Care Home: Magnolia Lodge

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What the care home does well This was not a full inspection looking at all aspects of life at Magnolia Lodge. We met with one of the Directors of Rotel, and advised where regulations had been breached. He authorised the immediate provision of staff to make good the deficit, and provide a safe level of staffing. We were assured that day care provision was being arranged away from the care home, and that the new facilities would be ready for use the following week. Therefore, in the future only people who live or work at Magnolia Lodge will be on the premises, and any people invited by the service users. We visited again the following evening, and found that the new rota had been put into practice. Three staff were on duty in the home to support the residents. The Senior on duty was expecting to take up a managerial role within the care home. She said she is keen to promote residents` independence within their home. She showed us the staff training that was planned. Person centred planning was included. We were toldthat another Senior Carer had started working in consultation with a service user, developing their person centred plan. There is normally a qualified first aider on duty, as both the Senior Support workers are competent in this respect. We were advised that first aid training will be updated as necessary. What the care home could do better: Immediate requirements were made with respect to providing sufficient staff to meet the assessed needs of the service users, and also of not employing people to work in the home unless the information and documents specified in the regulations have been obtained by the registered person. These were in order to assure the safety of people who live at Magnolia Lodge. The Registered Person must inform the Care Quality Commission without delay of any event in the home which affects the well being of any service user. This is so that we may judge how well the service is dealing with the matter. Service users` privacy and security had been jeopardised over recent weeks, as day care and Rotel`s domiciliary care office had been sited on the premises. This had led to unsettled behavior and an unfortunate incident involving service users. Only people who live at Magnolia Lodge, people who work there, and people who have been invited by residents, should be in the home. Other recommendations were made at the last inspection, and still remain to be fully met. These relate to person centred planning, involvement of residents in menu planning, shopping and meal preparation, hygiene in the bathroom, a method of communication with the downstairs flat, and moving and handling training for staff. Magnolia Lodge has had a series of managers over the past four years, but none of them have registered with the Care Quality Commission. A manager should be registered with the CQC, as it is a legal requirement. Random inspection report Care homes for adults (18-65 years) Name: Address: Magnolia Lodge Herbert Road Chelston Torquay Devon TQ2 6RP two star good service 11/12/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Stella Lindsay Date: 2 4 0 6 2 0 1 0 Information about the care home Name of care home: Address: Magnolia Lodge Herbert Road Chelston Torquay Devon TQ2 6RP 01803605348 Telephone number: Fax number: Email address: Provider web address: magnolia@hotmail.co.uk Name of registered provider(s): Name of registered manager (if applicable) Vacancy Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rotel Ltd care home 11 Number of places (if applicable): Under 65 Over 65 11 learning disability Conditions of registration: Date of last inspection Brief description of the care home 11 1 1 1 2 2 0 0 9 Magnolia Lodge is a care home for up to eleven adults with Learning Disabilities. This large detached house is in a residential area of Torquay, close to the railway station, bus routes, and the Riviera Centre. There is car parking space at the front of the house, and gardens to the back. There is level access to the house, through a sun lounge. The lounge, dining room, kitchen office and laundry are on the ground floor, as well as bedrooms, each with an en suite toilet and shower or bath. There is an accessible shower, for communal use. Stairs lead down to a flat on the lower ground floor, occupied by one resident. There is a staff bedroom on a mezzanine floor, and six further bedrooms and a bathroom on the first floor. Current fees range from 425 to Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home 998 pounds per week, and transport is provided in the homes minibus at 40 pence per mile, divided by the number of passengers. Taxis are paid for by the resident if the minibus is not available, but Rotel pay for transport to essential appointments. Information about the service is available in the lounge. The previous inspection report may be obtained from the office on request. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: We visited Magnolia Lodge at 10am on Wednesday 23rd June 2010. We found that three service users were in their own rooms, two were sitting in the lounge, and two were out, though one returned to the house shortly after our arrival. There were three people working in the home, who told us they were volunteers, one sweeping in the courtyard, one sitting in the dining room, prepared to take phone calls, and one preparing lunches. There were also three people who were service users at another care home, (not under the same ownership) who were sitting in the garden or conservatory. Two Rotel staff were on duty, but one went out to accompany the three visitors, leaving one Senior Support Worker on duty alone. We looked at the care plan and risk assessment of the most recently admitted resident at Magnolia, and saw that a high risk level was recorded, requiring one to one support, for the protection of this person and other vulnerable people. It was clear that this support was not possible with the current staff available. We looked at the written rota and saw that there were other times in the week when the Senior Support Worker would be alone, thus exposing people in the house to unacceptable risk. We also found that a person had worked at the home recently who had not been recruited by the registered person, Iona Fusco, who therefore had not carried out the checks required to meet regulations and ensure safety of people living in the home. We looked at incident reports, and saw that several incidents had been recorded with respect to the recently admitted service user, demonstrating that the assessed risks were not being managed effectively. The Care Quality Commission had not received any notifications during this period, to inform us of any event that might affect the well being of a service user. We also found that Rotels Domiciliary Care services office had just been moved off the site, to prevent any further intrusion into residents privacy and security. What the care home does well: This was not a full inspection looking at all aspects of life at Magnolia Lodge. We met with one of the Directors of Rotel, and advised where regulations had been breached. He authorised the immediate provision of staff to make good the deficit, and provide a safe level of staffing. We were assured that day care provision was being arranged away from the care home, and that the new facilities would be ready for use the following week. Therefore, in the future only people who live or work at Magnolia Lodge will be on the premises, and any people invited by the service users. We visited again the following evening, and found that the new rota had been put into practice. Three staff were on duty in the home to support the residents. The Senior on duty was expecting to take up a managerial role within the care home. She said she is keen to promote residents independence within their home. She showed us the staff training that was planned. Person centred planning was included. We were told Care Homes for Adults (18-65 years) Page 4 of 9 that another Senior Carer had started working in consultation with a service user, developing their person centred plan. There is normally a qualified first aider on duty, as both the Senior Support workers are competent in this respect. We were advised that first aid training will be updated as necessary. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 6 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 33 18 The registered Person shall, 25/06/2010 having regard to the ...needs of the service users ensure that at all times suitably qualified, competent and experienced persons are working in the care home in such numbers as are appropriate for meeting the needs of the service users. This is in order to avoid unacceptable risk to service users, following thorough assessment of their care needs. 2 34 19 Staff must not work at the 25/06/2010 care home unless their safety and suitability to work in the home has been confirmed, and documentation obtained in accordance with Schedule 2 of the Regulations. This is to protect service users from potential risk. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 37 37 The registered person must 30/07/2010 notify the Care Quality Commission when any event takes place the affects the well being of any resident. Page 7 of 9 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This is so that we may judge whether the event has been managed well. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 6 17 The plans to develop person centred planning should be implemented fully in consultation with residents. The home should enable residents to be more involved in menu planning, shopping for food, and preparing their meals. This is to promote their understanding of choices and feeling of control over their own life, and because some residents have expressed their interest. Good standards of safety and hygiene should be maintained in the upstairs bathroom. A method of communication should be provided for the occupant of the flat on the lower ground floor, so they may call for help in an emergency. Practical training in Moving and Handling should be provided, to promote staff safety and good health. A manager for Magnolia Lodge should be registered with the Care Quality Commission, as this is a legal requirement. A development plan should be produced for Magnolia Lodge, to inform residents and other interested people, and show when action has been taken effectively to improve outcomes for service users. 3 4 27 29 5 6 35 37 7 39 Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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