Magnolia Cottage

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.