We carried out a review of the data available to us about Magnolia House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Magnolia House, you can give feedback on this service.
Magnolia House is a residential care home providing accommodation to persons who require nursing or personal care, to up to 67 people. The service provides support to older people; some of whom live with dementia. At the time of our inspection there were 48 people using the service. People are accommodated in one adapted building.
People’s experience of using this service and what we found
The registered manager and provider had implemented new systems following our last inspection to ensure people received care that reflected their needs and preferences.
Effective action had been taken in relation to infection control, which protected people from the risk of infection, including COVID-19. The registered manager sought the guidance of professionals and acted on their recommendations.
People and their relatives spoke positively of Magnolia House and the registered manager. They told us that the service was improving.
Staff told us they had the training, support and skills they required to meet people’s needs. Staff had differing views on communication within Magnolia House. The registered manager and provider were aware of these views and taking action to engage with all staff.
People and their relatives told us Magnolia House was a safe place to live. There were enough staff, who had the training, support and skills they required, to meet people's needs.
People’s needs had been clearly assessed. Since our last inspection, the provider and registered manager had reviewed their care planning systems. Each person had a clear and concise care plan. Care and nursing staff understood people’s needs. Professionals provided positive feedback on the improvements made at Magnolia House.
People were supported with their nutritional needs. People were supported with choice and enjoyed a varied diet.
Mental Capacity Act
Staff supported people in the least restrictive way possible and in their best interests. Where people were living under Deprivation of Liberty Safeguards; staff understood the support they required.
Since our last inspection, the registered manager and provider had ensured records in relation to people’s mental capacity had been reviewed.
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.
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 requires improvement (published 7 June 2022).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 13 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve need for consent, safe care and treatment, and good governance.
We undertook this focused inspection to check whether the Warning Notices we previously served in relation to Regulation 12 and Regulation 17, and the requirement notice in relation to Regulation 11, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
For the 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 changed from requires improvement to good. This is based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Magnolia House on our website at www.qcq.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Magnolia House is a residential care home providing accommodation to persons who require nursing or personal care, to up to 67 people. The service provides support to older people; some whom live with dementia. At the time of our inspection there were 55 people using the service. People are accommodated in one adapted building.
People’s experience of using this service and what we found
People were not always protected from avoidable harm. People’s care plans and associated records were not always current, accurate and did not provide staff with the correct information they required to safely meet people’s needs.
People’s care plans did not detail where people could make a decision and the support they required. Where people were living under restrictions, there was not always a clear record of where decisions had been made in their best interest, or if the person had capacity to consent to the decision.
Infection prevention and control was not always effective. This placed, people, visitors and staff at risks of infection.
Monitoring systems were not always effective as the records supporting the management of the service were not always reliable. These systems had not identified or addressed concerns found during our inspection, including concerns in relation to people’s care records, infection control, recruitment and mental capacity act. The management had a system to monitor staff training, however there was limited evidence of action being taken to address the training needs of staff.
Staff told us that communication was not always effective. Staff told us they did not always have the information, training or support they required.
People told us they felt safe and well looked after. They told us the staff were tolerant, patient and friendly. Although there had been challenges in recruiting staff, there were enough staff to ensure people’s care needs were met.
People’s medicines were managed safely. However there had been times where medicines had not been checked or removed in accordance with the providers medicines policy.
The provider, registered manager and staff had learnt from a situation where an incident was not reported appropriately, and they had adjusted their risk management strategies accordingly.
People and their relatives felt able to approach managers and the staff as needed. People’s complaints had been acted upon.
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 9 October 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. This included information about the people’s assessed care needs, associated risks and falls management.
As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive 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 Magnolia House on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment, good governance, person centred care and reporting incidents at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Magnolia House is registered to provide accommodation, nursing and personal care to 67 older people and people living with a diagnosis of dementia. At the time of our inspection 50 people were receiving support at the service.
The home had a range communal areas on each floor for people to enjoy, as well as a garden area, enclosed garden and areas where people could sit and relax.
We found the following examples of good practice.
¿ The provider and manager had set up a visiting room in accordance with recognised safe visiting guidance. Additionally, alternative ways, including the use of technology, had supported people’s ability to remain in contact with their relatives. At the time of our inspection, visits were being supported. These were pre booked and the service were making changes in accordance with government guidance on visiting.
¿ Admission to the home was completed in line with COVID-19 guidance. People were only admitted following a negative COVID-19 test result and supported to self-isolate for up to 14 days following admission to reduce the risk of introducing infection. The home had a dedicated unit for new admissions and people who required support to be isolated.
¿ People’s health and wellbeing was monitored. People were observed for symptoms of COVID-19 and other potential infections. Healthcare professionals had continued to provide clinical support to people when this was required. This included assisting people with COVID-19 vaccinations.
¿ Action had been taken to reduce the risk of infection spreading which had included the correct use of personal protective equipment (PPE). Staff had received training and support in relation to infection control and COVID-19. The manager, deputy manager and representatives of the provider observed staff practice ensuring they were following the correct use of PPE.
¿ The manager and provider had clear plans in relation to the isolation of people affected by COVID-19 and the cohorting of staff to reduce the spread of infection.
¿ People and staff were tested in line with national guidance for care homes.
¿ As part of full infection control measures laundry and waste arrangements had been correctly implemented to reduce the spread of infection. The home had colour coordinated linen and a laundry room on each floor, which reduced the movement of laundry around the home (and the potential for cross infection).
¿ Cleaning schedules had been enhanced and were followed by care and maintenance staff. This included the additional cleaning of frequently touched surfaces to reduce the risk of infection spreading. People told us that the home was clean and that staff wore PPE as required.
¿ The provider’s policy for managing COVID-19 and related infection prevention and control procedures had been reviewed and kept up to date. COVID-19 guidance was also kept up to date for staff reference.
¿ People were being supported with activities and engagements which met their wellbeing needs, in a safe manner. The home focused on creating events for people, which included a club night and other events.
Magnolia House is a residential and nursing home which provides care to 67 older people and people living with dementia. The home is based over three floors and has a secure dementia care unit. Magnolia House has a range of communal areas, including a bar and enclosed courtyard. At the time of our inspection 61 people were living at Magnolia House.
People’s experience of using this service and what we found:
Through strong leadership the registered manager had instilled a highly person centred culture within Magnolia House. All care and nursing staff (including agency staff) had bought into this culture and shared the visions and aspirations of the registered manager. Since the registered manager had been in post they had instilled and embedded “Magnolia Magic”. “Magnolia Magic” is the provider's structured approach for “Transforming cultures of care, creating households and focusing on quality of life matters. This included the use of several tools such as their isolation and loneliness and service culture audits to further develop a highly personalised approach.
Staff felt inspired by the registered manager and told us the management team was approachable and available to support them. People and healthcare professionals told us Magnolia House was managed well. The registered manager and provider had clear and robust systems to assess, monitor and improve the quality of care people received. Systems were designed to continuously improve the service and drive positive changes.
People and healthcare professionals felt Magnolia House was a safe place. Peoples received appropriate care and treatment, based on current guidance and best practice. People’s risks were known by care and nursing staff. Care and nursing staff were fully aware of their responsibilities to raise concerns and the registered manager and provider ensured lessons were learnt from any incidents or accidents.
Staff were well trained and had the skills to meet people’s needs. Staff had access to training, support and continued professional development they needed and requested. People received effective care and treatment. The service worked alongside a range of healthcare professionals to ensure people’s health and wellbeing were maintained.
People told us care and nursing staff were kind, caring and compassionate. Staff were attentive to people’s needs and knew how to promote their wellbeing. When people were anxious, care staff took time to reassure them and promote their wellbeing. People were treated with dignity and respect.
People received care which was personalised to their needs. Where people’s needs changed or their health deteriorated, care and nursing staff took appropriate and effective action to ensure their health and wellbeing. People enjoyed an engaging and varied life at Magnolia House. People were supported to achieve their wishes. The registered manager and provider ensured people’s views were acted upon.
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 23 February 2017). We rated “Is the service responsive” as requires improvement as the provider were implementing a new care planning system to ensure people’s records were current and accurate. This system had not been fully embedded at the time of our last inspection.
Why we inspected
This was a planned inspection based on the previous rating. At this inspection we found that the service remained “Good”.
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.
There was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. Two managers had been appointed who were applying to be jointly registered with CQC as registered managers.
At our last inspection on 6 June 2016 this service was rated as requires improvement overall. We asked the provider to take action to make improvements to:
• ensuring people received their medicines safely and in line with the prescriber’s instructions
• ensuring equipment was used correctly and safely
• establishing and sustaining processes to assess, monitor and improve the quality and safety of the premises and we found all these actions had been met.
We also asked the provider to take action to make improvements to:
• the accuracy of people’s care records, ensuring an accurate, complete and contemporaneous record had been kept and we found although significant progress had been made by introducing new care records and methods of working. However, more work needed to be done to ensure these improvements were embedded and sustained.
There were systems were in place to prevent and control infections. Although we found one issue we have therefore made a recommendation about infection control measures and the cleanliness of some equipment.
People were treated with dignity and respect and felt safe living in the home. Staff understood their needs well and had positive relationships with them. Staff were kind, caring and chatted amiably with people. They gently reassured people when needed, attending to their health and well-being and discreetly helped them with their individual needs. People’s care records had been reviewed and amended when there were changes in their physical or mental health. Close working with health care professionals ensured their health care needs were responded to in a timely fashion. People’s nutritional needs were catered for offering fortified or soft diets if needed and a menu appropriate for people living with diabetes. People had access to a range of meaningful activities which reflected their interests and choices such as games, poetry and newspaper reading, knitting, quizzes and music. They also had access to therapeutic activities such as hand massage, fitness, music and reminiscence. People who wished to were supported to access places of worship and communion.
People were supported by staff who had access to training to equip them with the skills and knowledge they needed to provide people’s care. Staff spoke positively about the individual support they received to develop in their roles. Staff recruitment procedures were robust and there were enough staff employed to meet people’s needs. Changes to the working practices of the individual staff teams had improved people’s experience of care. The manager strove to implement a “whole home approach” whereby all staff had a responsibility to provide personalised care and to take time to be with people. A hostess service had relieved care staff at busy times in the mornings and evenings when people needed help with personal care. All staff took their part in delivering activities until the new activities co-ordinator was in post.
Significant changes had taken place to improve people’s experiences of their care and support. This was driven by a review of quality assurance processes and making sure any action plans had been completed to verify when improvements had been implemented. These included introducing care rounding whereby a senior member of staff monitored and supervised all aspects of care and support, new care planning processes, a new activities schedule and improved communication between staff. Future improvements were planned for the continued refurbishment of the home, additional activities and embedding the new care planning system. The manager had ensured people, staff and relatives were kept informed of any changes and feedback from them had been positive. This included the way in which the manager responded to complaints and their openness and accessibility.
At the last comprehensive inspection in May 2015 we found two breaches of legal requirements around inconsistencies in record keeping and failure to submit statutory notifications to the Care Quality Commission. These were followed up in November 2015 when we found the action plan had been implemented and improvements had been made to comply with the breaches.
The home had a 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.
People’s equipment had not been used correctly or safely in line with national guidance. This potentially increased risks of harm or injury instead of reducing the risks to them. People’s medicines had not been managed or administered safely. People’s creams were not being administered accurately and medicine administration charts had not been completed satisfactorily. People’s care records did not accurately reflect their changing needs and the care, support and treatment they were receiving. Quality assurance audits had not always addressed shortfalls or made improvements needed in a timely fashion.
People received care which reflected their individual preferences and routines important to them. Staff had a good understanding of their personal histories and their likes and dislikes. People had positive relationships with staff and were treated kindly and with compassion. Visitors were made to feel welcome and said the home was “a marvellous place” and “a happy house”. People had access to activities which reflected their interests and hobbies. People who preferred to stay in their rooms enjoyed the company of staff for chats or individual activities. People were supported to stay healthy and well. Their nutritional needs were monitored and they were encouraged to eat and drink. They had access to health care professionals who monitored their physical and mental wellbeing.
People were supported by staff who felt supported in their roles and were able to keep their knowledge and skills up to date. Staff respected people’s choices and encouraged them to make choices about their day to day care. When people’s liberty had been deprived the necessary authorisations were in place. When people were upset or anxious they were supported by staff who understood how to help them to become calmer, offering reassurance or diverting them with music, a walk or a drink. There were enough staff to meet people’s needs. The registered manager monitored staffing levels to make sure they reflected people’s changing needs.
People’s views and opinions about the service they received were encouraged. Quality assurance audits were carried out to check on people’s experience of the service. People knew how to make complaints which were investigated and any action taken to address concerns if needed. The registered manager was open and accessible. Staff morale was good and staff worked well as a team showing enthusiasm and genuine concern for people’s wellbeing.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a focused inspection on 17 November 2015 to check that they had followed their plan and to confirm that they now met legal requirements.
This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for ‘The Grange’ on our website at www.cqc.org.uk.
The Grange had a registered manager. 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.
At our focused inspection on 17 November 2015 we found the provider had followed the action plan which they had told us would be completed by 31 October 2015 and legal requirements had been met. People staying for short stays or moving into the home had care plans and risk assessments in place which had been developed from an assessment of their needs. These had been monitored and reviewed reflecting their current care and support needs.
People’s care records had been kept up to date and reflected any changes in their needs. New strategies had been put in place to monitor and audit care records to make sure they provided current and relevant information. People said staff understood how they liked to be supported. Staff were positive about new systems to monitor and audit people’s care and support.
Notifications of significant events were being shared with us in line with the requirements of the law.
This was an unannounced inspection which took place over two days on the 20 and 21 May 2015. The Grange provides nursing and personal care for up to 69 people. Accommodation can be provided for people who wish to live together. People have access to lounges and dining areas on each floor, en suite bedrooms, and assisted bathrooms. An internal courtyard provides an outdoor seating area and is accessible to all people. At the time of our inspection 49 people were living there. There were 18 people who had been assessed as needing nursing support and 20 people had been diagnosed as living with dementia.
The home has a 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.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were inconsistencies in the records being kept for people. Where some people’s needs had changed their care records had not always been updated to reflect this. Monitoring records were not always being kept to confirm when people had been repositioned or given food and drink. This could result in people receiving inappropriate care or support. People were not always treated with respect. The registered manager took appropriate action to address this. The provider had not informed us about incidents affecting the well-being of people such as alleged abuse, serious injury or death. The Care Quality Commission monitors events affecting the welfare, health and safety of people living in the home through the notifications sent to us by providers. You can see what action we told the provider to take at the back of the full version of the report.
People moving into The Grange were assessed to make sure their needs could be met. Care plans and risk assessments were put in place and developed further as staff got to know them. Some people commented about how they had gained more independence since moving into the home, regaining confidence to stand for transfers or to walk unaided. People’s likes, dislikes and routines important to them were highlighted in their records and the care and support they received reflected these. Their background and personal histories had been discussed with them or their families. Staff reminisced with them and talked about their interests and people important to them. Most staff treated people positively, enjoying their company, laughing with them and supporting them with sensitivity. People told us, “They look after us well” and “I can’t speak highly enough about the care I have received”.
People had access to a range of activities including trips out. These had recently been reviewed and extended as a result of feedback from people. People were supported to continue with interests and hobbies such as gardening. People attended religious services either within the home or their local community. People’s health and well-being was promoted through a balanced and nutritional diet and access to a range of health care professionals.
When people became unwell or their needs changed they were referred to health care professionals. Most people’s care records were updated to reflect these changes and staff had a good understanding of people’s needs. If equipment such as alarms, special mattresses or easy chairs were needed they were supplied. Accidents and incidents were monitored to prevent further harm to people. People told us they felt safe. Strategies were in place to identify and report suspected abuse. Staff had confidence any concerns they raised would be listened to and followed up.
Recruitment and selection processes made sure all information was obtained about new staff before they were appointed. They completed an induction programme and shadowed existing staff until assessed as competent to carry out their role. Training was provided to develop their skills and knowledge. Staff had individual meetings to discuss their roles and responsibilities and also attended staff meetings.
The provider monitored the quality of the service provided through monthly audits. Actions raised were followed up to make sure any issues had been addressed. The registered manager and staff completed other audits to check on the quality of service provided, for instance health and safety, care records, medicines and the environment. People, their relatives, staff and professionals were asked for feedback about their experience of the service. Their feedback was used to improve the service provided.
As part of this inspection we spoke with 17 people who use the service, 11 visitors, the registered manager, the registered provider and 13 staff. We also observed how people were being cared for. We reviewed records relating to the management of the service which included, six care plans, daily care records, quality assurance systems and staff recruitment records.
At this inspection we also followed up a compliance action issued in February 2014. The registered person had not ensured that people living in the home were protected against the risks of unsafe or inappropriate care arising from a lack of proper information about them. An accurate record in respect of people had not been kept and records had not been stored securely. The provider supplied an action plan telling us how they would address this non-compliance by June 2014.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
Is the service safe?
People were safe because staff shared information on risks associated with their care, treatment and support. Hazards were minimised and procedures were in place to keep people safe. The provider had put systems in place to make sure accurate records were kept in respect of people's care and support.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications needed to be submitted proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.
The service was safe because it followed safe recruitment practices. New staff had been appointed after all checks had been carried out. They then completed an induction programme.
Is the service effective?
People received an effective service because their individual needs, choices and preferences were reflected in their care plans. People's likes, dislikes and routines important to them had been recorded in their care plans. Staff spoken with had a good understanding of people's needs.
The service was effective because people's health was regularly monitored to identify any changes that might require additional support or intervention. Referrals were made to health care professionals when people's needs changed.
People received an effective service because their identified needs were monitored and managed. A relative told us, 'I have no worries my mum has been here for five years. The manager or her carers let me know if there are any problems or if things change. She gets very good care.'
Is the service caring?
The service was caring because the needs of people living with dementia had been considered. Changes to the environment and to their care and support had been made which reflected their preferences and personal histories.
People received a caring service because staff showed concern for their wellbeing in a caring and meaningful way and responded to their needs at the time they needed it. People said they were treated with kindness in their day-to-day care. People said, 'Staff are very kind and friendly', 'They look after me very well and they are very kind and take good care of me. I wouldn't want to be anywhere else'.
People received a caring service because their expressed preferences and choices for their end of life care were clearly recorded and acted on. The home worked closely with health care professionals to ensure people had the support they needed.
Is the service responsive?
The service was responsive because people had their individual needs regularly assessed. Staff understood the care and support needs of people.
The service was responsive because people received consistent, coordinated care and support when they moved between services. Staff liaised with social and health care professionals to ensure information was shared effectively.
People, their relatives and friends were encouraged to provide feedback. People and their relatives were given information about how to make a complaint. They were encouraged to discuss any issues or concerns with staff as they arose. A relative said, 'I have had a number of minor concerns relating to my mother's care but when I talked to the appropriate people the issues were resolved very quickly.'
Is the service well led?
Feedback from people who live in the home, their relatives and staff was encouraged. Action had been taken in response to their feedback. An open culture encouraged staff to express their views about the standards of care which resulted in improvements to the service provided.
Systems were in place to monitor accidents and incidents. The necessary action was taken to prevent these from happening again.
The service was well led because robust quality assurance processes were in place to check on the experience of people living in the home. Residents' meetings and annual surveys sent to people living in the home and their visitors gave the opportunity to feedback views on the quality of service provided.
The service was well led because they had links with organisations that acted as developers and sources of best practice. The service shared examples of their best practice with others promoting cooperation and joint working with other professionals.
The service was well led because there were clear and transparent processes in place for staff to account for their decisions, actions, behaviours and performance. Staff were confident if they raised concerns these would be listened to and acted upon.
People's wishes and aspirations were noted in their care records. These reflected their needs, preferences and diversity. Social and health professionals told us, "overall the care is very good". A visitor told us "I am very impressed with the care provided".
We observed staff administering and handling medicines. This was done safely and appropriately. Robust systems were in place for the administration, storage and disposal of medicines.
Staff had access to a comprehensive training programme enabling them to acquire the skills and knowledge to support people.
The provider regularly sought the views of people, their representatives and staff to help them come to an informed view about the quality of service provided.
People's safety and wellbeing were not protected due to inconsistencies in their personal records and lack of confidentiality. We found care records were not kept up to date. People's personal information was not stored securely.
At this inspection we spoke with three people who told us they were happy with the changes to their environment. Staff also said that the home was a happier place due to the refurbishments. We observed people enjoying using the newly redecorated lounges. Visitors told us they had no concerns about the home and were more than happy with the service provided.
Substantial work had been completed in communal lounges, dining rooms, bathrooms and toilets as well as corridors to create a pleasant environment. Areas were being kept clean and tidy. New systems were in place to prevent and control the risks of infection.
We found that records were being kept securely in nursing stations which could only be accessed via a key pad. People's nutrition was being assessed and reports produced electronically. For most people their care records were being kept up to date with changes in their dietary and nutritional needs.
We looked at staffing levels they were appropriate at the time of our visit.
We talked with people and their visitors about the environment. People said their rooms were kept clean. One visitor said the decor of the home needed attention but said that the quality of staff was more important. We found failures to adequately maintain the environment and to maintain appropriate standards of cleanliness and hygiene.
We discussed with people whether there were sufficient staff to meet their needs. Overall people said staff were very busy and they felt there were not enough staff. Most said they did not have to wait long for the call bell to be answered. Visitors said "there are always staff on hand". People told us "staff are polite and pleasant". We found that there were sufficient staff scheduled to work in the home.
People told us, "staff are very nice", "staff are lovely" and "staff are ok. They see to me at night if I need help".
Everyone we talked to spoke positively about the food saying it was "delicious", "really good" and "the kitchen is always open." People said they made choices about their diet and about the activities they took part in. Some people said at times they were bored and would like more activities, whereas others were happy with the range of activities provided. People said the staff were busy and said "you couldn't ask for better care. Staff are excellent."