Magnolia House

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• 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

We assessed 4 quality statements in the effective key question. People’s needs were assessed and care plans were developed from assessment information. Staff followed evidence-based good practice and people were supported to live heathier lives. People received appropriate support to meet their nutrition and hydration needs. Where people lacked capacity to consent, staff upheld their rights and acted in accordance with the Mental Capacity Act 2005.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Although people and family members were not all aware of care plans they were happy with the way care was provided. One family member told us, “The care has improved – there are more people [staff] about.” Another family member said, “Magnolia House have kept me up to speed with any issues or changes.”

The manager described the pre-admission process which included seeking information from the person, family members and any professionals involved in the person’s care. Following admission further information such as life history, cultural or religious beliefs, protected characteristics, and preferences was incorporated into the person’s care plan. The home used an electronic care planning system and the manager told us they were looking at how they could better evidence people and family members involvement in the assessment and care planning process. Staff confirmed they were provided with all necessary information about new and existing people to enable them to meet their care and support needs.

This was a robust system to assess people's needs prior to admission and determine if they could safely meet their needs at Magnolia House. Following admission, a range of monitoring tools were used to continually assess people's needs. Where risks had been identified, these were regularly monitored and action taken when needed.

We received mixed views in respect of meals however, everyone confirmed that they were provided with choices and staff would make every effort to accommodate individual requests. We saw staff asking people what they would like for the following days main meal and picture cards were available for people who may need support to make a decision. People appeared to be enjoying their main lunch time meals whilst we were in the service and were regularly provided with hot and cold drinks.

The management team told us they had worked hard to ensure that care plans were individual, reflective of people’s needs, were fit for purpose and reflected guidance and advice of external health and social care professionals. Care staff confirmed they were kept up to date with any changes in people’s care plans via handover meetings and through the electronic care planning system in use.

Care plans and related records viewed showed consideration and reflection of current legislation and best practice guidance. They also showed that external health and social care professionals had been consulted. External health and social care staff told us they worked well with the management team and were contacted appropriately and any suggestions made or guidance was followed.

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.

People and their family members told us they were supported to have medical appointments when required, and staff were supportive and caring. One person told us, “ They called the GP once as my knee was swollen so I did go for an x-ray.” An external health professional told us, “Managers are supportive of training and improvements and are involved with Restore 2 virtual ward and early detection and intervention when recognising an unwell resident.”

Managers understood how to access external health services and advocated on behalf of people to access these. For example, they described how they had requested occupational therapists to undertake equipment assessments. Arrangements were in place for opticians or hearing aid specialists to visit the service if people were unable to attend external appointments. Care staff described how they supported people to have regular short walks to maintain mobility and confirmed they had received training to identify and support people with a range of physical and mental health needs.

Care plans included information about peoples past medical history and how current medical needs should be supported. Incident reports detailed various examples of staff noting changes in people’s needs and taking any necessary action such as seeking prompt medical support. External health professionals felt they were contacted appropriately and any recommendations made were followed by staff.

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.

People were supported to make decisions about their care. One person told us, “They definitely ask permission.” Where people were unable to make some or all decisions themselves family members confirmed they were kept informed and their views sought as part the decision making process. One family member told us, “Yes, every care is taken and I am always advised of a problem and my wishes are honoured.”

Care staff understood people’s rights to decline care. They said that, should people decline care or medicines, they would return a short while later to offer assistance again. Should people continue to decline they would encourage but respect the person’s decision, document this and inform the management team.

Decision specific mental capacity and best interest decisions had been completed and were kept under regular review. Where one person who had capacity made what may be considered to be an unwise decision steps had been taken to ensure the person understood the risks of this decision. Where necessary, applications had been made to the relevant authority and nobody was being unlawfully deprived of their liberty (DoLs). There were systems in place to ensure the renewal of DoLs, applications were submitted in a timely way.