This inspection took place on 8 and 16 November 2017 and was unannounced. Magnolia House provides accommodation and personal care for up to three people with a learning disability. 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. Three people were using the service at the time of our inspection.
The service had 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 not always kept safe. We found there were no restrictors on windows on the first floor, where people were at risk of falling from a height. In addition, this was not in line with guidance on national safety standards for people living in a care home. The registered manager had identified the risk of a person falling out of a window. However, they had not taken the necessary action to minimise the risk of avoidable harm. We issued a warning notice after our first day of inspection in relation to the safety of people using the service; by the second of day of inspection, the provider had taken appropriate action to address this concern.
Aspects of the premises were cluttered with fitness equipment, containers with activity aids and furniture. There were loose floor tiles in an office/lounge, an unsecured skirting board in one of the corridors, and insufficient lighting on the first floor landing, which put people at risk of falls, trips and/or injury.
People did not always receive the support they required in line with the restrictions placed on them by a supervisory body under the Deprivation of Liberty Safeguards (DoLS).
Quality assurance checks and audits were not always effective in identifying and resolving shortfalls at the service.
People received support from a sufficient number of staff deployed to meet their needs. The provider carried out appropriate recruitment checks and ensured they employed staff who were suitable to provide care and support.
People were protected from abuse because staff understood the provider’s safeguarding procedures to identify and report abuse. Staff minimised the spread of infection by following good hygiene practices.
People’s care was delivered by staff who were supported, supervised and appraised in their roles. Staff underwent training required to undertake their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service did support this practice. Staff ensured they sought people’s consent before providing care and treatment.
People enjoyed the meals provided at the service and received the support they required to maintain a healthy and balanced diet. Staff supported people to access healthcare services when needed.
People were treated with dignity and respect. Staff respected people’s privacy. People told us the staff were kind, caring and respectful.
People took part in the assessment and planning of their care and support. Staff had sufficient guidance about how to provide people’s care. People received care that responded to changes in their health and support needs. People enjoyed taking part in a wide range of activities of their choosing.
The registered manager sought people’s views about the service and acted on their feedback. People using the service and their relatives knew how make a complaint if they were unhappy.
People using the service, their relatives and staff were happy with the registered manager and the management of the home. Staff understood their roles and responsibilities and followed the provider’s vision by providing person centred care.
The registered manager worked closely with external agencies to improve the quality of care they provided to people using the service.
We found one breach of regulation relating to safe care and treatment and issued a warning notice. You can see what action we told the provider to take at the back of the full version of this report.