Magnolia Court

Magnolia Court is a residential care home providing personal care to two people with autistic spectrum disorders and learning disabilities in a purpose-built building, comprising of two flats.

Services for people with learning disabilities and or autism are supported

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The service had comprehensive risk management plans in place to keep people safe from avoidable harm. People continued to be protected against abuse as staff received ongoing safeguarding training. Medicines were managed safely and in line with good practice. Sufficient numbers of suitably vetted staff were deployed. Infection control measures in place, minimised the risk of cross contamination. The registered manager was keen to ensure lessons were learned when things went wrong.

Staff continued to receive training that enhanced their skills. People were supported to have access to healthcare services to monitor and maintain their health and well-being. People were encouraged to maintain a healthy diet, where people had specific dietary requirements, these were catered for.

People spoke positively about the care provided. Staff were observed being respectful and supportive of their diverse needs. People’s independence was regularly monitored to ensure care provided met their needs. People continued to be encouraged to make decisions about the care they received.

People continued to receive care and support that was personalised and reflected their needs and preferences. The provider had a complaints policy that was in pictorial format. People’s communication needs were clearly documented in their care plans. People continued to be encouraged to participate in activities both in-house and in the local community. The registered manager was developing further ways to document people’s end of life care wishes.

People and staff spoke positively about the management of the service. Staff continued to receive guidance and support from management readily. Audits undertaken ensured issues identified were acted on swiftly. People’s views were regularly sought to drive improvements. Records confirmed the registered manager worked in partnership with stakeholders.

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.

The service placed an emphasis on supporting and encouraging people to remain independent. People had their privacy respected and were treated equally. Staff were compassionate towards the people they supported and treated them with respect. People continued to be supported to make decisions about the care they received and had their decisions respected.

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 13 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Magnolia Court on our website at www.cqc.org.uk.

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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service did not have a registered manager in place. At the time of the inspection the manager had applied to be registered with the commission. 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 continued to be protected against harm and abuse as the service had robust systems in place to safeguard people. Records confirmed and staff demonstrated sufficient knowledge in the reporting and escalating of suspected abuse.

The service had effective recruitment systems in place to ensure suitable staff were employed in line with good practice.

People continued to receive their medicines safely. Regular medicines audits carried out by the service, ensured issues were identified and rectified in a timely manner.

Staff had an adequate understanding of their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

The service had an embedded culture that encouraged people to make decisions and choices about the care and support they received and have those decisions respected.

People’s healthcare needs were monitored regularly to maintain good health. Guidance and support from healthcare professionals was implemented into the delivery of care. People continued to have access to sufficient amounts of food and drink to meet their dietary requirements and preferences.

Staff demonstrated and delivered compassionate care and treated people with dignity and respect. Records confirmed people’s equality and diversity were celebrated and encouraged. Staff continued to receive training to effectively meet people’s needs.

People continued to receive care and support that was person centred. Care plans were comprehensive and gave staff clear guidance on how to meet people’s needs, taking into account their preferences and wishes.

The service encouraged people to access the community and enhance their independence where possible. People were supported to raise their concerns and complaints. The manager was aware of the provider’s process in responding to complaints in a timely manner for seeking a positive resolution.

Audits were carried out regularly by the service to improve the service delivery. Feedback on the provision of care was sought and action taken to address concerns raised.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

One of the two people using the service told us they felt safe living there. The other person did not communicate verbally but we saw that systems were in place to keep them safe. Safeguarding procedures were in place and staff understood what to do to protect people. This meant that people could be confident that incidents of suspected abuse would be investigated properly. Systems were in place to ensure that the manager and provider reviewed incident reports written by staff to ensure that all necessary actions had been taken and authorities notified as required.

Equipment was maintained and serviced regularly, therefore not putting people at unnecessary risk. People had been cared for in an environment that was safe, clean and hygienic.

A member of the management team was available on call in case of emergencies. Staff had received training to meet the needs of the people living at the home.

Is the service effective?

People were involved in their health and care need assessments, and they were involved in writing their plans of care. Areas of support required for each person had been identified in care plans. Our observations confirmed that this support was provided.

Is the service caring?

People were supported by kind and attentive staff. Our discussions with staff on duty and our observations of the care and support provided confirmed this. We saw that staff showed patience and gave encouragement when supporting people.

Is the service responsive?

The staff responded quickly when people needed extra support from their health professionals. People completed a range of activities in and outside the service regularly. Staff were available to take people out when they wanted to go out. When incidents happened action was taken to reduce reoccurrence. People can therefore be assured that the service responds to their needs.

Is the service well-led?

The service was well- led. The manager was registered and we received good feedback about their management of this service and their approach and care of the two people using it. The manager facilitated the inspection well and demonstrated good leadership. The provider visited the service often and followed up on any quality issues identified. The service worked well with other agencies and services to make sure people received their care in a joined up way.

You can see our judgements on the front page of this report.

The mother of one of the people living at Magnolia Court told us "Things are shaping up. The staff are doing really well. They have taught my relative how to bake cakes and make desserts. They enjoy this and I was pleased to see the photographs. I have no complaints".

People's privacy, dignity and independence were respected. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People experienced care, treatment and support that met their needs and protected their rights.

People were protected from the risks of inadequate nutrition and dehydration. People were supported to be as involved as possible in choosing and preparing their meals and staff monitored what people ate and drank and how much they weighed. One person told us they liked their meals at Magnolia Court and a relative told us they had no concerns about the meals.

There were enough qualified, skilled and experienced staff to meet people's needs.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

There was an insufficient number of suitably skilled staff available to meet people's needs at some times. We found that this had impacted on people using the service. The two people who were living at Magnolia Court needed a vehicle and a driver for them to access the community safely and regularly. Neither a vehicle or driver were available and this meant there was a lack of activities for them to do outside the service and a lack of opportunity to get out of the house on a regular basis.

Staff reported that people's care and support needs had not been reviewed often enough and this meant they were at risk of not having their needs met properly.

The people who were living at Magnolia Court were unable to tell us whether they felt safe there or not. One person was asleep and another was unable to understand and answer the question because of their communication needs. Staff told us that they knew how to recognise abuse and they did not think any abuse was happening.