Magic House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. When we last assessed this key question, we rated it good. At this assessment we only looked at parts of the key question and the rating has remained good. This meant people’s outcomes were good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall, people and their representatives were involved in the regular assessments of people’s needs and planning of their care. This approach enabled staff to provide effective and personalised care and support to people. A relative told us, “Staff understood [person’s] needs.” Another relative told us they attended care planning meetings. However, 1 person told us they felt most staff did not understand their needs and they were not able to positively interact with their staff team due to cultural differences. The person also felt they could not interact with other people at the scheme due to communication barriers. The managers told us they were working to address the issue of compatibility of staff.

Staff told us they consulted people and their relatives when assessing and reviewing people’s needs. Staff also sought to keep relatives informed of changes in people’s needs. The registered manager told us they worked with other healthcare professionals when assessing and reviewing people’s needs.

Several meetings held by local authorities to discuss concerns at the service showed that health and social care professionals, including social workers and care commissioning managers, held different views about the way the service assessed and worked to meet people’s needs. Some of the partners felt people’s needs were safely and effectively assessed, staff knew people’s individual needs, and people were settled. However, other teams experienced a lack of effective communication from the service and found the service accepted placements for people with complex needs at a rapid pace without properly understanding those needs.

Although people received a full assessment of their needs prior to starting to use the service, we found some of these assessments were not thorough which meant there was a risk staff would not be able to meet the needs of these people safely and effectively due to a possible lack of insight into those needs. This could lead to inaccurate follow-on assessments.

While at the service, staff developed and updated people’s care plans by regularly assessing their needs. Care plans included information on people’s physical and mental health, communications needs, eating and drinking needs, mobility, medicines, night-time routines and behaviours.

Most people and relatives we spoke with indicated that the service took a person-centred approach in delivering care while considering people’s individual needs and aspirations. A relative told us, “[Person’s] social and cultural needs are met by staff who share [person’s] background and [person] is very content.” Another relative said they had noticed a “huge difference in [person’s] behaviour and they have become less angry and seem happy.” However, for some people and their relatives, their experiences of having their needs met were not always positive. According to a number of relatives, one of the main causes attributed to people’s needs not always being met was staff not knowing people well. Additionally, these relatives felt the main reasons some staff did not know people well were because of a lack of consistency in staffing and staff training not always being effective, especially in relation to people who had complex needs.

Regarding people’s eating and drinking needs, this issue also differed across the service. Comments included, “[Person] can choose their food and are encouraged to make healthier choices” and “[Person] is not feeding properly, don’t cook properly, no food in the house.” We found evidence of both people being supported with healthy and diverse meals, and people consuming less healthy foods on a daily basis.

Managers told us they sought support from external organisations when needed to improve the way they delivered care and support to people. An area manager told us, among the improvements they intended to make so that people could achieve better outcomes, was to improve communication and the matching of staff skills with people’s needs.

Staff kept daily records of people’s care and support which included how people presented, their moods, their engagement with staff and during activities, and the meals they had. People also had the opportunity, where possible, to feed back on how their day went. However, these records (from staff) were not always legible which made it difficult to understand the different accounts. Also, the language used in these records were not always respectful and/or dignifying. Managers were aware of these issues and were working to address them. In one of the schemes, staff completed progress notes electronically; however, the system used did not provide sufficient assurance around the integrity of the information recorded. Staff remained up to date with national legislation and the best practice guidance through training and regular meetings.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.