Magnolia Court

Magnolia Court is a Nursing home registered to accommodate up to 62 people. The service provides support to people living with dementia, older people and younger adults.. The home is set over three floors with people’s bedrooms on the second and third floor. The ground floor accommodates dining and living areas for people, offices, the kitchen, laundry and the hairdresser’s salon. On the day we inspected there were 45 people living in the home.

People’s experience of using this service and what we found

People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people.

People's care was planned and risks to their safety and wellbeing were assessed. The service reviewed these plans regularly, involving people in these reviews and asking for their opinions.

Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice.

People and staff praised the managers of the service and agreed that they were approachable, knowledgeable, fair and did their job well. The staff team worked well together and supported the manager.

Medicines were administered safely to people and staff following safe infection prevention control practices. Where incidents occurred, the provider had a system in place to review and learn from these to prevent reoccurrence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity.

Staff consistently strived to ensure that people had the best possible care, and that they were supported in a compassionate, dignified and safe way

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well.

Care plans contained information about each person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes for people.

Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

The managers of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.

The provider had systems in place to monitor and improve the quality and safety of the service provided. There was a positive culture throughout the service. Staff told us they enjoyed working at the service and felt valued.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection we rated this service Good. The report was published on 16 October 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the key questions safe, and Well Led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Magnolia Court is a residential care home registered to accommodate up to 54 elderly people some of whom are living with dementia. The home is set over three floors with people’s bedrooms on the second and third floor. The ground floor accommodates dining and living areas for people, offices, the kitchen, laundry and the hairdressers salon.

The service was last inspected in August 2016 and was found to be in breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to insufficient staffing levels. We carried out a focussed inspection in July 2017 to check whether the service had made the required improvements. We found that the service had made the necessary improvements and was no longer in breach of the Regulation. We rated the service ‘Good’ overall. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Risk assessments in place continued to assess risks associated with people’s health, social and care needs. Risk assessments detailed how risks were to be minimised or eliminated in order to keep people safe and free from harm.

Robust medicine administration and management processes were in place and followed to ensure people received their medicines as prescribed.

People and their relatives confirmed that they and their relative felt safe living at Magnolia Court. Care staff described the steps they would take to report any concerns relating to suspected abuse.

We observed there to be sufficient numbers of care staff to meet the needs of people living at the home.

Safe recruitment processes ensured that only staff assessed as safe to work with vulnerable adults were employed.

We observed positive and caring interactions between people and care staff. Care staff knew the people they supported well and had built relationships with them and their relatives based on trust and mutual respect.

Records confirmed that care staff were supported through training, supervisions, annual appraisals and team meetings.

People’s needs and requirements were comprehensively assessed prior to admission to Magnolia Court to determine that the home would be able to effectively meet the holistic needs of the person.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Care plans were detailed and person centred and clearly reflected people’s needs, choices and preferences. These were reviewed regularly.

People were seen to enjoy the meals provided. People were offered choice and always had access to a variety of drinks and snacks throughout the day. Where people had specialist dietary requirements these were appropriately met.

People had access to a variety of health care professionals where specific needs or concerns were identified.

People and relatives knew who to speak with if they had a complaint and were confident that the issues that they raised would be appropriately addressed.

The registered manager and provider had robust governance processes in place which allowed them to monitor, evaluate and improve the quality of care provision. Where issues were identified systems in place allowed for the service to address these and to continuously learn and improve.

Further information is in the detailed findings below.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach.

We undertook a focused inspection on the 20 June 2017 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Magnolia Court on our website at www.cqc.org.uk.

Magnolia Court is a nursing home registered to provide accommodation, nursing and personal care for up to 54 older people including people with dementia. The home is operated and run by the Barchester Healthcare Homes Limited. At the time of our inspection, 52 people were living in the home.

The home has 54 bedrooms with en-suite toilet facilities split into two units on two floors. Each floor has two shower rooms, one assisted bathroom, dining area and lounge. The ground floor has the main dining room with two lounge areas. The two floors are accessible via two lifts and there is an accessible garden.

The home had a registered manager who has been registered with the Care Quality Commission since 30 June 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At our focused inspection on the 20 June 2017, we found that the provider had followed their plan and legal requirements had now been met.

We found that the provider had employed additional bank and permanent care staff and accessed spare staff from neighbouring Barchester Healthcare operated care homes to cover staff absences and emergencies, staff had been deployed appropriately to meet people's needs effectively.

Magnolia Court is a nursing home registered to provide accommodation, nursing and personal care for up to 54 older people including people with dementia. The home is operated and run by the Barchester Healthcare Homes Limited. At the time of our inspection, 51 people were living in the home.

The home has 54 bedrooms with ensuite toilet facilities split into two units on two floors. Each floor has two shower rooms, one assisted bathroom, dining area and lounge. The ground floor has the main dining room with two lounge areas. The two floors are accessible via two lifts and there is an accessible garden.

The home had a registered manager who has been registered with the Care Quality Commission since 30 June 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People using the service told us they felt safe at the service. The service had robust safeguarding policies and procedures. Staff were able to explain their role when raising safeguarding alerts and concerns relating to abuse. The service had systems to identify and manage risks. Risk assessments were detailed and individualised, and care records were maintained efficiently.

The service was clean and had effective measures to prevent and control infection. There were clear medicines administration records and the service kept accurate records of medicines administered by staff. There were effective systems for medicines collection. Care plans and risk assessments supported the safe handling of people's medicines.

The service followed safe recruitment practices. Staff files had records of application form, interview notes, criminal record checks and reference checks.

Staff told us they were supported well and we saw records of staff supervision. Staff told us they attended induction training and additional training and records confirmed this. According to the registered manager there were sufficient numbers of staff employed to ensure that people’s individual needs were met. However people, their relatives and staff told us there were not enough staff at all times to meet people’s needs. We saw some people waiting longer than others for their food during breakfast and lunch times.

People were provided with choice of food at all meal times. Not all staff used appropriate methods to support people in making choices of what they wanted to eat.

The service operated within the legal framework of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff asked people their consent before supporting them. There were appropriate referrals for DoLS authorisation for people who were unable to consent to care to ensure their rights were protected.

People using the service and their relatives told us they found staff friendly and caring. People told us staff listened to them and their individual health and care needs were met.

Care plans were personalised and people’s life histories, individual needs and likes and dislikes were recorded. People and their relatives were involved in planning their care and were asked their views at residents’ and relatives’ meetings. There was a range of activities available for people. However, staff were not always available to assist people in accessing the activities. People and their relatives told us they were asked for their feedback and their complaints were acted upon promptly.

The service had robust systems and processes in place to assess, monitor and improve the quality and safety of service provided. There was evidence of regular monitoring checks of various aspects of the service.

We have made a recommendation about staff training on the subject of dementia.

We found that the registered provider was not meeting legal requirements and there was one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to sufficient numbers of staffing to meet people’s care and treatment needs.

Is the service safe?

The provider conducted regular audits to ensure the safety of the premises and the equipment used. Staff had all had training in moving and handling. There were appropriate checks completed on all staff before they were employed. All staff received a comprehensive induction before they commenced work with people who used the service.

Is the service caring?

People were supported by professional and attentive staff. We saw care workers showed patience and gave encouragement when supporting people .Comments from people using the service included, "staff are very good here", "the home has a fabulous atmosphere", "I am very happy with the care provided, I would recommend the home" and from a family member "I can't fault the care; I am confident my partner will be looked after."

Is the service effective?

People were asked about things which were important to them and information about people's life history and interests had been included in the care plan documentation to inform staff about significant life experiences and likes and dislikes. One person using the service told us, "I'm so happy here, the staff are always courteous and happy to help' and another person commented, "whenever I need assistance staff are there."

People's health and care needs were assessed with them or their relatives, and they were involved where possible in writing their plans of care. Visitors confirmed they were made welcome, able to see people in private if they wished and visiting times were flexible.

Is the service responsive?

People enjoyed a range of activities both in and outside the home. The home encouraged activities and we saw many activities happening during the inspection, both collectively and on a one to one basis with individuals. One person told us, 'the activities manager is excellent.' We saw care plans and risk assessments were completed for all people who used the service.

Is the service well led?

The provider had systems in place which ensured the service was responsive to change. There was evidence the service was modified when appropriate. Staff we spoke with were complimentary when asked about management.

Staff understood the importance of obtaining the consent of the person before any care or treatment took place. People we spoke with confirmed that staff communicated well with them and asked for their permission before they offered any assistance.

We observed staff supporting people in a friendly, patient and professional manner. Staff had a good understanding of the needs of the people they supported and the potential risks they faced.

People told us they had good access to health care professionals such as doctors, dentists and chiropodists. Relatives told us that the home kept them updated about people's health issues.

People were being protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Staff told us they felt supported by the management and that there were good training opportunities available within the organisation. Staff were able to tell us how the training they had undertaken informed their working practices.

People told us they had no current complaints about the service but knew how to make a complaint if they needed to. One person told us 'I would tell them straight. They would do something.'

People told us that they felt safe with the staff who supported them. They said they had no concerns or complaints about their care but would speak with their relatives, the manager or the care worker if they needed to. One person told us, 'there's not a lot to complain about.' People were confident that their concerns would be taken seriously and felt the manager was very approachable.

People who use the service told us they were satisfied with the support they received to take their medication. We saw that medication records were being regularly audited so that any issues or problems could be identified in a timely manner.

People told us that they thought there were generally enough staff on duty to support them properly. We observed a calm and relaxed atmosphere throughout the inspection and staff did not appear to be rushed and were able to spend time with people they were supporting.

People confirmed that the management and staff often asked them for their views about the quality of care they received and if they had any suggestions for improvements.