Magna House

Updated 9 November 2023

Magna House is a 29-bed independent hospital in Lincolnshire, providing acute care, treatment, and rehabilitation services to people who are experiencing mental health issues.

It registered with the Care Quality Commission in August 2020 for the following regulated activities:

• Assessment or medical treatment for persons detained under the Mental Health Act 1983

• Treatment of disease, disorder, or injury.

The hospital comprised of Redwood ward, an 11 bedded male acute ward. There were also four smaller wards, Aspen, a 7-bed female acute ward. Beech 1, a 5 bedded female rehabilitation ward, Beech 2 a three bedded male rehabilitation ward, and Beech central which could accommodate either 3 males or 3 females.

All bedrooms have ensuite bathrooms. The cottages are located on the ground floor, and Redwood ward is over two floors, in a separate building.

Magna House has a registered manager. A full comprehensive inspection of Magna House took place in October 2022. We found the provider to be in breach of the Health and Social Care Act (regulated activities) Regulations 2014:

Regulation 12 - Safe care and treatment

Regulation 15 – Premises and equipment

Regulation 9 – Person-centred care

Regulation 18 – Staffing

Regulation 17 – Good governance

Regulation 10 – Dignity and respect

We served requirement notices and subsequently received an action plan from the provider which they completed. On the 26 and 27 April 2023, we undertook a focused unannounced inspection looking at two key questions, safe and well led. This was in response to concerns bought to our attention from members of the public, people using the service, the Integrated Care Board (ICB), as well as the police. Following this inspection, we took urgent civil enforcement action which consisted of placing 9 conditions upon their registration. This included that the service must not admit any new patients without the written permission of CQC.

We completed a specific inspection to check that the provider had taken immediate actions, as directed by CQC on 14 and 15 June 2023. Following this inspection improvements were noted, and the conditions placed upon the provider’s registration were removed and therefore the provider is no longer in breach of regulations.

At the time of this inspection there were two patients receiving care at Magna House Hospital.

What people who use the service say

We spoke with one patient during the inspection. They were very happy with level of care and support. They said staff were good and helped them with their day-to-day needs. They said the environment was very clean and furnished to a high standard. They attended the multi-disciplinary meetings and was happy that their carer could attend as well.

Updated 9 November 2023

Our rating of this location improved. We rated it as good because:

• The hospital was clean and well maintained. Cleaning records were up to date and the wards were bright, airy, well-furnished, and fit for purpose. The hospital had a dedicated maintenance team, we saw all staff had access to an electronic log, where issues were prioritised, actioned in a timely manner and signed off on completion.
• Staff completed risk assessments for each patient on admission, using a recognised tool, and reviewed this regularly, including after any incident. Staff documented the individual risks for each patient and acted to prevent or reduce them. Staff we spoke were aware of what strategies to use to minimise and manage risks and how to support individuals when they posed a risk to themselves, others, or their environment. Accurate risk information was handed over and recorded in the morning management meeting.
• Staff followed National Institute for Health and Care Excellence (NICE) guidance when using rapid tranquilisation. They ensured it was recorded in the care record and an incident form completed. The hospital incident reporting system would not allow the incident to be closed unless all physical health checks had been completed and recorded appropriately.
• Staff completed a comprehensive assessment of each patient either on admission or soon after. We looked at six care records, all of which reflected patients’ assessed needs and were holistic and recovery oriented.
• Managers supported staff with appraisals, supervision, and opportunities to update and further develop their skills. Staff supervision and appraisal rates were 100%. They identified any training needs and gave staff the time and opportunity to develop their skills and knowledge. Staff received specialist training for their role, for example Oliver Mc Gowan training, diabetes, oral health and learning disability. Staff told us managers were supporting them to undertake a master’s degree.
• We saw “you said - we did” boards on all wards. Patients had provided feedback and suggestions which they recorded on the boards. Managers had acted upon feedback for example; we saw white boards had been installed in bedrooms where patients could write down the name of their nurse, and more evening activities had been planned and a new washer/dryer had been purchased.
• We saw staff involved patients in decisions about the service, when appropriate for example suggestions on the décor, menu choice and therapeutic activities. Staff and patients attended weekly community meetings where topics discussed included the environment, meals, patient involvement opportunities, achievements and celebrations and staying connected with family and friends.
• Leaders were visible and approachable, not only to them but for patients too. Staff told us leaders often visited the wards and would work shifts to support the team and were always available whenever for whatever they needed. They confirmed development opportunities for career progression were available and were encouraged to take these up.

However:

• Staff used a range of rooms and equipment to support treatment and care, however there was no dedicated spaces for therapeutic activities which were undertaken in dining and lounge areas.
• We found left over medicines from a patient who had been discharged in cupboards on two wards. We brought this to the attention of the nurse in charge who disposed of the medicines immediately.
• We were concerned that governance systems and processes were not sufficiently embedded so that when the patient numbers and acuity increase, they remain effective to support the operational performance of the service.

Updated 9 November 2023

Our rating of this location improved. We rated it as good because:

• The hospital was clean and well maintained. Cleaning records were up to date and the wards were bright, airy, well-furnished, and fit for purpose. The hospital had a dedicated maintenance team, we saw all staff had access to an electronic log, where issues were prioritised, actioned in a timely manner and signed off on completion.
• Staff completed risk assessments for each patient on admission, using a recognised tool, and reviewed this regularly, including after any incident. Staff documented the individual risks for each patient and acted to prevent or reduce them. Staff we spoke were aware of what strategies to use to minimise and manage risks and how to support individuals when they posed a risk to themselves, others, or their environment. Accurate risk information was handed over and recorded in the morning management meeting.
• Staff followed National Institute for Health and Care Excellence (NICE) guidance when using rapid tranquilisation. They ensured it was recorded in the care record and an incident form completed. The hospital incident reporting system would not allow the incident to be closed unless all physical health checks had been completed and recorded appropriately.
• Staff completed a comprehensive assessment of each patient either on admission or soon after. We looked at six care records, all of which reflected patients’ assessed needs and were holistic and recovery oriented.
• Managers supported staff with appraisals, supervision, and opportunities to update and further develop their skills. Staff supervision and appraisal rates were 100%. They identified any training needs and gave staff the time and opportunity to develop their skills and knowledge. Staff received specialist training for their role, for example Oliver Mc Gowan training, diabetes, oral health and learning disability. Staff told us managers were supporting them to undertake a master’s degree.
• We saw “you said - we did” boards on all wards. Patients had provided feedback and suggestions which they recorded on the boards. Managers had acted upon feedback for example; we saw white boards had been installed in bedrooms where patients could write down the name of their nurse, and more evening activities had been planned and a new washer/dryer had been purchased.
• We saw staff involved patients in decisions about the service, when appropriate for example suggestions on the décor, menu choice and therapeutic activities. Staff and patients attended weekly community meetings where topics discussed included the environment, meals, patient involvement opportunities, achievements and celebrations and staying connected with family and friends.
• Leaders were visible and approachable, not only to them but for patients too. Staff told us leaders often visited the wards and would work shifts to support the team and were always available whenever for whatever they needed. They confirmed development opportunities for career progression were available and were encouraged to take these up.

However:

• Staff used a range of rooms and equipment to support treatment and care, however there was no dedicated spaces for therapeutic activities which were undertaken in dining and lounge areas.
• We found left over medicines from a patient who had been discharged in cupboards on two wards. We brought this to the attention of the nurse in charge who disposed of the medicines immediately.
• We were concerned that governance systems and processes were not sufficiently embedded so that when the patient numbers and acuity increase, they remain effective to support the operational performance of the service.

Updated 9 November 2023

Our rating of this location improved. We rated it as good because:

• The hospital was clean and well maintained. Cleaning records were up to date and the wards were bright, airy, well-furnished, and fit for purpose. The hospital had a dedicated maintenance team, we saw all staff had access to an electronic log, where issues were prioritised, actioned in a timely manner and signed off on completion.
• Staff completed risk assessments for each patient on admission, using a recognised tool, and reviewed this regularly, including after any incident. Staff documented the individual risks for each patient and acted to prevent or reduce them. Staff we spoke were aware of what strategies to use to minimise and manage risks and how to support individuals when they posed a risk to themselves, others, or their environment. Accurate risk information was handed over and recorded in the morning management meeting.
• Staff followed National Institute for Health and Care Excellence (NICE) guidance when using rapid tranquilisation. They ensured it was recorded in the care record and an incident form completed. The hospital incident reporting system would not allow the incident to be closed unless all physical health checks had been completed and recorded appropriately.
• Staff completed a comprehensive assessment of each patient either on admission or soon after. We looked at six care records, all of which reflected patients’ assessed needs and were holistic and recovery oriented.
• Managers supported staff with appraisals, supervision, and opportunities to update and further develop their skills. Staff supervision and appraisal rates were 100%. They identified any training needs and gave staff the time and opportunity to develop their skills and knowledge. Staff received specialist training for their role, for example Oliver Mc Gowan training, diabetes, oral health and learning disability. Staff told us managers were supporting them to undertake a master’s degree.
• We saw “you said - we did” boards on all wards. Patients had provided feedback and suggestions which they recorded on the boards. Managers had acted upon feedback for example; we saw white boards had been installed in bedrooms where patients could write down the name of their nurse, and more evening activities had been planned and a new washer/dryer had been purchased.
• We saw staff involved patients in decisions about the service, when appropriate for example suggestions on the décor, menu choice and therapeutic activities. Staff and patients attended weekly community meetings where topics discussed included the environment, meals, patient involvement opportunities, achievements and celebrations and staying connected with family and friends.
• Leaders were visible and approachable, not only to them but for patients too. Staff told us leaders often visited the wards and would work shifts to support the team and were always available whenever for whatever they needed. They confirmed development opportunities for career progression were available and were encouraged to take these up.

However:

• Staff used a range of rooms and equipment to support treatment and care, however there was no dedicated spaces for therapeutic activities which were undertaken in dining and lounge areas.
• We found left over medicines from a patient who had been discharged in cupboards on two wards. We brought this to the attention of the nurse in charge who disposed of the medicines immediately.
• We were concerned that governance systems and processes were not sufficiently embedded so that when the patient numbers and acuity increase, they remain effective to support the operational performance of the service.