Archived: Mahogany Care Home

We asked the following five questions.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Is the service safe?

Both the people who lived in the home and their relatives were pleased with the care provided and felt their views were respected and listened to. The staff worked in a safe and hygienic way and used appropriate protective clothing. There were mixed opinions as to whether there were enough staff to meet the needs of the people living in the home. One person said: 'Sometimes it takes a long time for people to come.' Another person said: 'They come right away.' One relative said: 'There's not always enough staff.' Another relative said: 'There's plenty staff.'

The deputy manager told us a major recruitment drive was underway in order to reduce the reliance on agency staff.

The registered manager and the staff we spoke with understood the importance of safeguarding vulnerable adults, could identify potential abuse and knew how to report any incidents of abuse.

Is the service effective?

People told us they were happy with the care delivered. A person who lived in the home said: 'You could feel it picking up since this home manager arrived. They are doing the best they can.' Another person said: 'It's belting here. I'm alright now.'

Care records confirmed people's preferences, interests and needs had been recorded and care and support had been provided in accordance with people's wishes. One relative said: 'They tell me everything that is going on.'

We heard information was shared very effectively between staff. Several ways of sharing information included handovers, daily records, and monthly reviews with relatives.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and encouragement when supporting people. One relative said: 'They can't do enough for her.' One person using the service said: 'I think it's lovely.'

Is the service responsive?

People's needs had been assessed before they were admitted to the home. People's needs were carefully described so care workers knew exactly what tasks to undertake to support them. Changes in people's care needs were reported to the senior carers and they briefed care staff at handovers and via the updated care plans.

One relative said 'I tell them she needs more help and she gets it immediately.' They also commented that a doctor called regularly as did a district nurse and an occupational therapist. They felt their relative was receiving good care from the team.

Is the service well-led?

Staff had a good understanding of the culture of the home and quality assurance processes were in place. People told us they had received customer satisfaction surveys and staff acted upon their concerns. The manager met informally with families and was available whenever they visited. Staff told us they were clear about their roles and responsibilities and said: 'They are giving me the support I need to work through the process.' We heard that staff had confidence in the home manager. One said: 'I feel like I can go and talk with her.'

The home had issues which needed to be addressed but it was clear from our observations and information received the home manager was fully aware of the need to drive this service forward.

The people who lived in the home that we spoke with told us they thought there was enough staff to support them in the way that they needed. One person commented 'There always seems to be enough staff.'

Comments from people living in the home included 'The staff are very nice'

Staff spoken with said " things have really improved since the new manager has been in place" "the manager is very approachable and has improved training and everything really," " from the entrance hall to the care plans things have improved since the new manager came" and "staff morale is much better now."

We conducted a tour of the home and saw that the fixtures and fittings were showing considerable signs of wear and tear.

The people that we spoke with told us that '' all of the care staff are good'' and '' I have everything that I need ''.

We saw that there was a complaints notice displayed on the wall that was providing out of date information. This meant that there could be a delay in contacting the relevant people if the need arose to raise an issue. It was of concern as this matter had been raised previously at the last inspection. The area manager told us that she would personally ensure that this was rectified.

We were aware that there had been some issues with medication in the home. This was discussed with the provider at the visit who had been working to ensure that correct actions had been taken following these events. Following the inspection, arrangements were made for a pharmacy inspection to take place and the outcome of this can be found in a separate report.

At the time of the inspection the manager was on maternity leave. A deputy manager had been appointed and was on duty. She told us that she was currently undergoing her induction training. An interim manager from the company was in day to day charge of the service until the manager returned.

We saw that written guidance was mostly in place to help ensure consistency in the use of 'when required' medicines. However, one person we spoke with said that the eye drops they used 'when needed' were not being administered when they needed them. Following a visit in February the manager sent us an action plan detailing how they were going to bring about improvement in medicines handling at the home. At this visit we saw that this plan was being acted upon and medicines handling had improved.

Staff told us that they felt they "needed a manager who was going to stay" but said that they were supported and that they enjoyed being part of the staff team at Mahogany. Some staff had been at the home for a long time. Comments from staff such as "I love it here"; "this is a great place to work "and "we get plenty of training and I feel supported".

However, as identified by the manager in their medicines audits, we found that the home's medicine policies were not consistently adhered to, increasing the risk of errors and omissions.

We found that some of the detailed information required to be updated as this could be misleading for people and result in a delay in being able to contact the appropriate person, authority or regulatory body.

A visitor that we spoke with told us that overall they are satisfied with the care that their relative receives.