Magnolia Cottage

Updated 23 August 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Day one consisted of one inspector, and one specialist medicine inspector. Day two consisted of one inspector.

Service and service type

Magnolia Cottage is a ‘care home’. People in care homes receive accommodation and nursing and or personal care as a single package under one contractual agreement dependent on their registration with us. Magnolia Cottage is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager. There was a new manager who had been in post for approximately four weeks and was in the process of submitting an application to register. They will be referred to as the manager within the report.

Notice of inspection

Both days of this inspection were unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sourced feedback from the local authority and used information we held about the service on our system, this information was all considered as part of the inspection planning process.

During the inspection

We spoke with five members of care staff including agency staff, the manager and regional manager. We spoke with one person who lived at the service, and observed care provided in communal areas.

We reviewed a range of records, including four people’s care and medication records. We looked at staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with five relatives by telephone, about their experiences of the care provided. We liaised with the local authority quality assurance and safeguarding teams. We wrote to the nominated individual, to seek additional assurances about the actions they were going to take in response to our inspection findings, and feedback to make improvements at the service. (The nominated individual is responsible for supervising the management of the service on behalf of the provider).

Updated 23 August 2022

About the service

Magnolia Cottage is a residential care home providing personal care and support to up to four people with a learning disability and or autistic people. At the time of our inspection there were four people using the service. The service consisted of single storey bungalow accommodation, with shared communal spaces and bathing facilities. One bedroom had an ensuite bathroom.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Right support: The standards of care provided gave people some choice and control over their own care and lifestyles. There was variability in the consistency of staff working at the service, as a number of agency staff were used. This impacted on their knowledge and understanding of people’s assessed needs and risks to enable people to be active members of the local community. People did not live in a clean and comfortable care environment, and the service needed a deep clean and areas of refurbishment. We identified some areas of improvement needed for people’s medicines management and ensuring people had access to regular medication reviews. Our findings are reflected in the breaches of regulation detailed in the body of the report.

Right care: Care records were not of a good quality, had not been regularly reviewed, and did not demonstrate people and their relative’s involvement in their development. This resulted in people’s individual wishes and preferences not being consistently reflected. However, since the new manager had come into post, people’s care records were under review. People’s dignity, privacy and human rights were not fully being upheld. The service was fully locked; therefore, people were unable to leave if they wished to. People were supported to have some choice and control of their lives, although improvements were identified to ensure each person’s mental capacity, and potential need for a Deprivation of Liberty Safeguards had been fully considered and an onward referral made where required. Staff did their best to support people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There were gaps in staff training and competency checks, however this was being addressed, to ensure staff had the necessary skills, knowledge and expertise to safely meet people’s needs.

Right culture: There had been a lack of consistent leadership of the service, with a gap of approximately five months since there had been a manager in post. In the absence of a registered manager, the provider had not ensured staff had been supported to maintain and uphold standards of care, and condition of the care environment. Records showed staff had not had supervision in approximately a year, to ensure their performance and development needs were kept under regular review, there was also no record of staff meetings being held. Since the new manager had come into post, meetings and supervision sessions dates were now booked. Our findings are reflected in the breaches of regulation detailed in the body of the report.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This was the first inspection of this service under a new registered provider. The service had previously been inspected on 30 May 2019, the report was published on 06 July 2019, with an overall rating of Good.

Why we inspected

The inspection was prompted in part due to concerns received about the provider level oversight of this service, and in response to some incidents that had happened. A decision was made for us to inspect and examine those risks.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.