We undertook an unannounced inspection of Magdalen Park Nursing Home on 30 March 2017. At the last inspection in December 2014, the service was found to be meeting all of the regulations we inspected.The service provides nursing and personal care for up to 70 adults of all ages who may be living with dementia and/or physical disability. Accommodation is provided over three floors. The ground floor has 24 bedrooms which are split into two separate units (Haven North and South), for people living with dementia. On the first and second floors there are 40 bedrooms in total for people with nursing and residential care needs. Some of the rooms at Magdalen Park are used for double occupancy. The service has an extensive variety of communal areas including lounges, dining rooms, an in house pub, hairdressing/beauty salon and a shop. There is also a library, rooftop garden, and conservatory and entertainment room. There were 62 people using the service when we visited.
There was a registered manager employed when we visited. 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.
The registered provider demonstrated how they had achieved outstanding practice, development and improvement at the service. The leadership sought out creative ways to provide a personalised service and had achieved excellent results through exploring best practice and implementing this at Magdalen Park. The staff team were highly motivated and were actively involved in and contributed to continuous improvements in care and running of the service.
The registered provider and manager were dedicated to providing care which met the highest of standards. They strived for excellence through consultation and continually reflecting on how to improve the service further for people who lived at Magdalen Park. They registered manager demonstrated a strong and supportive leadership style, seeking feedback in order to further improve what was offered.
People received a consistently high standard of care because the service used evidence of what works best to continually review and improve their practice. For example, by using The National Institute for Health and Care Excellence (NICE) guidelines. In pursuit of excellence, the registered provider regularly read the 'outstanding' rated CQC inspection reports for other services and visited other services that had achieved this rating. They used them as a way to benchmark the quality of care provided at Magdalen Park and as a source of best practice ideas they could adopt.
Communication at all levels was clear and encouraged mutual respect. The service was recognised by schemes which reward quality, for example, achieving a Healthcare Design Award. The management team respected, supported and listened to staff at all levels to improve the quality of service. Staff members had lead roles for promoting best practice in chosen areas to improve the quality of the service. This showed that the registered provider placed a high value on meeting the needs of people and their relatives.
People received exceptionally effective care. The service demonstrated person centred ways of meeting people's hydration and nutritional needs and were proactive in ensuring these needs were met. Staff worked creatively to meet people’s needs and practices were actively followed by staff which had resulted in positive outcomes for people living at Magdalen Park.
There was a truly friendly and open atmosphere on entering the premises. A positive and inclusive practice for managing risk at the service had been adopted. All areas of Magdalen Park had been designed for the needs of people who used the service and there were specific areas to promote the independence and wellbeing of people who lived with dementia. There was plenty of communal space, with additional quiet areas where people could sit in peace. We observed that this was a safe home with a well-designed layout enabling staff and visitors to move freely within the environment and its grounds safely.
The service provided outstanding care to people, which was continually reviewed to ensure the best possible outcomes were achieved. People and their relatives told us staff were exceptionally caring and sensitive to their requirements. We found, without exception, staff went the extra mile to ensure people were safe and happy within their lives. People were at the heart of the service, which was organised to suit their individual needs and aspirations. People’s achievements were notable and their views were sought and acted on. People were supported by staff that were compassionate and treated them with dignity and respect. Without exception, people who used the service and their relatives were extremely complimentary and positive about the staff that supported them.
The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. The registered provider's recruitment processes ensured suitable staff were recruited and during this inspection we saw there were sufficient staff available to provide support to people when needed. This included support for people to eat, drink, and move around the home safely and to be involved in activities when they wanted to. We found that people’s medicines were safely managed
There were procedures and risk assessments in place that staff implemented to reduce the risk of harm to people. This included staff's understanding of the signs of abuse. People's ability to make decisions was assessed and where people lacked the mental capacity to consent to their care and welfare, actions were taken in their best interests. There was evidence of communications with other health care professionals and peoples relatives ensuring that significant individuals were involved in making decisions about people's needs where appropriate. The registered manager had taken appropriate action when people did not have capacity to consent to their care or treatment and applications had been made to authorise restrictions on people's liberty in their best interests.
We saw that people were cared for and supported by qualified and competent staff that were regularly supervised and appraised regarding their personal performance. Staff told us they felt supported by the registered manager and provider and were supported through training and meetings where their views were listened to.
There were a wide variety of activities for people to participate in both within and outside of the home. Activities were individualised and meaningful to people and designed around people's own interests and hobbies.
There were systems in place to monitor the quality and safety of the service and identify any improvements that were needed. People who used the service, relatives and staff were confident in the leadership of the service. They were encouraged to raise any areas of concern, which were taken seriously and the appropriate action taken.