Inspection on 28/04/08 for Magnolia Lodge

This inspection was carried out on 28th April 2008.

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

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia Lodge 09/12/09

Magnolia Lodge 25/02/09

Magnolia Lodge 25/04/07

Magnolia Lodge 05/10/06

Magnolia Lodge 30/11/05

Magnolia Lodge 15/12/04

Magnolia Lodge 16/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Magnolia Lodge Herbert Road Chelston Torquay Devon TQ2 6RP Lead Inspector Stella Lindsay Key Inspection (unannounced) 28th April 2008 12 Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 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 DS0000018392.V362335.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 DS0000018392.V362335.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magnolia Lodge Address Herbert Road Chelston Torquay Devon TQ2 6RP 01803 605348 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) Rotel Ltd Vacancy Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (11) of places Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2007 Brief Description of the Service: Magnolia Lodge is a care home for up to eleven adults with Learning Disabilities. The large detached house is situated in a residential area of Torquay, close to the railway station, bus routes and the Riviera Centre. There is a car park to the front and gardens are laid out mainly to lawn at the back. Entrance to the Home is by level access into a sun lounge. This had been used by smokers in the home, but new arrangements were being considered. The ground floor has a lounge and dining room, office, kitchen and a laundry, and six bedrooms each with an en suite toilet and shower or bath. One of these is used by staff on sleep-in duty. Stairs lead to the lower ground floor, which is a self contained flat for one resident. It has a bedroom, bathroom, and lounge. Stairs lead to the first floor; a staff sleep-in room is situated on a mezzanine floor halfway up the stairs. The first floor has a further six single en-suite bedrooms, and a bathroom. Current fees range from £420 to £1,200 per week. Information is available in the lounge, including the Service users’ Guide. There is access to the internet in the home’s office, and a copy of the inspection report could be made available there. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what the Inspector did for this inspection. • Before the inspection Mark sent the Inspector some information. • Residents and staff and answered questions about the home. The Inspector looked around the home. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 6 Residents and staff spoke with the Inspector. The Inspector looked at Care plans. Mark showed the Inspector other records about the home. What the service does well: Magnolia Lodge is a friendly and comfortable place, and residents feel at home there, with the staff that they know well. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 7 Staff help residents to look after their health. Everybody who lives at the home has their own bedroom and toilet. They have good food, and can make drinks when they like. They go on outings and holidays. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? What has got better since the last inspection? Magnolia Lodge has a new Manager, who listens to people, and gets things done. Well done, Mark. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 9 What they could do better: The residents would like to have more staff at evenings and weekends, so that they can have more choice of activities. They would like the staff to stay, when they have got to know them, and not be moved to another house. They would like new sofas in the lounge, and the lounge and dining room to be redecorated and look better. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 10 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 DS0000018392.V362335.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was a suitable policy and procedure but it had not always been fully carried out. People already living and working at Magnolia Lodge are not always considered, or fully prepared, for new people moving in. EVIDENCE: The Service user guide was available in the lounge, and contained many photos to give a clear idea of the premises and service provided. There was a suitable policy and procedure for the admission of new residents, which included visits to the home and consultation with current residents, but this had not always been followed. Two residents had moved in since the last inspection. One had come from an assessment resource, and came with records from there and from their previous placement. One resident came from another care home under the same ownership. The care plan and records accompanied them, but they did not visit beforehand and the current residents were not given time for discussion or preparation. They knew each other from social events and day care. The support that would need to meet the person’s needs satisfactorily had not been fully appreciated. The resident wanted to leave their previous placement, and the Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 12 Manager said that the move had been urgent. When urgent situations need prompt action, care must be taken to maintain good practice, and to share views and information clearly and quickly. The contract with the resident’s Social Services Community team was not available in the home. The statement of terms with Rotel still referred to their previous placement. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are able to communicate well with the residents and understand their needs, but further progress could be made in involving all residents in the planning of care and supporting residents to take control of their own lives. EVIDENCE: Each resident had a plan of care clearly written addressing aspects of their care and support needs. The Manager said in his Quality Assessment report that he considered it would be good practice for his team to rewrite these in ‘an appropriate format so that service users are empowered to make their own choices and have a better understanding of their power to choose.’ Some residents had been able to contribute to updates of their own plans. Progress and evaluation sheets were stored on computer, for easy updating. Staff were seen to write in residents’ daily diaries, recording health and social events. Each resident had a keyworker, who was expected to make sure they had time for one-to-one chats, to make sure everyone had their views and feelings considered. Records were seen of these monthly meetings. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 14 The Manager has started to promote the setting up of a person centred planning circle for all the residents receiving residential or day care with Rotel, to involve residents, staff and management, and health and social service professionals. Monthly residents’ meetings had been held in the home. At the previous one in April 2008, all but one of the residents had attended, it was lead by the junior staff member on duty, and discussion covered activities, meals, household chores and changes in staff and residents. Information about Speaking Out In Torbay (SPOT) meetings was on display in the entrance hall, and residents had been supported to attend meetings. Funding was being sought for an alternative advocate for a resident who had not been comfortable with a previous helper. Residents each had their own bank account. Two managed their own cash, while the others have amounts for daily use kept in a safe in the office, in individual cash boxes. A record of transactions was kept and was seen to be accurate. The Senior Support Worker on each shift checked these at each handover, and receipts were kept and audited. Risk management strategies were seen to have been agreed and recorded in residents’ care plans. A meeting was being convened later that week, three weeks after the admission of a resident from another home in the group, to work on a new behavioural plan. This recognises that in a new environment, careful consideration must be given to stresses and strains as well as opportunities. A professional from the Learning Disability team said they were pleased with the risk assessments and recording in the home. They paid tribute to the organisation’s considerable experience of working with people who had complex problems. Safety while travelling in the home’s vehicle had been considered, and because of some residents’ health problems it was decided by staff that no residents should travel in the front seat. This was mentioned as ‘silly rules’ by two residents. Further discussion with residents is needed, so that essential safe measures are agreed and accepted. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents enjoy their activities, but there was little choice of activities and staff had not been effective in motivating people to engage in a variety of activities, particularly in the evenings and at weekends. More involvement with provision of meals would help residents feel more in control of their lives. EVIDENCE: Residents were participating in a variety of activities. Two residents were at home during the day and this was by choice. Rotel provide day care in a facility in central Torquay called Focus 2000. During this inspection four Magnolia Lodge residents were attending this provision, with one of the Support staff from Magnolia. On their return this member of staff said she had been able to accompany people on outings during the day. People going to Focus 2000 from Magnolia take packed lunches with them. One resident was going regularly to another local day care facility. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 16 One enjoyed horticulture and also worked regularly on a training farm. They said they would like more tools for working in the garden at home. One resident was planning to move to more independent living arrangements. The Manager was making contact with health professionals needed to make progress with this process. One resident was pleased to show us the bike and karaoke machine given by their Mum, and family photos. ‘It’s alright here’, they said, and could not think of anything that needed to be improved. Residents said that they had been pleased when the company provided Skye television, but it had later been taken away with no discussion, which disappointed and disturbed them. There were attractive pictures by residents framed and displayed on the walls of the communal areas. There are not always enough staff to support residents in their activities. One resident said that they were ‘lucky’ at Easter, because some residents had gone home, so a Support Worker could be spared to accompany them. A staff member suggested in a survey that, ‘I think our clients would benefit from an activities co-ordinator so we would have an extra member of staff to enable us to participate in more outdoor excursions etc.’ Staff said that residents often do not want to go out in the evenings, even when an activity is arranged. Residents said they would like to go out in the evenings ‘if someone suggested something good.’ They said they would like more trips to the pub to socialise. Suggestions of outings to Paignton Zoo and the annual Bikers’ conference on the green at Paignton had also come from residents. At weekends one resident is supported to go to the bank, sometimes accompanied by one or more other residents. Otherwise weekend outings need to be group outings, as with eight residents and two staff it is paramount to watch for the safety of residents. Safety in the locality had also become a concern, as the buses do not run past the house, and there had been an assault on a resident, reported to the police, which highlighted residents’ anxiety about being out alone. When we arrived at the start of this inspection, a group of residents was packing up to leave for a holiday at Butlins, Minehead. On their return, they said they had enjoyed themselves, in spite of changeable weather. Others were considering a trip to Alton Towers. Residents said they liked their food, had plenty of vegetables, and fruit was available. One resident brought fresh vegetables from their workplace. During the Residents’ Meeting, people had said they enjoy the takeaways on Friday evenings. During the inspection there was a choice of sandwiches and omelettes for lunch. The main meal is in the evening. A three weekly rotation of menus was Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 17 displayed, with photos, to make sure people knew what was on offer. This is good, but residents said they would like to join in more with cooking and shopping. Staff do not eat with the residents. They said it is too busy around meal times, and the Manager said they need their own breaks and to keep control of their meals, because they work such long shifts. Residents should be able to choose whether to eat alone or with others, including staff. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff had given personal care according to individual need, with residents being supported to keep their appearance as they wished, and to have their health care needs well met. EVIDENCE: Personal care was offered with care to meet people’s individual needs. One resident said that they made it clear about who they wanted to work with, and they were pleased to find that they had been listened to. Information in easy read format was seen on residents’ files about going to the doctor, including help with describing what was wrong. Each resident had a daily diary, with records kept of support with health interventions, including preventative measures, blood tests, Occupational Therapy assessments and exercise programmes. The home had established good working relationships with G.Ps, care managers, day services representatives, continence nurses, community support nurses, the specialist support team, and learning disabilities teams. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 19 A resident had been supported regularly to attend Alexander technique sessions, which they had found to be helpful for their condition. A chiropodist visits the home regularly, for which residents pay. One resident goes by choice to the podiatry service. A specialist nurse had been to advise a resident on their dietary needs, and records of this person’s food is kept regularly. Otherwise, menus are recorded in the home’s diary. Residents felt comfortable with members of staff and agreed that they receive good personalised individual care. One resident was pleased that staff had helped colour their hair. One resident was being supported to attend a Safeguarding group for help with their relationship problems. The management had provided staff to be available at night for a resident who needed company till midnight or later. A monitored dosage system is in place for the safe administration of medication. Controlled drugs were stored properly and recorded accurately. A questionnaire was seen on a residents file showing that an assessment had been carried out with respect to their competence to manage medication, and their ability and choice to manage their inhalers, with reminders from staff, was recorded on their care plan. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents feel safe in the home, and have opportunities to give their views. However, the registered providers have sometimes taken advantage of some residents’ lack of understanding of money, and have required residents to pay for items that should be provided by the organisation to meet their needs. EVIDENCE: Rotel had a complaints policy and a ‘service user friendly’ copy which is on display in the home so can be seen and used by both staff and residents. Residents have had the opportunity to discuss any complaints with their respective keyworker on a 1:1 basis at regular intervals. Residents said they would be able to speak to the Senior Support Worker or to the Manager if they were worried. No formal complaint had been received by the home since the previous inspection. The Manager understood the need to update the home’s procedure to include his responsibility to alert the local authority’s safeguarding team if any allegation of abuse comes to his notice. He should access training for Managers in the Protection of Vulnerable Adults. There is an in-house training resource for staff which had been used to maintain awareness. An allegation of financial abuse had been included in an anonymous complaint received by the Commission for Social Care Inspection. The Manager stated that no resident had been required to pay for furniture or decorating materials since he took on this post in January 2008. The Responsible Individual agreed Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 21 that a former resident had been required to buy furniture, because they had destroyed the furniture that had been provided. She agreed that this resident could not appreciate the value of money, and would not treat object with more respect because they had paid for them, and also that the furniture had not been moved when the resident moved to another home within the group because there was not enough space. It was still being stored at Magnolia Lodge, as there was currently an unoccupied room available for this purpose. The record of a Managers’ Meeting dated 28th March 2008 included an instruction to Managers that if residents need a waterproof mattress ‘it would be recommended to purchase these on their behalf’ ie the resident would pay. These are all basic items that should be provided by the home to meet the assessed needs of residents. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements to the kitchen and laundry have promoted the health & safety and wellbeing ofpoeple who live and work at the home. The lounge and dining room were shabby. EVIDENCE: Magnolia Lodge is a detached villa with a pleasant garden. Residents all have their own bedroom with en suite toilet and shower. The Manager had made monthly reports to the directors of maintenance requirements, and a good standard was upheld, with a maintenance worker employed regularly. Action had been taken with respect to requirements made by the Environmental Health Officer in their visit of 26/03/08, with worktops and a handbasin replaced in the kitchen. The ceiling above the cooker had been repaired, and the tables in the dining room had been given a smooth washable surface. The enamel on the bath had been repaired, but the same problem had developed again, so another solution should be considered. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 23 The lounge and dining room were in need of redecoration, and looking drab. The sofas in the lounge are low, uncomfortable and in a state of collapse. Both these rooms are a good size and have large windows looking on to the home’s attractive garden. Magnolia Lodge needs to review its smoking policy, as the use of the conservatory for smoking contravenes the 2006 regulations. Options for an outdoor shelter were being considered, in consultation with the Environmental Health Officer. One bedroom had been redecorated since the last inspection, before the admission of a new resident. A new carpet had been laid in the hallway. Some residents used their own en suite showers, while some preferred to use the communal bathroom. Management should consider the installation of an accessible shower (wet room) as there is one long term resident who is currently unable to use any of the bathing facilities. Access to the laundry is through the kitchen, so sealed containers are used for transporting soiled clothes. A new floor was being laid in the laundry at the time of this inspection, to maintain a hygienic area. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff were committed to their work and had good attitudes to the residents. Not enough staff were available to support activities at weekends or to cover for absences. People felt undermined because staff had been moved without consultation. EVIDENCE: There was a small staff group of four Support Workers, working together in pairs. One pair came on duty at 9am on Friday morning and stayed till 9am on the following Monday while the other pair had their days off. This arrangement may have benefits for residents in the continuity of care, and ability to plan activities for the weekend knowing the person will be there to carry out plans. However, it is a long time for staff to be on duty. They take turns to have time off in their rooms during the day, and are on sleeping-in duty by night. It had become a problem recently, as a service user was making constant demands on certain staff, which they found wearing over a long period. There was also a problem as only one of these four staff were able to drive the home’s minibus, which meant that no driver was available on alternate Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 25 weekends. The Acting Manager was in the process of recruitment to meet this need. Another Support Worker is needed at weekends and some evenings to enable more activities to be offered within and outside the home. The availability of another worker would also give flexibility with allowing for time off. At the time of the last inspection, a third worker was employed during the evenings to promote and encourage activities, but this had been discontinued. The residents’ main problem with regard to staffing was anxiety about continuity. ‘You get used to one person then they’re taken away’, they said to us, and ‘I would like *** to come back, I miss him.’ They knew that they had been moved by directors of the company to cover for absences in other services within the group. A resident wrote in a survey, ‘We get upset with changes in the staff who work. I do not like it. They change the staff all the time.’ Staff also had expressed concern about being moved. One staff member writing in a survey said that they had been moved to Magnolia Lodge by the directors, when their preference was working one-to one, as they had previously, in another Rotel service. It is written in the staff handbook that with a week’s notice the directors can move their place of employment to another service within the group. An urgent situation may best be tackled using staff who have previously met the residents involved, and know the organisation’s shift pattern, care planning formats etc. However, this movement of staff had been over-used recently, and staff and residents were unsettled. Recruitment should continue until each unit has sufficient staff to cover normal absences, and the managers of the residential homes within the group should be entrusted with the task of dealing with emergencies, as they know from the closest range the stresses and strengths of individuals in their teams and in their care. Some residents have particular difficulty with changes because of their condition. Staff and residents within the homes could feel more empowered if they were involved in such decisions. A staff member pointed out that particularly when overseas workers are on the team it is unhelpful to move them ‘out of the blue’ when they have developed their knowledge and communication skills with residents. No recruitment procedure was available in the home. The Manager’s job description stated that he should ‘assist the directors in recruitment’. This is not appropriate, as the Manager should be competent to deal with recruitment in the home, and be given the scope to do this. It needs to happen within each home to give residents a meaningful opportunity to give their opinion about the people who will be supporting them. The Manager said that residents had met applicants informally, and said he planned to include a resident in a forthcoming interview. We saw that a service user questionnaire had been used in an interview. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 26 We looked at two files of staff who had recently joined the team. One had moved to Magnolia Lodge from another home a few months ago. The Manager said that he had requested the personnel file, but it was not on the premises. It should be in the home to meet the regulations and so that the Manager can see whether any issues had been identified that might impact on his service users. A new CRB check had not been done at the time of the move, and the Manager had not had sight of any that might have been carried out at the time of their original employment. Written references and proof of identity were seen for both staff members. A short induction had been completed for the person who had moved from another home. A Skills for Care Induction programme was available in the home for the next new recruit. 80 of the existing staff team have achieved or are working toward NVQ qualifications in social care. Courses were being accessed through Devon Care Training. The Manager had programmed in regular supervision sessions so that further training needs can be assessed and actioned, though there were concerns over financial constraints. He was collating this information into a matrix for easier scrutiny of achievement and training needs. A staff member completing a survey said they appreciated the regular bi-monthly supervision meetings with the manager. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 27 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An effective manager had been appointed and had instilled confidence in the residents and staff. The systems used accross the organisation are not in the best interests of people living at Magnolia Lodge and this compromises the manager’s ability to provide a good service. EVIDENCE: A Manager had been appointed in January. He had achieved the NVQ level four in Care and has two further units to complete the Registered Managers’ Award. An application to register with the Commission for Social care Inspection must be submitted promptly. He had been given a job description by the Service Providers, but it needed revising to refer to the correct registration body, and to give the Manager the Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 28 overall responsibility to manage the home and ensure that the written aims and objectives of the home are met, and policies and procedures are implemented, in particular with respect to recruitment of staff and the admission of new residents. The Manager was working effectively and had instilled confidence in the residents and staff. A well-established staff member said he ‘is excellent, and puts the residents first.’ He was developing quality audit systems, and delegating specific duties to staff, including health and safety checks and care planning reviews. One of the Directors had been to the home in January and in March to carry out the quality check as required by regulation 26, but had not yet produced a report. The Providers should forward a copy of the report of their monthly visit to the home to the Commission for Social Care Inspection, to keep the Inspector informed about developments in the home. Hold-open devices had been fitted to bedroom doors, as residents like to have them open during the day. However, in basement flat, two further doors were seen propped open, and these must also be made safe. Fire drills had been held monthly, with records kept, including residents. Call bells had been checked weekly by staff. The fire extinguishers had been serviced professionally on 03/05/07, and were due another check. The fire precaution system had been checked professionally on 15/02/08. The Manager said that staff had attended fire safety training in another Rotel home. It would be good practice for this training to be provided at Magnolia Lodge. The last record of a satisfactory test of the electrical circuit was not available, but the Registered Provider undertook to send a copy to the CSCI, to assure us that the system is safe. The Manager said that he had engaged an electrician to carry out the work identified by the test that had been carried out last year. Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 29 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 2 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 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 30 Yes 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 YA23 Regulation 16(2)c Requirement The Registered Providers must not charge residents for furniture as specified in standard 26.2, (unless agreed otherwise in the person’s individual Plan) and equipment to meet their assessed needs. A smoking area must be provided that meets the regulations of the Health Act 2006. The Registered Person shall, having regard to the size of the care home…and the numbers and needs of the residents, ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the service users. This is in respect to evenings and weekends. All records must be obtained and kept in the care home, in order to protect residents from potential harm. An application must be submitted to the CSCI to register the Manager. DS0000018392.V362335.R01.S.doc Timescale for action 31/05/08 2. YA28 16(2)j 31/07/08 3. YA33 18(1)a 31/08/08 4. YA34 17(2) sch4 8(2) 31/07/08 5. YA37 31/07/08 Magnolia Lodge Version 5.2 Page 31 6. YA42 23 (4) The fire precaution system must be complete in order to protect residents from the dangers of fire - fire doors must not be held open. Previous timescales 25/11/06 and 31/08/07 31/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. 8. Refer to Standard YA2 YA7 YA13 YA17 YA23 YA27 YA28 YA37 Good Practice Recommendations The Manager should ensure that the home’s policy on admission is carried out satisfactorily in each case. The Manager and staff should continue to promote and develop person centred care. Staff should make arrangements to enable residents to engage more in local social and community activities, including training, fitness and recreation. Staff should enable residents to be more involved in the preparation of their meals. The Manager should attend training for Managers on the Protection of Vulnerable Adults. Plans should be drawn up for the provision of an accessible shower. The lounge and dining room should be redecorated, after consulting with residents on style and colour, and all chairs should be comfortable and easy to get out of. The registered provider should provide the Manager with a Job Description that refers to the regulatory body correctly, and sets out the Manager’s overall responsibility to enable him to ensure that policies and procedures are implemented, with particular regard to recruitment and deployment of staff. The service providers should supply the CSCI with a copy of the report they produce following their monthly visit in accordance with regulation 26. 9. YA39 Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Magnolia Lodge DS0000018392.V362335.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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