Background to this inspection
Updated
22 June 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team consisted of 2 inspectors. An onsite inspector and another inspector who assisted with telephone calls to get people’s feedback of using the service. An Expert by Experience also supported the inspection by obtaining feedback of people’s experiences via telephone calls. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Magdalene House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us.
Magdalene House Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the start of our inspection a manager was in post, but we were advised during the inspection they had not been successful in their probation period and recruitment was underway. The provider’s regional manager with support from the deputy manager of the home were overseeing the day to day running of the service.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 26 April 2023 when we visited the service and ended on 18 May 2023 when we gave feedback.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
During our visit we spoke with 5 people who used the service and 1 relative. We spoke with the deputy manager, two senior carers, 2 care staff and the maintenance person. We spoke briefly with the activities lead, the cook, 2 domestic staff, an administrator, and the receptionist.
We undertook a tour of the home and observed the interactions between staff and people using the service to help us understand the experience of people who could not talk with us. We reviewed records relating to maintenance and health and safety, including fire safety checks and audits. We looked at 2 people’s care records including their risk assessments and medicine administration records and 2 staff personnel files.
After the site visit the inspectors and Expert by Experience spoke with 16 relatives via telephone interviews on 3 & 10 May 2023.
We also reviewed records remotely, away from the home, including 3 people’s care records and records relating to the governance of the service. We received electronic feedback about the hom
Updated
22 June 2023
About the service
Magdalen House Care Home is registered for 53 people, providing personal care and support to older people and some people living with dementia. The residential care home is split over 3 levels with personalised bedrooms, dining and communal areas and adapted bathrooms. At the time of our inspection there were 52 people living at the home.
People’s experience of using this service and what we found
There was a warm and friendly atmosphere within the home. Overall feedback from people and relatives about the care they received and experience of living in the home was positive. They described being safe, their needs being met and being treated with respect and dignity. However, they said the home was not consistently well led. We received feedback citing inconsistencies with communication, laundry, cleanliness in the home, staff approach, and concerns not being acted on appropriately by management due to personnel changes.
Since our last inspection there had been a new provider and several management changes which had impacted on the stability in the home. Staff feedback and morale was mixed, several cited too many changes at once and inconsistent messaging from management which caused confusion.
The management team comprised of the provider’s regional manager and the deputy manager. They were open and honest about the shortfalls at the home. They engaged with the inspection positively and were committed to making any necessary improvements in the home. We were given assurances that the regional manager would be visible in the home supported by the deputy manager till a successful manager was appointed. Feedback about the regional manager who was previously the registered manager in the home was positive along with the deputy manager.
Governance and oversight systems had identified gaps within the home and the regional manager with support from the deputy manager were working to improve the standards and culture in the home and shared with us the action plan they were implementing. These took into account the inconsistencies we had found but it was too soon to assess the effectiveness of the proposed changes. These need to be sustained and embedded into the home.
There were ongoing improvements to the staffing levels, including recruiting new staff. Vacancies and the use of agency staff had reduced. There were enough staff on duty to meet people’s needs and they had been recruited safely.
Systems were in place to reduce the risks of avoidable harm and abuse. Staff understood their responsibilities to report any concerns about people's care and safety. Staff were familiar with people’s assessed medical needs and associated risks. These were monitored and managed safely.
People were provided with their medicines safely. The home was visibly clean and good infection control processes followed. Relatives told us they could visit their family members when they chose to.
Processes were in place to learn lessons when things had gone wrong with actions taken to reduce future incidents happening.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 5 December 2020).
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
No areas of concern were identified in the other key questions. We therefore did not inspect them. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the well-led section of this report. The provider is implementing an action plan to address the inconsistencies found.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Magdalen House Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.