This inspection was carried out on 23 February 2017, and was an announced inspection. The provider was given one working days’ notice because the location provides a care service to a small number of people and we needed to be sure that someone would be available at the location to see us.

Magnolia House is a residential home providing care and support for up to six people with learning disabilities, autism and some people had limited verbal communication. The service is arranged over two floors and is wheelchair accessible. The provider organisation is a company that has other services across the South and East of England. At the time of our inspection, six ladies lived at the service.

At the last Care Quality Commission (CQC) inspection on 26 March 2015, the service was rated Good in all domains and overall.

At this inspection we found the service remained good.

The safety of people using the service continued to be taken seriously by the management team and staff who understood their responsibility to protect people’s health and well-being. Staff and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Systems were in place to protect people’s finances from potential misuse.

Risks to people’s safety had been assessed and measures put into place to manage any hazards identified. Staff followed appropriate guidance to minimise identified risks to people’s health, safety and welfare. The premises were maintained and checked to help ensure people’s safety. Medicines were managed safely and people received them as prescribed.

There were enough staff on duty with the right skills to meet people’s needs. Staff had been trained to meet people’s needs. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and their relatives and regularly reviewed to ensure people continued to have the support they needed. People were treated with dignity and respect by staff who also maintained people’s privacy.

Staff had a full understanding of people’s care and support needs and had the skills and knowledge to meet them. People received consistent support from the same members of staff who knew them well. People were supported to be fully involved in the care and support they received and, decisions relating to their lives.

People had access to the food that they enjoyed and were able to access drinks and snacks throughout the day. People’s nutrition and hydration needs had been assessed and recorded. Staff met people’s specific dietary needs. Staff ensured people remained as healthy as possible with support from health care professionals, if required.

People and their relatives were involved and asked for suggestions of ways the service could be improved, these were acted on. People and their relatives had access to a compliant policy and procedure. Systems were in place to monitor the quality of the service being provided to people. People participated in activities of their choice within the service and the local community. People were actively encouraged to maintain and increase their independence. The provider ensured the complaints procedure was made available in an accessible format if people wished to make a complaint. Systems were in place to monitor the quality of the service being provided to people.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The management team and staff understood their responsibilities under the Mental Capacity Act 2005.

Further information is in the detailed findings below.

We carried out this inspection on 28 November 2014, it was unannounced.

The provider organisation is a company that has other services across the South and East of England. Magnolia House is a service providing accommodation for up to six people who require personal care and who have a learning disability.

The six people living in the service had varied levels of verbal communication but showed affection to the manager and staff who were supporting them. They said “staff are nice”. We saw that staff were available throughout the day, and responded quickly to people’s requests for help. Staff showed consideration for each person’s different needs and wishes and showed understanding of these when spending time with them. Staff supported them when they needed it.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run. The registered manager took part in the inspection.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The six people living at the service had been assessed as lacking mental capacity to make complex decisions. There were completed mental capacity assessment records in place in people’s plans of care. There were clear records to show who their representatives were, who could act in in their best interests if complex decisions were needed about their care and treatment

There were enough staff to make sure that people’s needs were met. Staff had been trained in how to protect people from harm or abuse. They knew what action to take in the event of any suspicion of abuse. Staff understood the whistleblowing policy, and were confident that they could raise any concerns with the registered manager or outside agencies if this was needed.

Staff supported people to make decisions in relation to their care plan, and helped them in making arrangements to meet their health needs. Care plans were regularly reviewed to show any changes in people’s needs. Staff interacted well with people, and supported them in carrying out their preferences.

There were formal processes for actively involving people in making decisions about their care and treatment. The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. People felt able to raise any concerns with staff or the management.

The quality of the service was regularly reviewed. Meetings held regularly gave people the opportunity to comment on the quality of the service. People were listened to and their views were taken into account in the way the service was run.

There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements.

People were provided with a varied and nutritious diet. Comments from people included “I like the food”. Staff respected people and gave a kindly touch or a joke and conversation as drinks or lunch was served.

Medicines were managed and administered safely. People received their medicines on time and record keeping was accurate.

People were given individual support to take part in their preferred hobbies and interests, such as attending a social club and visiting places of interest.

There were systems in place to obtain people’s views about the service. These included formal and informal meetings; events; questionnaires; and daily contact with the registered manager and staff.

Recruitment checks were completed and staff files contained the required information. New staff were taken through a staff induction programme which included basic training subjects. They worked alongside other staff until they had been assessed as being able to work on their own. There were systems in place for on-going staff training; and for staff one to one meetings and support.

There were five people living in the home. People living in the service had a limited ability to communicate with us or engage directly in the inspection process. The service made sure people were offered choices about their care and treatment in ways they could understand. People indicated that they were happy in their home and showed open affection to the manager and staff who were supporting them.

People were asked for their consent before any care or treatment was given.

People received care and support that was well planned and sensitively delivered.

People received the medicines they needed, when they needed it.

Robust recruitment and selection procedures ensured that people were cared for by suitable staff.

Effective quality assurance procedures ensured that people were provided with a good service.

Overall we found that this service was safe, effective, caring, responsive and well-led and had achieved compliance.

There were five people living in the home. People living in the service had a limited ability to communicate with us or engage directly in the inspection process. The service made sure people were offered choices about their care and treatment in ways they could understand. People indicated that they were happy in their home and showed open affection to the staff supporting them. We found that the care and support that people received was well planned and sensitively delivered. People were supported to eat a balanced and healthy diet, they were given choice and had their preferences taken into account. The home was clean throughout. Staff were given appropriate professional development to enable them to understand people’s needs and provide appropriate care and support.

We spoke with three people who lived in the home and spent time with all the six people during our visit. People told us they were happy with the care they received at Magnolia House. They told us their privacy and dignity was respected and staff knocked on their bedroom doors. People said they were happy living in the home and felt safe. They told us they were able to do what they wanted when they wanted to and staff were kind and helpful.