CQC report explained · a nursing home
What the CQC found at Magnolia House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found clear risk assessments, enough staff, safe medicines systems and effective infection control. They found the home was no longer in breach of Regulation 12.
- Effective?
- Good
- People's consent and mental capacity records had been reviewed. Inspectors found good support with nutrition, staff training and people's individual needs.
- Caring?
- Good
- This question was not inspected during this visit. The rating from the previous inspection was carried forward.
- Responsive?
- Good
- This question was not inspected during this visit. The rating from the previous inspection was carried forward.
- Well-led?
- Good
- Inspectors found new audits and clinical checks, timely action after incidents and complaints, and an open approach to working with professionals and families.
What inspectors found, November 2022
Rated Good; inspectors found safer care, kind staff and better records, but some staff still had concerns about communication.
This was an unannounced focused inspection on 20 and 21 October 2022. Inspectors spoke with people, relatives, staff and healthcare professionals. They observed care and checked care records, medicines, recruitment, maintenance and quality monitoring.
The home was rated Good overall. Safe, Effective and Well-led were also rated Good. Inspectors found improvements since the previous inspection, including clearer care plans, better risk assessments, improved medicines systems and stronger checks on quality.
People and relatives generally said the home was safe and improving. Staff were described as kind and skilled, and there were enough staff. Infection control was effective, including during an outbreak in August and September 2022.
This inspection did not cover Caring or Responsive. Their previous ratings were carried forward. One line in the report says the service was not effective, but the rating and detailed findings for Effective are Good.
Clearer care planning
The home had reviewed its care planning system. Inspectors found care plans were clear and gave staff appropriate guidance about risks and support.
“Each person had a clear and concise care plan.” from the report
Enough staff
People, relatives and staff said there were enough staff. Inspectors saw staff supporting people calmly and spending time with them.
“People and their relatives confirmed there were enough staff to meet their needs.” from the report
Improved medicines safety
New systems had been introduced for giving and storing medicines. These included support for people taking time-sensitive medicines.
“These systems enabled staff to ensure people received their medicines as prescribed, including people who were prescribed time sensitive medicines.” from the report
Effective infection control
Inspectors were assured about infection prevention, protective equipment and outbreak management. An outbreak in August and September 2022 was managed effectively.
“The service had an outbreak in August and September 2022 which they managed effectively.” from the report
Communication between staff
minorStaff had differing views about communication in the home. The manager and provider knew about this and planned to listen to staff and act on their views.
“Staff had differing views on communication within Magnolia House.” from the report
- 01What specific steps have you taken to improve communication between staff?
- 02How do you check that my relative's care plan remains accurate when their needs change?
- 03How are time-sensitive and other medicines checked and recorded for my relative?
- 04What did you learn from the infection outbreak in August and September 2022?
- 05Which ratings for Caring and Responsive were carried forward from the previous inspection?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 15 November 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found kind care and enough staff, but serious gaps in risk records, consent, infection control and oversight.
This was an unannounced focused inspection on 13 and 14 April 2022. Three inspectors and an Expert by Experience spoke with people, relatives, staff and a healthcare professional. They reviewed care files, recruitment files, medicines records and the home's quality checks.
The home was not always keeping people safe. Care plans and handover records did not always describe people's risks accurately. Inspectors also found gaps in bed rail checks, falls prevention, repositioning records, infection control, recruitment checks and medicines procedures.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were Requires Improvement. Responsive was Good. The Caring question was not inspected in this visit, so its rating was carried forward from the previous inspection.
Enough staff
Inspectors found staffing levels were suitable for people's needs. Agency staff and the registered manager were used when needed.
“Suitable staffing levels were in place to meet the needs of people using the service.” from the report
Kind and respectful care
People said they felt safe and well looked after. Staff were described as patient, friendly and tolerant.
“People told us they felt safe and well looked after. They told us the staff were tolerant, patient and friendly.” from the report
Food and healthcare support
People had choices of food and drinks, and staff acted when someone was at risk of losing weight. The home worked with healthcare professionals on complex needs.
“Staff had identified one person had some unplanned weight loss. They implemented more frequent monitoring, high calorie food and snacks for the person to enjoy.” from the report
Complaints were acted on
People and relatives knew how to complain. The registered manager responded to concerns and used them to improve care.
“The registered manager acted on complaints and concerns in a timely manner.” from the report
Support at the end of life
The home worked with healthcare professionals to keep people comfortable and supported visits from loved ones.
“The service worked with healthcare professionals to ensure people were comfortable at the end of their life.” from the report
Risk information was incomplete
seriousCare plans did not always give staff the information needed to manage risks such as choking, falls, bed rails and skin damage. Inspectors saw one person without a required sensor mat and with no staff present.
“People's care plans and associated records were not always current, accurate and did not provide staff with the correct information they required to safely meet people's needs.” from the report
Consent records were missing
seriousThe home did not always record mental capacity assessments, best-interest decisions or whether restrictions were necessary and lawful.
“People's capacity to make decisions was not always recorded.” from the report
Infection control was inconsistent
seriousInspectors were not always assured that staff removed and stored protective equipment safely. Infection control audits did not always record what action had been taken.
“We were not always assured that the provider was using PPE effectively and safely.” from the report
Quality checks did not find problems
seriousAudits failed to identify concerns in care records, recruitment, infection control and mental capacity records. There were no provider audits or checks in place.
“The provider had no current systems in place to ensure the quality of care people received was meeting their expectations.” from the report
Staff information and training
needs fixingSome staff said communication was not effective. Training records showed that some mandatory training was incomplete, and supervision records were limited.
“Some staff felt they did not receive effective communication to carry out their role.” from the report
Recruitment records
needs fixingSome required references and interview records were missing before staff started work. The provider was asked to review its recruitment processes.
“Appropriate recruitment checks had not always been completed prior to staff starting work.” from the report
- 01How have you updated care plans and handover records so staff know each person's current risks, including choking, falls, bed rails and skin damage?
- 02What records now show mental capacity assessments, best-interest decisions and the legal basis for any restrictions?
- 03What changes have you made after the warning notices for safe care and governance?
- 04How do you check that PPE is removed, stored and disposed of correctly?
- 05How are you making sure staff complete mandatory training and receive regular supervision?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and its previous rating was carried forward. This explanation was written from the published report of 7 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Magnolia House
7 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2022Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- May 2021Inspected but not ratedSafe: Inspected but not rated
- October 2019Goodstayed GoodSafe: GoodEffective: GoodResponsive: OutstandingWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementstayed Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2015Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 29 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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38 live-in carers within about an hour of Gloucestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.