About the service:

Magellan House is a residential care home. The home is registered for up to nine young people living with a learning disability or autism. There were seven people living at the home at the time of inspection. People had access to a communal lounge, dining area, activity room, sensory room and kitchen. People had their own bedrooms with en-suites.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; promotion of choice and control, independence and inclusion. People’s support focussed on them having as many opportunities as possible for them to gain new skills and become more independent.

People were safe from the risk of abuse. Staff had a flexible approach to risk management which ensured people could have new experiences and maintain their independence. There were sufficient numbers of staff to meet people’s need. A relative told us, “The staff are consistent and I think they are a fabulous team, they know our son so well.”

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff had the skills and knowledge to deliver effective care and support. People were supported to maintain a balanced diet and had access healthcare services as and when needed.

People were treated with kindness and respect. A relative told us, “The staff are so kind. I trust them with my precious daughter and I wouldn’t if they weren’t so caring.” People were supported to be involved in decisions about their care and given support to express their views. People’s independence was promoted and their differences respected.

Care was personalised to meet people’s care, social and wellbeing needs. People had access to a range of activities that met their interests. A relative told us, “They are out and about all of the time, taking part in activities that they would not have had access to before living at Magellan.”

People, their relatives and staff were complementary of the manager and staff felt well supported. A member of staff told us, “We are well supported and have regular supervision where the manager gives us feedback. She is great, really open and approachable.” The culture of the home was positive. Systems and process were in place to monitor the quality of the service being delivered.

Further information is in the detailed findings below.

Rating at last inspection:

Requires Improvement (28 March 2018). At this inspection the overall rating has improved to Good.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our re-inspection schedule for those services rated Good.

This focussed inspection took place on 29 March 2018. We carried out an announced comprehensive inspection of this service on 25 October 2017. A warning notice was issued for a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and we found breaches of other regulations. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches of regulations.

We undertook this focused inspection to check that the provider had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Magellan House on our website at www.cqc.org.uk.

Magellan House is a 'care home.' People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Magellan House provides accommodation and personal care for up to nine people specialising in care for young adults with autism and learning disabilities who have communication and positive behaviour support needs, seven people were living at the service on the day of our inspection. They required support with personal care and had additional communication needs. Accommodation was arranged across two floors of a large house. The service is one of three residential care homes run by Pathway Healthcare Ltd, a specialist provider of care, support and housing services. The service had been developed in line with the values that underpin the Registering the Right Support guidance and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any other citizen.

The service had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run.

We inspected the service against two of the five questions we ask about services. Is the service well led and is the service safe? This is because at our previous inspection on 25 October 2017 we identified breaches of the Regulations. We issued a warning notice telling the provider to carry out improvements in the area of safeguarding people from abuse and improper treatment. We also asked the provider to carry out improvements in the area of medicines management.

At this focussed inspection on 29 March 2018 sufficient actions had been taken to address these issues. People were being supported safely with minimal physical intervention. Staff had received the training they needed to support people effectively. Incidents and accidents were recorded and monitored and staff understood their responsibility for safeguarding people. “One relative told us that the atmosphere at the home was calmer and they felt confident that their relation was safe living at the home.”

People’s medicines were managed, stored and administered safely. Staff had received training and there was clear guidance and protocols to support the administration of medicines. Records were accurate and there were systems in place to monitor and address any shortfalls.

Staffing levels were sufficient to support people’s needs. A relative spoke positively about the improvements they had noticed at the home and attributed this to having more consistency within the staff team.

Risks to people had been assessed and there was clear guidance for staff in how to support people. Positive Behaviour Support (PBS) plans were comprehensive and

The inspection took place on 25 October 2017 and was announced. Magellan House provides accommodation and personal care for up to nine people specialising in care for young adults with autism and learning disabilities who have communication and positive behaviour support needs, nine people were supported at the service on the day of our inspection and were aged from 18 to 30 years. They required support with personal care and had additional communication needs. Accommodation was arranged across two floors of a large house. The service is one of three residential care homes run by Pathway Healthcare Ltd, a specialist provider of care, support and housing services.

The service had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the home is run.

The provider was not consistently working within the principles of the Mental Capacity Act 2005. Mental capacity assessments were not in place to demonstrate whether people could consent or not consent to the use of restrictive practice. Accurate, complete and contemporaneous records had not been maintained.

Statutory notifications had not been routinely submitted to CQC by the provider. A notification is information about important events which the provider is required to tell us about by law. A quality assurance framework was in place but this had not always been effective in driving improvement and identifying shortfalls.

The management of medicines was not safe and the administration of medicines was not always undertaken in a safe manner. Staffing levels were maintained with regular use of agency staff, however, the provider could not consistently demonstrate that agency staff had the right training and skills to provide safe and effective care.

Safeguarding procedures were in place and where required the provider had raised safeguarding concerns. However, steps had not been taken to ensure that any outcomes of safeguarding enquiries had been met. Systems were not consistently safe in ensuring that people were protected from the risk of improper treatment. People were at risk of not always receiving personalised and responsive care.

Staff told us they worked as part of a team, that the service was a good place to work and staff were committed to providing care that was centred on people's individual needs. There was a strong caring culture in the care and support team.

People were supported to maintain good health through regular visits with healthcare professionals, such as GPs, dentists and the specialists involved in their specific healthcare needs.

Staff treated people as individuals. Staff were knowledgeable about people's likes, dislikes, preferences and care needs. They approached people in a calm, friendly manner which people responded to positively. Relatives spoke highly of the service. One relative told us, "They couldn't be in a better place."

People were encouraged to lead active lives and were supported to participate in community life where possible. People were empowered to access support from a range of services and staff worked alongside these organisations to support people when required.

There were sufficient numbers of staff to meet people's needs and to keep them safe. The provider had effective recruitment and selection procedures in place. Relatives confirmed that they felt their loved one was safe living at Magellan House. People, relatives and staff spoke highly of the registered manager. One staff member told us, "The manager is so lovely and approachable."

During our inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered providers to take at the back of the full vers