CARE HOME ADULTS 18-65
Magnolia Lodge Herbert Road Chelston Torquay Devon TQ2 6RP Lead Inspector
Peter Wood Unannounced Inspection 29 November 2005 15:00 Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 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.V261965.R01.S.doc Version 5.0 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.V261965.R01.S.doc Version 5.0 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 Mrs Iona Susan Campbell Fusco 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.V261965.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16/08/05 Brief Description of the Service: Magnolia Lodge is a care home for adults with Learning Disabilities. The large detached house is situated in a residential area of Torquay. There is a car park to the front and gardens laid out mainly to lawn at the back. Entrance to the Home is level access into a sun lounge that is used by the smokers in the Home. The ground floor has 6 single en-suite bedrooms, 1 of which is used by staff on sleep-in duty, a lounge and dining room, office, kitchen and a laundry. Stairs lead to the lower ground floor, which is a self contained flat for one service user. It has a bedroom, bathroom, and lounge. Stairs lead to the first floor; a staff sleep-in room is situated halfway up the stairs. The first floor has a further 6 single en-suite bedrooms, and a bathroom. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over an afternoon and evening on a weekday in November 2005. The inspection was timed so as to be able to meet as many residents as possible, most of whom are out of the house during most days enjoying day opportunities. All residents, who are now quite familiar with the inspection process and officer, were consulted regarding their experience of living at this home, and most proudly showed their room. Indeed, the main focus of this inspection was to spend as much time as possible with the residents, very little time spent on examining documentation. Opportunity was taken during the inspection to enter into a discussion with residents and a speech and language therapist. She was at the home to work with a resident who himself works alongside the therapist to help others with learning disability communicate more effectively using signs. The current Registered Manager has recently returned from maternity leave and is now managing another home in the Rotel portfolio. The current acting manager has been put forward to become the Registered Manager, and is the process of becoming registered. She assisted throughout the inspection. What the service does well: What has improved since the last inspection?
The acting manager has grown in confidence and competence since being put forward to become the Registered Manager of the home. This growth has been enabled to a great extent by the recent appointment of the new Responsible Individual of the company. Until recently the new Responsible Individual was the exceptionally experienced and skilled Registered Manager of another home in the group, who now acts as a peripatetic adviser to all the managers of homes within the Rotel portfolio. The acting manger has revised further the policy and practice in the event of a fire, following consultations with colleagues and the fire officer to make sure that residents are protected if there is a fire. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 6 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 Lodge DS0000018392.V261965.R01.S.doc Version 5.0 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 DS0000018392.V261965.R01.S.doc Version 5.0 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): 1, 2, 3, 4 The home provides sufficient information to allow parents and sponsoring authorities to make an informed choice as to whether this home can meet the needs of prospective residents. However, this documentation remains inaccessible to prospective residents. EVIDENCE: The Home has a Statement of Purpose but the Service User Guide remains a work in progress after considerable time in the planning stage. The company intends to produce a Service User Guide in various formats, including in video, but it is now time to focus on completing a simple document, understandable by residents, within the timescales. New residents are admitted only on the basis of a full assessment undertaken by people competent to do so. This was evident regarding a recently admitted resident who previously lived in a care home in another part of the country. Residents and their families and care managers are able to visit the home before making a decision to move in. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 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): 7, 8, 9, 10 Residents are encouraged, enabled, supported and empowered to make their own decisions in as many areas as possible. EVIDENCE: Residents are treated with dignity and respect, their individual needs are met and they are able to exercise choice in as many areas as possible. Residents are addressed as they prefer, staff don’t enter residents’ bedrooms without knocking or permission, and any personal care is undertaken discreetly. Choice was demonstrated during discussions with residents about their bedrooms, food preferences, day opportunities and particularly their summer holidays, amply recorded in scores of photographs. Residents confirmed that they take full part in their assessments and care plans. They are consulted on all aspects of life in the home, from menus to individual risks and the degree of support necessary. Residents trust that the management and staff act in their (i.e. residents’) best interests, including maintaining confidentiality within the professional community, including the learning disability team and, for example the speech and language specialist who was visiting the home at the time of the inspection. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 10 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): 11, 12, 13, 14, 15, 16, 17 Residents have considerable opportunities to engage in a range of activities including leisure activities to assist their personal development. Meals are nutritious and varied. EVIDENCE: Residents have a rich lifestyle, are able to participate in the running of the home and have fulfilling activities, both at the home and at their day opportunities. Many residents attend Focus 2000, a day facility also operated by Rotel, while others attend local authority day centres or have other occupations, which may include paid employment. One of the residents, for example, works in the office of a private firm undertaking such tasks as paper shredding. The home encourages every individual to express his or her own opinions, as has been very clearly demonstrated during each of my visits to this home. The home encourages family contact and friendships, but also has to manage situations where relationships develop with differing understandings and expectations of the parties. The menus indicate the care taken to provide variety in meals, including promoting healthy eating, whilst taking into account resident’s preferences. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 11 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, 19, 20, 21 Residents appeared to feel safe and well supported living at this home. They are respected and are encouraged and enabled to have as much control over their lives as possible. EVIDENCE: The home provides sensitive and flexible personal support and care to maximise service users’ independence and control over their own lives. One resident specifically mentioned that she likes to wash herself all over without assistance except that she needs her back washed for her, and appreciates her key worker performing just that part of the task for her. Another resident expressed appreciation for the limited degree of support he knows he needs regarding managing his money. One or two residents take a degree of responsibility for their own medication following risk assessment. All residents have a lockable cabinet in their rooms for medication and personal items. Staff provide sensitive and flexible personal support to maximise service users’ privacy, dignity, independence and control over their lives. The home had good support from the local Learning Disabilities specialist support service, demonstrated by the coincident visit of the speech and language therapist during the inspection. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 12 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): 22, 23 Complaints and suggestions from service users, relatives or other visitors to the home are treated seriously. Service users are listened to and issues resolved promptly. EVIDENCE: The Home had an appropriate complaints procedure, though no complaints have been made regarding care offered to be recorded. In practice, complaints from residents tend to be about the behaviour of a fellow resident. The Commission has not received any complaints about the home. Residents know how and to whom to complain should they need or wish to, and are encouraged to speak out if they are unhappy or uncomfortable about anything. Residents appeared confident enough to be able to do so should the need arise. Additionally, the acting manager takes the opportunity to let residents know that part of the inspector’s role is to listen to any resident who may be unhappy about anything and ensure that something is done about it. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 13 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, 25, 26, 27, 28, 29, 30 Residents live in a pleasant home that is well maintained and comfortable and provides sufficient facilities to meet their needs. EVIDENCE: The home is a large house in good condition in a pleasant part of Torquay near to all amenities. Toilet and bathroom facilities are particularly good, as all bedrooms have en suite facilities. One resident has sole occupation of a large garden flat with own access to the garden. The home is efficient and safe yet with a homely character, quite well decorated and furnished. Although all rooms have been subject to a general risk assessment, a specific risk assessment of all hot surfaces and hot water should be undertaken, and identified corrective work undertaken, to ensure residents are protected from burns and scalds. The home does not have a passenger lift, but there are several ground floor bedrooms which can appropriately accommodate people with physical disabilities. The environment and culture of the home is one which best suits relatively young, able and active residents. Few environmental adaptations and disability equipment are currently necessary to meet the assessed needs of the residents. The home has always been clean on each of my visits to the home. Residents take the major responsibility to keep their bedrooms clean and tidy. Most take a pride in their appearance and bedrooms, and each bedroom reflects the character and interests of the occupier.
Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 14 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): Residents are cared for by staff in sufficient numbers to meet the needs of those currently living in the home. EVIDENCE: Previous inspections have evidenced that staff are motivated and well trained. The previous inspection detailed the training and recruitment processes undertaken by the home to protect vulnerable residents. However, this section was not a focus of the unannounced inspection. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 15 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, 38, 39, 42, 43 This is a good, well-managed home for people with mild to moderate learning disabilities. The management of the company and of the home strive to provide a stimulating, safe environment that respects and protects residents. EVIDENCE: Rotel has recently created a new post to strengthen the senior management team. The post holder now acts as a peripatetic adviser to all the managers of care homes in the group. Until recently the new post holder was the registered manager of another care home in the Rotel group. The acting manager is sufficiently qualified, competent and experienced to run the home and has grown in confidence and competence owing to a great extent on the assistance given by the new post holder, There is an open, positive and inclusive atmosphere, and the health, safety and welfare of residents are promoted and protected. Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Magnolia Lodge Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 3 3 DS0000018392.V261965.R01.S.doc Version 5.0 Page 17 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 YA1 Regulation 5 Requirement The Registered Provider must produce a Service User Guide in a format understood by Service Users, and send a copy to the NCSC. A copy must be given to each Service User. The Registered Provider must undertake a specific risk assessment of hot surfaces and hot water, with corrective action as necessary, to ensure residents are protected from burns and scalds. The Registered Provider must have a business and financial plan open to inspection. Timescale for action 28/02/06 2 YA24 16, 23 28/02/06 3 YA43 25 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 18 Magnolia Lodge DS0000018392.V261965.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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