Magic House

About the service

Magic House (commonly known as Magic Life) is a supported living service providing personal care to people with varied physical and mental health needs, including people with a learning disability and autistic people. At the time of the inspection, the service comprised 16 supported living settings in the form of houses and purpose-built flats, most of which were located in North London.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection, the registered manager reported 86 people were using the service, out of whom 46 people received personal care.

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

Right Support:

People were supported by trained staff to take their medicines. However, we found inconsistencies in how medicines were managed, mainly around guidance on some medicines and audits.

Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

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.

Right Care:

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so but the management team did not always notify CQC of safeguarding incidents as required. Staff had training on how to recognise and report abuse and they knew how to apply it.

People’s care and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. The service assessed people’s risks and enabled them to take positive risks where appropriate.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People received kind and compassionate care. Staff understood and responded to people’s individual needs.

Right Culture:

Managers evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. However, existing quality assurance systems were less effective in some areas, including medicines management, statutory notifications and staff training.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

People and those important to them were involved in planning their 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 12 March 2020).

Why we inspected

The inspection was prompted in part due to concerns received about medicines management, assessing risks to people and staff competencies. As a result, we undertook a focused inspection to review the key questions of safe and well-led only to examine those risks. You can see what action we have asked the provider to take at the end of this full report.

For those 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 good to requires improvement based on the findings of this inspection.

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

Enforcement and Recommendations

We have identified a breach in relation to good governance.

We have also made a recommendation around the safe management of people’s medicines.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Magic Life Limited is a domiciliary care service providing personal care to people living in their own home within supported living projects. At the time of the inspection the service was supporting 16 people with learning difficulties, autism and mental health problems.

Magic Life Limited currently support 16 people within nine supported living schemes in London and Hertfordshire. The supported living schemes known as projects are located within residential areas as part of the local community and vary in size, supporting from three to up to ten people in one project. Each project is a residential house within which people have their own flats.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

Some people were able to express how they felt about living at their home and the support they received. People told us they were happy. Other people who were unable to communicate due to their disabilities appeared to be happy, content and well supported.

Support staff understood how to safeguard people from abuse and the actions they would take to report their concerns.

People’s individualised risks associated with their health, care and social needs were comprehensively assessed giving clear guidance to staff on how to minimise the identified risks to keep people safe.

Medicines management and administration was safe. People received their medicines on time and as prescribed.

Support staff recruited were appropriately checked and assessed to ensure their suitability for the role and to ensure they were safe to work with vulnerable adults.

People’s needs were comprehensively assessed prior to any placement and support plan being agreed to confirm the service could effectively meet their needs.

Support staff received appropriate training and support to carry out their role effectively.

People were appropriately supported with their nutrition and hydration which considered any specialist dietary requirements.

People were supported with their health and medical needs where required. We saw records where the service had requested specific involvement from specialist services to address people’s health and care needs.

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 applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Care plans were person centred and comprehensive giving clear information about people’s care needs and how they wished to be supported.

We saw positive and caring interactions between people and support staff. People were observed to know the support staff well and were comfortable and confident around them.

Relatives knew who to speak with if they had any concerns or complaints and were confident that their concerns would be addressed.

Management oversight processes in place enabled the provider to monitor the quality and people’s experiences of the care and support that they received. Where issues were identified action and improvement plans were in place to address these.

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 24 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

The inspection was prompted in part due to concerns received from the local authority about staff skills, training provisions and medicines management. We inspected and examined these risks as part of this inspection process.

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.

The service was last inspected and rated on 7 April 2015 and was rated ‘Good’.

At this inspection we found that the service remained ‘Good’.

Magic House currently provides personal care to 26 people living in four supporting living accommodation settings. The service aims to support people with mental health needs and learning disabilities.

People and relatives told us that they felt safe and were happy with the support that they received from care staff. Care staff understood how to keep people safe from harm and the actions to take where abuse was suspected.

The provider had a variety of systems and processes in place to ensure people were kept safe and free from harm. This included individualised risk assessments which gave information and guidelines to staff on how to reduce or mitigate risks in order to keep people safe.

Safe recruitment processes were in place to ensure that only suitable staff safe to work with vulnerable adults were recruited.

Safe medicine management processes were in place which ensured that people received their medicines safely and according to their needs and requirements.

Care staff told us and records confirmed that care staff received the required and, where appropriate, specific training to support them in their role. Staff also received regular support through the supervision and appraisal process.

People were enabled to make their own choices and decisions in the least restrictive way possible and were offered support where required.

Most people living at the scheme, lived their life according to their own wishes. This included the choosing and preparation of meals. People decided what they wanted to eat on a daily basis and supported by care staff when required. Care staff were always available to guide people in making appropriate decision in relation to healthy eating.

Most people were able to manage their own healthcare matters and appointments. However, staff were always available if and when support was required.

We observed that senior manages and care staff had developed and established positive and caring relationships with people that were based on trust and respect. Staff knew each person’s likes, dislikes, mannerisms and behavioural traits and were seen to support people appropriately according to these.

Care plans were person centred and detailed and contained support plans and goal support plans which identified and monitored each person’s individual goal which they had identified and wished to achieve in order to support independent living where possible.

The service had received five complaints since the last inspection. Records on the detail of the complaint and how it hand been handled and responded to were available. People and relatives knew who to speak with if they had any concerns. People were actively encouraged to complete a complaints form if they had concerns to raise.

We observed that people knew the operations manager and area manager extremely well and were confident in approaching them. Staff also confirmed that they were very well supported in their roles and were able to speak to a member of the management team at any time.

A variety of quality monitoring systems were in place which allowed the service to monitor the quality of care provision and where appropriate, learn from and make the necessary improvements when issues were found therefore ensuring that the quality of care was never compromised.

Further information is in the detailed findings below.