Care Home: The Magna Care Centre

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What the care home does well Residents were encouraged to maintain their links with friends and family and all visitors were made welcome. People living at the home liked the food provided and enjoyed the choices offered at each meal. The complaints procedure reassured residents that their views were important to the home and that any complaints they raised would be properly investigated.The home protected the residents from abuse by ensuring robust policies and procedures were in place, which staff could easily follow. The house and gardens were maintained to provide residents with a comfortable place to live. Residents were encouraged to personalise their rooms with items of furniture, pictures and a variety of mementos. Sufficient numbers of staff were on duty throughout the day and night to be able to meet the needs of the residents. What has improved since the last inspection? At the random inspection in July 2008 we saw that the home had made many improvements to the service provided to the residents. At this inspection we had seen further improvements and the home has met all the previous requirements and recommendations that were made. Improvements have been made to care documentation and staff had sufficient information to be able to carry out their caring duties appropriately. The training programme had been developed further and some staff had received training in palliative care and dementia care as well as the mandatory training required. This meant that competent staff were looking after people living at the home. There home had an ongoing maintenance programme. Some areas of the home had been refurbished and this included the replacement of worn carpet in some of the communal areas. The home was being well managed by Mrs Armstrong, the new manager. Through the home`s quality assurance procedures she was ensuring the Magna Care Centre was being run in the best interests of the residents living there. What the care home could do better: The care documentation had improved but there were still some shortfalls in recording, which need to be addressed so that a clear picture of the residents needs and how they respond to care is maintained. The policy relating to care of the dying needed to be revised and made available to staff so that they would ensure that residents received the appropriate care in such circumstances. CARE HOMES FOR OLDER PEOPLE The Magna Care Centre Arrowsmith Road Canford Magna Wimborne Dorset BH21 3BQ Lead Inspector Amanda Porter Unannounced Inspection 18th September 2008 10:00 X10015.doc Version 1.40 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 The Magna Care Centre DS0000067493.V368029.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 Older People. 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. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Magna Care Centre Address Arrowsmith Road Canford Magna Wimborne Dorset BH21 3BQ 01202 601831 01202 691503 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) www.concensusupport.com Caring Homes Healthcare Group Ltd Vacant Care Home 69 Category(ies) of Old age, not falling within any other category registration, with number (69) of places The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 69 persons over the age of 65 may be accommodated as follows: In Segovia, 24 older persons who may require nursing care. In Granada, 24 older persons who do not require nursing care. In Canford, 21 older persons who do not require nursing care. One named person (as known to CSCI) who is under the age of 65 may be accommodated in Segovia unit. 6th March 2008 2. Date of last inspection Brief Description of the Service: The Magna Care Centre is located in a rural setting approximately two miles from the local shops and amenities of Broadstone. It is a care home offering both nursing and residential care to Older people and provides long and short-term care as well as respite care. The home has 69 registered beds and can provide nursing care to a maximum of 24 people. The Magna Care Centre is owned by Caring Homes Healthcare Group Ltd, who have appointed a new manager, Mrs Angela Armstrong, to run the home on a day to day basis. The home is divided into 3 units; two provide residential care and are staffed with trained care staff and the third provides nursing care and has a qualified nurse on duty at all times. The majority of rooms are on the ground floor, there are twelve rooms on the first floor and these can be accessed by a through floor passenger lift. All rooms are for single occupancy and most have en-suite facilities. The home has two dining rooms, three lounges and a large conservatory as well as specially adapted bathrooms and a hairdressing salon. It sits within beautiful, well-maintained gardens, which have ample parking and a quiet courtyard and summerhouse. Weekly fees range from, approximately £650 to £850 at the time of inspection. Additional charges are made for hairdressing and chiropody. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Two inspectors carried out this unannounced key inspection over approximately four and a half hours on the 18th September 2008. This was a statutory inspection and was carried out to ensure that the residents who are living at The Magna Care Centre are safe and properly cared for. Requirements and recommendations made as a result of the last key inspection in March 2008 and the random inspection in July 2008 were also reviewed. The new manager, Mrs Angela Armstrong, was on hand throughout to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment completed by the home. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. During the course of the inspection we spoke to a number of residents and staff and asked their views on the service the home provides. The comments we received included: “The care staff are very good.” “Angela (the new manager) is a breath of fresh air.” “There are a lot of improvements. We get a good amount of training.” What the service does well: Residents were encouraged to maintain their links with friends and family and all visitors were made welcome. People living at the home liked the food provided and enjoyed the choices offered at each meal. The complaints procedure reassured residents that their views were important to the home and that any complaints they raised would be properly investigated. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 6 The home protected the residents from abuse by ensuring robust policies and procedures were in place, which staff could easily follow. The house and gardens were maintained to provide residents with a comfortable place to live. Residents were encouraged to personalise their rooms with items of furniture, pictures and a variety of mementos. Sufficient numbers of staff were on duty throughout the day and night to be able to meet the needs of the residents. What has improved since the last inspection? What they could do better: The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 7 The care documentation had improved but there were still some shortfalls in recording, which need to be addressed so that a clear picture of the residents needs and how they respond to care is maintained. The policy relating to care of the dying needed to be revised and made available to staff so that they would ensure that residents received the appropriate care in such circumstances. 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. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable for this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents move into the home having had their needs assessed and been assured that these needs will be met fully. EVIDENCE: The pre admission assessments for people who had moved into the home recently were seen. The initial assessments were completed by the manager and gave enough information for her to be able to determine whether the home could meet the person’s needs. One individual had moved in the previous evening, they told us that they were settling in, and that everyone had been friendly. They said “a lady (the manager) came to see me in the hospital to see what help I needed and told me about the home”. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 10 The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Since the last inspection the standard of written assessment and care planning had greatly improved. The care documentation for four residents was reviewed and it contained the relevant assessments and care plans needed so that staff had the information to be able to give a good standard of care. The care plans were evaluated on a monthly basis. However there were still some shortfalls in recording that were noted. Generally the daily written statements in the care files lacked detail about what sort of day the resident has had, how they have been occupied and whether they were in a state of well or ill being. Where there had been later additions or alterations to care plans these were not The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 12 always signed or dated so that it was unclear when changes to care had been implemented. Where the need for specialist equipment was identified it was provided. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, district nursing services and chiropodists. The medications policies and procedures were reviewed and we observed medications being administered to some people living at the Magna Care Centre. The home had a medicines policy and procedure including reference to self-administration and associated risk assessment and arrangements for ordering, administration and disposal. Examination of records and observation of medication administration showed us that medicines were properly administered in accordance with the prescriber’s instructions and residents could be assured that they were getting the medication that their doctor said they needed. Residents we spoke with said they were happy with the care they received and confirmed that staff treated them with respect and were supportive and kind. The home did not have any up to date written policies to direct staff when caring for someone with palliative care needs. However some staff have received training in this area and further training was proposed. At the time of inspection there was no one living at the home with palliative care needs. The manager has had a lot of experience in caring for people who were dying and was aware of current good practice. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to maintain their independence, contact with important others and lifestyle, which enhances their quality of life. EVIDENCE: An activities coordinator works at the home on weekday mornings. Another activities coordinator has now been employed to work in the afternoons. We observed the activities in the main lounge. People actively participated in a quiz and a card game. The activities were suitable for people who had differing levels of communication and physical abilities. People visited the hairdresser during the inspection. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 14 There is a weekly plan of activities that is displayed around the home. The activities on offer the week of inspection were: • Manicure • Holy communion • Quizzes • Cards The manager had produced a newsletter to keep people up to date with any changes at the home and any planned events and activities. People at the home were encouraged to maintain links with their family and friends who were made welcome on their visits. The home supports people in their spiritual needs by the involvement of church ministers of varying denominations if necessary. An interdenominational Christian communion service was also held in the home each month. People spoken with and observed spent their time how and where they chose. Menus showed that the people who live there have a choice of meals through the day. The menu was varied and meals appeared nutritious. There are choices offered for each meal each day, specialist diets are catered for including diabetic, wheat free, pureed and soft diet alternative when necessary. People order their meals the day before. All of the people spoken with said it was sometimes hard to think what you might like a day ahead and then remember. The cook told us that they make spare dishes for if people change their mind or do not remember. Staff observed at lunchtime, supported people in a quiet and sensitive way, they sat down with people and described the food that they were helping them with. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. EVIDENCE: A copy of the complaints procedure was displayed on each of the living units. All six people spoken with knew how to complain and who to speak to if they were unhappy. People told us that they felt safe living at the home. The adult safeguarding procedures and the different ways to report allegations abuse were also displayed alongside the complaint procedure on each living unit. Staff spoken with told us that they had received training and guidance on how to recognise and report any allegations of abuse during their induction. They were able to give examples of when and how and to whom they reported their concerns. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained and furnished so that people live or stay in a homely, clean, comfortable environment. EVIDENCE: Since the last inspection, the carpet has been replaced in some of the communal areas of the home. The manager told us that there was a plan to replace the remainder of the communal area carpets as they are worn and frayed in places. The lounges were light and comfortable with a mix of sofas and armchairs. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 17 There was an active refurbishment programme. We looked at some of the bedrooms with people’s permission. They were well furnished. The rooms were personalised with their own belongings. There was an accessible garden and people were growing tomatoes in the garden. People were observed to walk all around the home and garden quite freely. People socialised with other people and staff whenever they chose. Some people choose to spend their time in their bedrooms. Equipment was available to assist people and staff in the delivery of personal care, which included assisted baths, profiling beds, accessible showers and moving and handling equipment including hoists. Each person had their own sling in their bedroom; there were plenty of spare slings so that they can be laundered. A range of pressure relieving equipment, including specialised ‘air’ mattresses were available. The laundry room was clean, tidy and well organised. All of the washing machines were in working order. Hand washing facilities and protective clothing was available. Alginate bags were in use for soiled laundry to minimise handling and reduce the risk of infection. Systems were in place to reduce the risk of infection. Disposable gloves, aprons and hand scrub were available and were used by staff when handling soiled linen and when supporting people with personal care. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can give a good standard of care to the residents living at the home. EVIDENCE: At the time of inspection staff rosters demonstrated that there were sufficient staff on duty at that time. During the inspection staff were on hand to meet the needs of the residents. Residents spoken with confirmed that staff were available when they needed them and they were not kept waiting. The home has an ongoing training programme, which includes NVQ level 2 in care and at the time of inspection the recommended level of 50 of care staff held this award. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 19 We reviewed five staff recruitment files. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Training files demonstrated that staff were receiving induction training and staff we spoke with confirmed that they were encouraged them to take up training opportunities provided. Recent training included: • Protection of vulnerable adults • Moving and handling • Fire safety Some staff have received training in palliative care and dementia care. Further training in these areas is being organised. Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the daily management and running of the home centres round the care of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: Since the last inspection Mrs Armstrong had been appointed manager at The Magna Care Centre. She confirmed that she would be submitting an application to the Commission for Social Care Inspection to become the Registered The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 21 Manager of the home. She has many years experience of running care homes. Through discussion it was evident that residents and staff enjoyed the way the home was run and found Mrs Armstrong was very approachable and supportive. One person described her as “A breath of fresh air.” Mrs Armstrong showed us that she had good managerial procedures in place, which included robust recruitment and training of staff, so that people living at the home could be assured they were being looked after by staff who could meet their needs. There was a quality assurance and quality monitoring system in place. The home took steps to review its performance regularly and residents’ views were sought and suggestions put forward were acted upon. The home did hold “pocket money” for residents at their request and accurate records were held of any monetary transactions. Residents were encouraged to either deal with their own finances or elect a representative to do it for them, often a family member or solicitor. The manager confirmed that staff supervision had just started. Staff spoken with confirmed this. Records showed that staff had received recent training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and appropriate action was taken as necessary. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 OP7 OP7 OP11 Good Practice Recommendations Daily records should reflect the wellbeing of the resident. Any alterations made to care plans should be signed and dated. There should be written guidelines for palliative care available to staff, which are based on current good practice. The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 24 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 The Magna Care Centre DS0000067493.V368029.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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