CQC report explained · a residential care home
What the CQC found at The Magnolia Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2022
The Magnolia Care Home is rated Requires Improvement; inspectors found good progress in safety and management, and the home is no longer in Special Measures.
This was an unannounced, focused inspection on 27 April 2022. Two inspectors spoke with people, a relative, staff and managers. They also checked care records, medicines records and management documents.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safer medicines records, updated risk assessments, emergency evacuation plans and effective checks by managers. People said they felt safe and staff understood their needs.
The previous inspection had rated the home Inadequate, with breaches of regulations. Inspectors found enough improvement for those breaches to end. The overall rating is now Requires Improvement because some other areas were not inspected during this visit and earlier ratings were used.
People felt safe
People told inspectors they felt safe and happy. Staff knew how to recognise and report possible abuse.
“People felt safe and happy at the home.” from the report
Safer medicines records
The medicines records checked by inspectors were accurate and complete. Staff followed instructions about giving medicines and applying creams.
“At this inspection, all the records we looked at were accurate and filled out correctly.” from the report
Improved management
Management checks covered areas such as medicines, cleanliness and falls. Actions were taken promptly when changes were needed.
“At this inspection, sustained improvement had been made in all the areas we looked at, which were embedded in the way staff worked.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks included identity, references and criminal record checks.
“There were enough staff deployed to meet people's needs.” from the report
Overall rating remains Requires Improvement
minorThe home had improved from Inadequate, but the overall rating remained Requires Improvement. This was partly because some key questions were not inspected and earlier ratings were carried forward.
“The overall rating for the service has changed from Inadequate to Requires Improvement.” from the report
- 01What evidence shows that the improvements found in Safe and Well-led have been sustained since the inspection?
- 02What are the current ratings for Effective, Caring and Responsive, which were not assessed during this visit?
- 03How are medicines records checked now, and what happens if an error is found?
- 04How do managers use audits and weekly meetings to identify and fix risks?
- 05How can families raise concerns, and how will the home keep them informed about investigations and actions?
This was a focused inspection of Safe and Well-led, including infection control; the other key questions were not inspected and their earlier ratings were used for the overall rating. This explanation was written from the published report of 28 May 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, October 2021
Rated Inadequate and still in special measures; inspectors found unsafe care, weak management systems and some improvements.
This was an unannounced focused inspection over three days in August 2021. Inspectors spoke with people, relatives, staff and a health professional. They observed care and checked care records, medicine records, staff files, accident reports, complaints and management audits.
The home was still not safe in important areas. Fire safety work was unfinished, risk assessments were incomplete, and medicine records showed that one person missed medicine on 11 of 28 days. The home also did not have an effective system for learning from incidents.
There were some positive findings. Infection control and visiting arrangements were good, staff knew people well, and relationships between staff and people were positive. Care plans and end of life planning had improved, but more work was needed.
The overall rating remained Inadequate. Safe and Well-led were rated Inadequate, while Responsive remained Requires Improvement. The home remained in special measures because it had not made enough improvement.
Infection control
Inspectors found good infection control arrangements, including supplies of protective equipment, testing processes and safe visiting arrangements.
“Good infection control practices were in place. There was sufficient supply of personal protective equipment (PPE) available including hand sanitiser, gloves, aprons and masks.” from the report
Staff relationships
Staff knew people well and inspectors saw positive relationships between staff and people living in the home.
“Staff knew people well and we saw positive relationships between carers and people living in the service.” from the report
Improving care plans
Care plans had improved since the previous inspection. The home was rewriting them and had an action plan to track the work.
“Improvements had been made to people's care plans since our last inspection and there was evidence of reviews of documentation taking place.” from the report
Management approach
The new manager understood the improvements needed and received positive feedback from people, relatives and staff.
“The manager had the knowledge and experience to implement improvements and was passionate about people receiving good care.” from the report
Fire safety
seriousNot all actions from the fire risk assessment had been completed. Inspectors said this left people at higher risk of physical harm if there was a fire.
“The fire alarm system had not been upgraded and the external fire escape steps required work.” from the report
Medicines
seriousPeople remained at risk because medicines were not always given as prescribed and records were incomplete. One person's records showed medicine was not received on 11 of 28 days.
“People remained at risk of harm due to not receiving their medicines safely and as prescribed.” from the report
Risk assessments
seriousAssessments for risks such as falls, skin damage and malnutrition were sometimes missing, incomplete or not updated. Some specific risks, including catheter and wheelchair use, did not always have assessments.
“People did not always have assessments in their care records for known risks such as skin integrity, falls and malnutrition.” from the report
Learning from incidents
seriousThe home did not have an effective way to learn from accidents and incidents. Inspectors found missed opportunities to reduce the chance of the same event happening again.
“There was no effective system in place for the staff team to learn lessons when an incident took place.” from the report
Management oversight
seriousAudits did not always identify problems, and oversight of care records and the new electronic system was not established. The provider could not assure inspectors that people's care consistently met their needs.
“The provider had failed to ensure adequate systems and processes were in place to ensure effective management oversight and quality assurance of people's care.” from the report
Activities and complaints
needs fixingOpportunities for activities and hobbies were limited. Complaint records did not contain enough evidence to show how investigations had been carried out.
“There were limited opportunities for people to enjoy activities or hobbies.” from the report
- 01What has been completed to address the fire alarm and external fire escape problems?
- 02How do you now check that every person receives their medicines as prescribed, and how are missed doses followed up?
- 03How do you make sure risk assessments for falls, skin integrity, malnutrition, catheters and wheelchair use are complete and kept up to date?
- 04What evidence can you show that accidents and incidents are investigated and used to prevent the same thing happening again?
- 05What progress has been made against the monthly improvement updates required by CQC?
This was a focused inspection of Safe, Responsive and Well-led; the ratings for Effective and Caring were carried over from the previous comprehensive inspection. This explanation was written from the published report of 16 October 2021 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 The Magnolia Care Home
9 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- May 2022Requires improvementcurrent ratingup from InadequateSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- October 2021Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
- March 2021InadequateSafe: InadequateResponsive: Requires improvementWell-led: Inadequate
- September 2020Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- October 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2018Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2019
Registered with the Care Quality Commission on 18 November 2019.
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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