. There is a lot of medication to administer and there were some gaps noted in the administration records. EVIDENCE: Individual support requirements are contained in service user’s files and there is good continuity of staff who know service users well. It was identified in the last inspection report that although the medication systems generally work well, during the inspection there was a potentially serious medication error. It was an unmet requirement at the last inspection that the medication administration systems are reviewed and monitored. On this inspection the medication administration records showed that the staff team administer a large and changeable amount of medication. Although the system in place is that two staff administer the medication, it was evident that one service user had not had his medication administered the previous evening and this oversight had not been noticed and brought to the Manager’s attention when the next medication was administered in the morning. In addition, there had been an occasion in the past month when a service user had not had a prescribed medication administered for a period of 9 days when the medication had not been supplied by the chemist. Fortunately, there were no lasting consequences but these are serious issues which have been raised in previous reports. The inspector was informed that external medication training Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 14 is being provided for one member of staff but training should be given to all staff who administer medication to avoid any further mistakes. It remains an unmet requirement to review and monitor the medication administration systems. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The home is in urgent need of a major overhaul regarding decoration, carpets and furniture. The plans for a major extension have been delayed until March or April 2006 and the rest of the building will be renovated during this work. Some improvements were noted since the last inspection. EVIDENCE: When the new owners, Caretech, took over the building in August 2005 it was in need of a major overhaul which included complete redecoration, recarpeting and the purchase of much new furniture. Some immediate work was undertaken in terms of decoration but it was planned that building work to add a large extension would be starting in October 2005. This has been delayed and it is now planned that the extension will be started in March/April 2006. This will add a further four en-suite bedrooms to the home bringing the total registration numbers to 10. The delay to the extension has meant that other areas of the house are still in need of urgent attention as it is planned that during the building works all areas of the house in need will be redecorated. The carpets on the ground floor in the communal areas are heavily stained and do not match. It is a requirement that they are replaced if there are further delays to the start of the building works. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 17 There have been some improvements to the building since the last inspection as some new chairs and settees have been bought for the lounge as well as a new television. New furniture has also been purchased for the dining room and was waiting to be assembled. There was a lot of old furniture at the rear and the side of the house which looked unsightly. The inspector was informed that a skip was being arranged to collect all these items. The homes current laundry arrangements are not satisfactory. There is a domestic washing machine sited in the room near the office and a domestic tumble drier in a room next to the kitchen. The washing machine does not have a sluicing facility or the capability of washing soiled laundry at appropriate temperatures (minimum 65C for not less than 10 minutes). It is a requirement that a suitable washing machine is purchased and advice is given that this is an industrial model. It is noted that there is provision for a separate laundry room in the new plans. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 The home continues to have a stable and experienced staff team. The numbers of staff on duty has increased since the last inspection. EVIDENCE: The home has an experienced and stable staff team and no staff have left since the last inspection. There have been some new staff appointments and it is positive that the number of staff on duty during the day has increased from two to three. At night there continues to be a waking member of staff and a sleep-in. There has been no use of agency staff with existing staff covering staff absences. It was an unmet requirement at the last inspection for the Providers to ensure that training needs assessments and appropriate training courses are developed. From discussions with the Manager it was clear that most staff have now attended all the core training available and one staff is starting a medication course. The Manager had met with the organisations training Manager and there are a range of courses available. It is a requirement that all the staff working in this house receive training in mental health as the majority of service users have mental health problems as well as a learning disability. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 The home is well run but there is still a need to ensure that monthly monitoring visits take place and a copy of the report is kept at the home. EVIDENCE: There are some proposed changes to the management of the home. The current Manager has decided to become the Deputy Manager and a new Manager has to be recruited. Until this time, the existing Manager will continue in post but the requirement to submit an application form to the CSCI to be the Registered Manager is no longer necessary. It is a requirement that a new Manager is recruited as soon as possible. There were two unmet requirements at the last inspection relating to quality assurance. It was a requirement to develop an effective quality monitoring system and to ensure that monitoring visits take place on a monthly basis. Both of these requirements remain unmet. There was no evidence that there is an effective monitoring system in place although the inspector was informed that a visit is being made in the next few weeks by the person responsible for monitoring from Caretech. There was no evidence that the monthly monitoring Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 20 visits are taking place. There were no reports kept in the home and no reports have been sent to the CSCI. These matters must be addressed. The requirement that the home displays a current certificate of registration has not been met. The certificate on display still shows the previous owners of the home. Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 1 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 x 33 3 34 x 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 1 x 2 x 2 x x x x Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15(2) Requirement Service users plans are reviewed to ensure that they contain all the required information and are up to date. (Previous timescale of 04/01/06 not met) Timescale for action 25/04/06 2 YA20 13(2) The medication administration 25/03/06 systems are reviewed and monitored. (Previous timescale of 04/12/05 not met) To develop an effective quality monitoring system. (Previous timescale of 04/01/06 not met) Monitoring visits take place on a monthly basis. (Previous timescale of 04/12/05 not met) There is written information for each service user regarding how their finances are managed. (Previous timescale of 04/01/06 not met) DS0000065611.V276622.R01.S.doc 3 YA39 24 25/04/06 4 YA39 26(2) 25/03/06 5 YA7 17(2) Schedule 4 25/04/06 Magnolia Lodge Version 5.1 Page 23 6 YA43 28 of C S Act 2000 The current certificate of registration is on display at the home. (Previous timescale of 04/12/05 not met) The Providers provide a secure place where the money and valuables of service users may be deposited for safe keeping at the home. Staff attend training in the administration of medication The carpets in the communal areas on the ground floor are replaced. There are suitable laundry facilities at the home including a washing machine with a sluicing facility or capability of washing at appropriately high temperatures. All staff receive training in mental health. The Providers recruit a suitably qualified and experienced Manager for the home. 25/03/06 7 YA7 16(2)(l) 25/04/06 8 9 10 YA20 YA24 YA30 13(2) 18(1)(c) 16(2)(c) 13(1)(3) 25/04/06 25/04/06 25/04/06 11 12 YA35 YA37 18(1)(c)(i) 8, 9 25/04/06 25/04/06 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 YA6 Good Practice Recommendations There is clarity regarding the information contained in service users files. (This recommendation is outstanding from the last inspection) The completion and the storage arrangements for risk assessments are reviewed. DS0000065611.V276622.R01.S.doc Version 5.1 Page 24 2 YA9 Magnolia Lodge Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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. Extracts may not be used or reproduced without the express permission of CSCI Magnolia Lodge DS0000065611.V276622.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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