Magdalen House Residential Home

Magdalen House Nursing Home is a residential nursing home providing personal and nursing care to up to 29 people. The service provides support to older people and people living with a diagnosis of dementia or age-related frailty. At the time of our inspection there were 26 people using the service.

People’s experience of using this service and what we found

People and their relatives told us the service was safe and staff responded to their needs safely. There were enough staff deployed to meet people’s needs. Staff told us they had the skills, time and support they needed to meet people’s needs.

Staff had received training in recognising safeguarding and knew the actions to take to protect people from harm. There were recruitment processes in place and checks were carried out before staff were appointed.

The provider had infection control procedures in place to protect people and prevent the spread of infection. Staff accessed personal protective equipment (PPE) and acted in accordance with government guidance.

People's needs, and choices were assessed, and their care was reviewed regularly. Care records identified people's individual risk and how these should be managed to reduce the risk of harm.

We observed positive interactions throughout our inspection between people and staff. Staff said they enjoyed working at Magdalen House and felt well supported by their colleagues and the registered manager.

Incidents and accidents were reviewed to reduce the risk of a reoccurrence. Complaints were responded to appropriately and opportunity was made to identify and make improvements.

People and their relatives spoke positively about the management and the caring culture of staff. The registered manager was supported by the provider. A board of trustees (for Gloucester Charities Trust as the provider) and the chief executive officer carried out regular quality processes to monitor and improve the quality of people’s care.

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 7 November 2019)

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

This was a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Magdalen House Nursing 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.

Magdalen House Nursing Home is a residential care home providing personal and nursing care to 29 older people, who may be living with dementia, at the time of the inspection. The service is registered to support up to 30 people, one former bedroom is no longer used for accommodation.

Magdalen House accommodates 29 people in a purpose-built home, with accommodation over two floors. Stairs or a passenger lift were used to access the upper floor. The gardens were fully wheelchair accessible and the provider’s day care service, which people could attend, was located next door.

People’s experience of using this service and what we found

People felt safe and risks to them were managed. Nobody we spoke with had any concerns about people’s safety and staff followed the systems in place to keep people safe. There were enough experienced staff to meet people’s needs and staff had been recruited safely. Lessons were learned in response to any adverse events or outcomes, following which improved systems and checks were put in place to improve outcomes for people.

People’s needs were supported by a stable, well trained and empowered staff team who knew and supported them as individuals. This included timely referral to health care professionals, preventative healthcare and emergency services. Staff worked in partnership with health professionals to maintain people’s well-being and avoid unnecessary hospital admissions.

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. Staff were proactive in overcoming barriers related to people's disabilities. They used a variety of techniques to communicate with people and information about the service was available in a variety of formats. Staff worked in partnership with people, their relatives and health and social care professionals to ensure people’s needs were met in accordance with their wishes (and/or best interests).

People were treated with kindness, respect and dignity. In feedback to the service, relatives thanked staff for, “compassionate, patient, kind, understanding and very professional care.” People’s feedback was sought regularly and acted upon. People and their relatives understood how to raise concerns but told us they were happy with the service they received.

People were cared for by a staff team who worked flexibly and creatively to meet their needs, to ensure people had a good quality of life and were able to follow their interests. Staff were happy to take a person-led approach, particularly when planning activities to meet people's social and emotional needs. Relatives were welcomed, and often joined people in meals, activities and social events.

People benefitted from a service with an open and inclusive culture, where they were enabled to maintain control and were valued and respected as individuals. People were listened to and supported to maintain their independence as their needs changed. They had regular opportunities to go out, be part of their local community and pursue activities that were meaningful and relevant to them. This was made possible by a culture where staff felt valued and supported and where staff development and well-being were invested in by the provider.

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 8 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Magdalen House Nursing Home provides residential and nursing care for up to 30 older people. When we visited 27 people were accommodated. The home is purpose built over two floors and a passenger lift provides easy access to both floors. There are two communal rooms, one on each floor, where people can dine and seat comfortably in easy chairs. There is a small day centre people can access adjacent to the home. There are well tended gardens and parking at the front of the home.

There was no registered manager. 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 current new manager was in the process of applying to become the registered manager.

There were some minor shortfalls in the administration of medicines and we have made a recommendation about the management of some medicines. However these issues had been identified through their own quality assurance processes. People and their relatives told us they felt safe in the home. Staff knew how to keep people safe and were trained to report any concerns. People were supported by staff that were well trained and had access to training to develop their knowledge.

People had a choice of meals. We observed one meal time and people’s experience could be improved. There were insufficient staff to support people in the dining room. When people required assistance with their food in their bedroom staff supported them and gave them time to enjoy their meal. People had a range of activities to choose from which included exercise classes, arts and crafts, musical entertainments and weekly trips out in the mini buses. There were links with the local community at the adjacent day centre and a church social club.

The current care plan records were not as person centred as they could be but we could see the new care plans were an improvement. Each day one care plan was reviewed and the person would be included in the ‘Resident of the Day’ review where all aspects of their care were looked at.

The manager, compliance manager and the Chief Executive Officer monitored the quality of the service with regular checks and when necessary action was taken. Staff felt well supported by the manager. Staff meetings and resident/relative meetings were held and they were able to contribute to the running of the home.

People were treated with kindness and compassion and we observed staff engaged with people in a positive way and they were caring when they supported them. Relatives felt welcomed in the home and told us the staff were kind.

People were able to make some choices and decisions and staff supported them to do this. Staff knew what people valued and how they liked to be supported. People's care was regularly reviewed. External healthcare professionals supported people when required and they were well supported by their GP.

At this inspection we looked at the care records for four people and spoke with the registered manager and a senior member of staff. We did not speak with people as the purpose of this visit was to check if assessments of peoples' mental capacity to make decisions about their daily living were recorded.

We found records showed that people's decision making ability in relation to day-to-day decisions had been assessed and the outcome recorded. Records also detailed the type of decisions that people would not have the capacity to make and would have to be made in their best interest. We found the provider was meeting the requirements of the MCA by keeping accurate records where people were unable to consent to some or all aspects of their care.

Care plans were personalised to each individual's needs, risks were identified and assessed appropriately and all records were kept under regular review. The home had a range of activities on offer including: arts and crafts, nail and hand care, music and movement and trips out. One person told us, 'we went to Weston-Super-Mare last week and that was very nice'.

There were enough qualified, skilled and experienced staff to meet people's needs. Appropriate arrangements were in place in relation to obtaining, recording and the storage of medicines. We found that although the home's practice was in line with the requirements of the Mental Capacity Act 2005, records did not always evidence this.

The regulated activities of diagnostic and screening procedures and treatment of disease, disorder or injury were being carried out at this location. Our records showed that these regulated activities had not been registered with the Care Quality Commission. However, we discussed this with the provider and we were advised that arrangements would be made to register these regulated activities at this location.