Magnolia House

Updated 12 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 4 December 2018 and was announced. We gave the service 24 hours’ notice of the inspection visit because it is small and the manager is often out supporting staff or providing care. We needed to be sure that they would be in. The inspection was carried out by one inspector.

Before the inspection we looked at information we held about the service. This included previous inspection reports and statutory notifications sent to us by the service. These are forms the provider must complete to tell us about significant events that take place within the service.

During the inspection, we observed how staff interacted with people. We looked at two people’s care plans and other records including medicines records. We also checked two staff files and spoke with one person who used the service, one relative of a person who used the service, one member of staff and the registered manager. Because the service is small, we made sure people we spoke with were aware they could potentially be identified by their comments and checked they consented to them being used in the report.

Updated 12 January 2019

This inspection took place on 4 December 2018 and was announced. At our last inspection in November 2017 we found a breach of the regulation in relation to safe care and treatment. This was because some upper floor windows were not appropriately restricted. However, the provider took action to rectify this by the time we completed the inspection. We also found one person was not receiving care in line with restrictions placed on their liberty by a supervisory body and that the registered manager did not always identify and act on problems such as those we identified at the inspection. We rated the service 'Requires Improvement' overall and in the key questions, 'Is the service safe?' 'Is the service effective?' and 'Is the service well-led?' In the key questions, 'Is the service caring?' and 'Is the service effective?' we rated the service Good.

Magnolia House 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. Magnolia House is able to accommodate up to three people within one building. At the time of our inspection there were two people using the service. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. 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 were safe because the provider had appropriate systems in place to safeguard people from abuse and avoidable harm. This included management plans for people who had a history of engaging in risky behaviour. People had personalised risk assessments covering both generic risks and those that applied specifically to them. Risk management plans were designed to keep people safe without overly restricting their freedom.

The provider took steps to reduce the risk of infection spreading. They carried out a number of checks to ensure the premises were safe, well maintained and clean. This included the safe storage of medicines. People received their medicines as prescribed and the registered manager ensured staff were competent to administer them. There were enough staff to care for people safely.

The provider kept up to date with relevant guidance and worked alongside other providers to ensure the care they provided at Magnolia House was effective and in line with best practice. People had their needs assessed and care planned to take into account their specific needs in relation to healthcare and the provider worked with mental health professionals to meet their needs effectively. People had enough suitable food and drink to meet their needs. The home environment was suitable for the people who lived there and met their individual needs.

The provider understood their duties under the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). People received care that they had consented to and did not unnecessarily restrict or deprive them of their liberty.

Staff received support to provide effective care. The registered manager shared best practice knowledge with the staff team and staff received regular training, supervision and appraisals.

Staff cared for people in a compassionate and respectful way. People had good relationships with staff who understood them well. Staff knew how to communicate information to people in ways they understood to help them make informed choices about their care. Staff promoted people’s privacy, dignity and independence.

People’s care was personalised and they were involved in planning their care. Care plans took into account people’s diverse needs, interests, abilities and preferences. There were several activities available that were appropriate for people’s abilities, cultural backgrounds and interests and helped protect them from social isolation.

There was a robust complaints procedure and people knew how to complain although no complaints had been received since our last inspection.

People, their relatives and staff gave positive feedback about the registered manager. The manager listened to people and acted on any concerns they had. People had opportunities to feed back and there was an open, person centred culture within the organisation. The provider had systems to check and monitor the quality of the service and ensure people received care in line with their care plans.