Inspection on 04/10/05 for Magnolia Lodge

This inspection was carried out on 4th October 2005.

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 9 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 25/01/06

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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 Announced Inspection 4th October 2005 10:00 Magnolia Lodge DS0000065611.V250864.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 DS0000065611.V250864.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 DS0000065611.V250864.R01.S.doc Version 5.0 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.V250864.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/10/04 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.V250864.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection which started at 10am and finished at 3.15pm. Since the last inspection the home has been sold to new Providers, Caretech Community Services Limited, who took over on 12th August 2005. The inspector visited the home on two occasions as part of the registration of the new Providers. On this inspection the inspector spent time with the newly appointed Manager and spoke individually to one other member of staff on duty. Four of the five service users were seen and greeted, and two were spoken with individually. A variety of records, including service users files were seen. What the service does well: What has improved since the last inspection? The home had been without a Registered Manager for over a year and it is positive that the new Providers appointed one prior to taking over the running of the home. There have been some improvements made to the decoration and furnishing of the home. An extension to add a further four en-suite bedrooms is due to start in the next few weeks. At the last inspection there were 13 requirements made and on this inspection, 8 had been met. It has only been 6 weeks since the new Providers took over and this is an encouraging start. It is commendable that the new Manager has spent considerable time getting to know staff and service users and spending time on shift. Both service users and staff appreciated this. Magnolia Lodge DS0000065611.V250864.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 DS0000065611.V250864.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 DS0000065611.V250864.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 The new Providers have written an up to date statement of purpose and provided each service users with a new service users guide. EVIDENCE: The new Providers of care at Magnolia Lodge, Caretech Community Services Limited, have written a new statement of purpose and provided each service user with a new service users guide. It was apparent that the new Manager has spent much time with the service users and the staff team, explaining the changes and the ethos of the new Providers. Magnolia Lodge DS0000065611.V250864.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): 6, 7 Service user’s plans do not include all the relevant details at present and there is a need to ensure that details of how service user’s finances are managed are clearly recorded on file. EVIDENCE: It was a requirement made at the last inspection that service users plans are reviewed to ensure that they contain all the required information and are up to date. This requirement was not found to be met. Two files relating to service users were seen and neither contained detailed information regarding their needs. There were no details regarding communication and for one service user who exhibits challenging behaviour, there were no written guidelines on behaviour management in his file. Each service user has more than one file and there is a need to clarify what should be recorded in each file. It is acknowledged that new individual support requirements are in the process of being written and are including the views of service users. In the meantime, it is essential that basic information is on file. In addition, the only information recorded daily regarding the behaviour and activities of service users is in the handover sheet. This is not satisfactory and there should be individual information recorded regarding each service user on Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 10 a day-to-day basis which can be looked at and monitored. It is a recommendation that this is set up. The new Providers are in the process of clarifying the complex financial arrangements in place for each service user. At present, there are a variety of arrangements and one service user has total control over all his finances. It is a requirement that there is information in each service users file regarding how their finances are managed. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 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): None EVIDENCE: Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 12 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): 19, 20 There was evidence that service users’ healthcare needs are met. The medication administration systems generally work well but there was a medication error during the inspection. EVIDENCE: It was a requirement made at the last inspection that there is evidence in service users files that health care appointments are made and attended. This has been met and recent appointments were recorded. There is a need to ensure that with the change of files and of recording sheets that important medical information is not lost or followed up. At the last inspection there were some gaps in the medication administration records and it was made a requirement that the medication administration systems are reviewed and monitored. On this inspection, the administration records were seen and there were no gaps and the Manager felt that the systems worked well. Staff were being encouraged to administer the medication in pairs to reduce the risk of errors. However, during the inspection there was a potentially serious medication error when medication was signed as given but was left in a pot on a table in the kitchen. Fortunately, the error was quickly noticed. The requirement to review and monitor the medication systems remains outstanding to ensure that further errors do not happen. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 13 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 Service users feel listened to and they are protected from abuse. EVIDENCE: There is a consistent staff team and new Manager has spent time getting to know the service users. Those service users spoken with felt listened to and there was evidence from the complaints book that service users are aware of the complaints procedure and use it. Two complaints had been made by service users since the last inspection and action had promptly been taken regarding both matters. It was a requirement made at the last inspection that the complaints book is reviewed to ensure that there is clear evidence of the actions taken to investigate the complaint and the outcome. This has been met. All the staff team have attended training in adult protection since the new Providers took over the running of the home. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 14 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 The home is in need of a major overhaul regarding decoration, carpets and furniture. There are plans for an extension and the rest of the building will be renovated during this work. Some redecoration has already been carried out. EVIDENCE: At the time the home changed ownership in August 2005, it was in need of a major overhaul which included complete redecoration, most carpets were in need of replacement and a lot of new furniture purchased. The new Providers have given an undertaking to upgrade the premises and a number of rooms have been painted and some new furniture has already been purchased. It has not been possible to undertake more extensive work as a large extension is planned to add a further four en-suite bedrooms to the property. The inspector was informed that the rest of the house, including service users bedrooms will be redecorated as part of this work. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 15 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): 32, 33, 34, 35, 36, The home has an experienced and stable staff team who are supported and who have undertaken a number of training courses in recent months. EVIDENCE: The home has an experienced and stable staff team and no staff have left since the last inspection. The new Manager has been in post since the new Providers took over the running of the home in August 2005. It is positive that the Manager has spent time getting to know the staff team and formal supervision sessions are taking place and are recorded. It was a requirement made at the last inspection that formal supervision sessions take place at least six times a year and this has been met on the evidence that sessions have taken place since August 2005. Staff meetings have also been taking place on a regular basis and have been well attended. There are some vacancies in the staff team, including a Deputy Manager. At present, there is some use of agency staff but efforts have been made to recruit new staff. Staffing levels remain at a minimum of two staff on duty during the day with a waking member of staff and a sleep-in at night. There have been changes to the hours worked on shift to ensure greater consistency and to increase the number of staff on duty until 9.30pm. This is a welcome move and will allow service users to go out more in the evenings. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 16 No new staff have been recruited since the new Providers took over but the personnel files have been reviewed. It is planned that new enhanced CRB (Criminal Records Bureau) checks will be carried out on all existing staff members. This will meet the requirement made at the last inspection that there is confirmation held in the home that all staff have had an enhanced CRB check undertaken. The Manager, from discussions held with the staff team, believed that three members of staff have a care NVQ 2 or above. This is less than 50 of the staff team which totals nine, excluding the Manager. Information from the new Provider has been given to the staff team regarding NVQ training and it is a requirement that there is a rolling programme of staff training in NVQ’s. It was an unmet requirement at the last inspection to ensure that training needs assessments and appropriate training programmes are developed. It is commendable that in the six weeks since the new Providers took over, a wide range of training has been arranged for all staff including rectal diazepam and epilepsy, manual handling, health and safety, adult protection, fire awareness and first aid. However, the requirement has not been fully met as there is still a need to ensure that training needs assessments are carried out. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 17 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 The home is well run but monthly monitoring reports need to be written and sent to the CSCI. Health and safety matters are taken seriously at the home EVIDENCE: The new Manager in post has spent time building up relationships with the staff team who were all employed by the previous Providers and the service users. Both the staff spoken with and the service users felt listened to by the Manager who is aware of the work needed to be undertaken at the home. It is recommended that the Manager in consultation with the Providers, writes an Action Plan outlining and prioritising the work to be done in the next twelve months. The Manager has yet to submit an application form to register and it is a requirement that this is done. Three of the requirements made at the last inspection relate to quality assurance. It was required to develop an effective quality monitoring system, that monitoring visits take place on a monthly basis and that the home has an annual development plan. None of these requirements have been met. As outlined in the previous paragraph, the requirement to have an annual Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 18 development plan has been changed to a recommendation to write an Action Plan. There were two requirements at the last inspection relating to health and safety matters. Both have been met and the new Providers have ensured that the home is safe. A new fire panel and new smoke detectors have been installed as well as servicing of the fire system, fire extinguishers, central heating system and testing of the portable electrical appliances. New valves to restrict the temperature of the hot water were being fitted on the day of this inspection. It was an unmet requirement at the last inspection to provide records to evidence budget monitoring and financial control. This is no longer relevant since the change of Providers and financial matters were considered during the registration process. The Manager confirmed that the budgetary arrangements are satisfactory and that money has been made available as required. The new registration certificate giving details of the new Providers was not on display in the home and it is a requirement that this is done. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 19 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 3 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Magnolia Lodge Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 3 2 X X 3 2 DS0000065611.V250864.R01.S.doc Version 5.0 Page 20 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 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 19/1/05 not met) The medication administration systems are reviewed and monitored. (Previous timescale of 19/12/04 not met) The Providers to ensure that training needs assessments and appropriate training courses are developed. (Previous timescale of 19/1/05 not met) To develop an effective quality monitoring system. (Previous timescale of 19/1/05 not met) Monitoring visits take place on a monthly basis. (Previous timescale of 19/12/04 not met) There is written information for each service user regarding how their finances are managed. The Providers ensure that there is a rolling programme of NVQ DS0000065611.V250864.R01.S.doc Timescale for action 04/01/06 2 YA20 13(2) 04/12/05 3 YA35 18(1) 04/01/06 4 YA39 24 04/01/06 5 YA39 26(2) 04/12/05 6 7 YA7 YA32 17(2) Schedule 4 18(1) 04/01/06 04/01/06 Magnolia Lodge Version 5.0 Page 21 training for staff. 8 9 YA37 YA43 9 28 of C S Act 2000 The Manager submits an application to the CSCI to be the Registered Manager. The current certificate of registration is on display at the home. 04/12/05 04/12/05 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 Refer to Standard YA6 YA39 YA39 Good Practice Recommendations There is clarity regarding the information contained in service users files. The behaviour and activities of service users are recorded on a day-to-day basis at the end of each shift. The Manager, in consultation with the Providers, writes an Action Plan and sends it to the CSCI, outlining and prioritising the work to be done in the next 12 months. Magnolia Lodge DS0000065611.V250864.R01.S.doc Version 5.0 Page 22 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.V250864.R01.S.doc Version 5.0 Page 23 - 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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