Archived: Magnolia House

Magnolia House is a care home providing personal care and accommodation to up to 96 people, some of whom may be living with dementia. When we inspected 77 people were living in the service.

We found the following examples of good practice.

¿ Visitors were asked a set of screening questions and their temperatures taken to ascertain any risks and their details were kept for track and trace purposes. All visitors were supervised to ensure they followed infection control guidelines and wore appropriate Personal Protective Equipment (PPE).

¿ Measures had been put in place to support social distancing and included the rearranging of furniture to encourage people to socially distance themselves.

¿ People who used the service were supported to maintain contact with their families and friends through phone calls, video calls and two safe visiting areas which had been set up. Booking systems were in place to ensure people had the support they needed and to safely manage visitor numbers.

¿ The provider was fully aware of all current best practice guidance including the safe admission of people from hospital. The provider communicated updates to people, their families and staff when they happened.

¿ Designated stations for the use of PPE were situated around the service to enable staff to regularly change their PPE and reduce the risk of transmission. Staff were trained in the use and disposal of PPE and senior staff were appropriately trained to complete testing for Covid-19.

¿ Regular testing of people who used the service and staff was completed in line with current guidance. Clear procedures were in place to make sure people and staff self-isolated when necessary.

¿ The service was clean and tidy, and any equipment used was regularly cleaned to minimise the risk of people catching or spreading Covid-19.

¿ The provider had contingency plans in place which included the use of agency staff who only worked at the service to reduce the risk of transmission to and from other services.

Further information is in the detailed findings below.

Magnolia House is a is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates 96 people across four separate wings, each of which has separate adapted facilities. One of the wings specialises in providing care to people living with dementia.

At our last inspection we rated the service good. 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 on-going 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.

People were protected from avoidable harm and abuse. Staff had good knowledge of the types of abuse and how to report them. Systems supported staff to record and take appropriate actions in line with their safeguarding policies and procedures.

Assessments of risks associated with people's care and support had been completed to ensure people received safe care and support.

Recruitment included pre-employment checks to ensure people were of a suitable character to work in a care home environment. Staffing levels were consistently maintained to provide safe care and support to people.

Systems and processes ensured safe management of medicines and infection control.

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

People received person centred care and support to meet their individual needs, considering their preferences. Staff could access training relevant to their role and received supportive supervisions both face to face and in the form of observational practice.

Staff encouraged people to be as independent as they could be and offered choices for people to maintain control of how they wanted to live.

People told us they felt staff were caring, considerate and kind to them. They felt staff respected their wishes and that their privacy, dignity and independence was maintained.

Policies were in place to support staff in promoting equality and recognising people's diverse needs.

Activities were centred around people's previous employment, interests and hobbies. People had a choice of attending both group and one to one close space activities or events.

Systems were in place and easily accessible for people or their relatives to raise a complaint if they wished to do so.

The provider sought feedback from people and their relatives to improve the service. Planning of care and support involved the person and their relatives or representatives so that they could make suggestions or voice any concerns.

Quality assurance systems identified when improvements needed to be made. However, we identified some minor areas that required further improvements to be made. This was a proportionately small area and overall the providers systems were effective in driving improvements in the service.

Further information is in the detailed findings below.

Magnolia House provides accommodation and personal care for up to 96 older people. People who use the service may also have a physical disability, sensory impairment, mental health condition or be living with dementia. The home is situated in Cottingham, close to the city of Kingston Upon Hull, but in the East Riding of Yorkshire. The service is divided into four units: Maple Court, Willow Court, Cedar Court and Lavender Way. Maple Court is a separate unit where the safety of people living with dementia is more easily maintained, while the other three units are open plan and people can move between them at their will. Accommodation is mainly single occupancy with a selected number of bedrooms that are shared. A very high proportion of bedrooms have en-suite toilet facilities. There is a hairdressing salon on Lavender Way and a separate flat where one person lives that is much more independent and therefore has their own front door entrance with key. Gardens are extensive and secure.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager that had been registered and in post for the last four months. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found that people were protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were managed and reduced on an individual and group basis so that people avoided injury or harm, wherever possible.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Staffing numbers were sufficient to meet people’s need and we saw that rosters accurately cross referenced with the staff that were on duty. We saw that recruitment policies, procedures and practices were carefully followed to ensure staff were ‘fit’ to care for and support vulnerable people. We found that the management of medication was safely carried out.

People that used the service were cared for and supported by qualified and competent staff that were regularly supervised and received appraisal regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing.

The premises were suitable for providing care to older people and we found that the unit designated to accommodating people living with dementia was also suitable for its purpose. Everyone that lived in Maple Court had their own front door in bold colours, with letter box, door knocker and memorable signage, so they could identify their bedrooms.

We found that people received compassionate care from kind staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

People’s wellbeing, privacy, dignity and independence were monitored and respected and staff worked to maintain these wherever possible. This ensured people were respected, that they felt satisfied and were enabled to take control of their lives.

We saw that people were supported according to their person-centred care plans, which reflected their needs well and which were regularly reviewed. People had the opportunity to engage in some pastimes and activities if they wished to. These included activities to stimulate the brain, keep skills going or just for pure pleasure and occupation. People had very good family connections and support networks and family members were encouraged to be involved in people’s care.

We found that there was an effective complaint procedure in place and people were able to have any complaints investigated without bias. People that used the service, relatives and their friends were encouraged to maintain healthy relationships together by frequent visits, joining in with organised events, telephone calls and letters.

We saw that the service was well-led and people had the benefit of this because the culture and the management style of the service were positive. There was an effective system in place for checking the quality of the service through the use of audits, satisfaction surveys, meetings and good communication.

People had opportunities to make their views known through direct discussion with the registered provider or the staff and through more formal complaint and quality monitoring formats. People were assured that recording systems used in the service protected their privacy and confidentiality as records were well maintained and were held securely in the premises.

We found that people were consulted whenever possible about their care needs and wishes. We found that people were generally satisfied with the service they received, but that they were able to express their minor 'niggles' about things quite openly with staff. People said, "Everything is quite satisfactory. The staff are helpful", "I am well looked after" and "I don't require a great deal of help, but when I do ask for it the staff are helpful".

We found that the service had strategies for cooperating with other providers and organisations so that people received continuous care and support when moving between services.

People were protected from the risks of harm or abuse as the provider had safeguarding systems in place and the staff were appropriately trained. The provider protected people from the use of unsafe or unsuitable equipment and ensured equipment was safe by maintaining it as necessary.

People were assured of improvements in service provision because the provider had a system in place to monitor care and audit the overall performance of care and support. Complaints were satisfactorily handled and addressed so people knew their needs would be met.

Records held and maintained in the service were fit for purpose and were appropriately and securely stored, so people knew their information was kept confidential.

At this inspection we did not speak with people that lived in the home about these issues but we looked around the premises and we spoke with the manager. We found that improvements had been made to the environment and were on-going. We were encouraged by this and accepted the provider's undertaking that further improvements would be made. We will visit again to look at regulation 15 regarding the ongoing refurbishment of the home. We found that infection control and staff training issues had been addressed and the service was compliant with regulations 12 and 23.