Inspection on 18/05/05 for Mondial

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mondial 23/09/08

Mondial 10/10/07

Mondial 07/11/06

Mondial 20/12/05

Mondial 19/10/04

Mondial 08/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Mondial 3 Old Road Clacton on Sea Essex CO15 1HX Lead Inspector Marion Angold Unannounced 18/05/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mondial Version 1.10 Page 3 SERVICE INFORMATION Name of service Mondial Address 3 Old Road Clacton on Sea Essex CO15 1HX 01255 420995 01255 420995 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Robert Clarkson Mr Robert Clarkson Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Mondial Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 19 October 2004 Brief Description of the Service: Mondial provides a service for three people with moderate learning disabilities, situated in the heart of Clacton, near to shops and other amenities. All the service users were previously in other care homes before coming to live at Mondial. Mondial is a detached bungalow with three single bedrooms, all with en-suite WCs. Two of the bedrooms are on the ground floor, along with a bathroom, kitchen, lounge and conservatory. The upstairs accommodation includes a laundry and a room for the member of staff sleeping in at night. A large garden is situated to back of the house and there is a small front garden with off road parking. Mondial Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 10.45 a m and ended at 2.30 p m. All three service users were involved in outside activities that day, but two were available at different times to help with the inspection. Apart from the manager, there were two people employed at the home. The newer of the two staff members was on duty but the other came in especially, when they heard the inspection was taking place. This was another positive inspection. The premises and garden were found to be in good order and service users very content with the way things were and the people who cared for them. Some progress had been made with all but one of the 5 requirements arising from the inspection in October 2004. On this occasion, 21 of the National Minimum Standards were inspected. The outcome was that 16 were met and 5 were nearly met. The changes the home has been asked to make are listed at the end of this report. What the service does well: Service users were encouraged to make decisions for themselves, for example about how they would occupy themselves and what they would like to eat. Staff were good at supporting them to take risks that were carefully planned, for example, going out by themselves. Staff also supported them to become more independent in handling their own money. They were able to choose from a range of meals that suited them. Mondial was typical of other homes in the neighbourhood and service users had contact with the community through their use of local amenities and chosen activities. The hub of the home was the conservatory, overlooking the garden. Everywhere in the house looked clean and bright and just like a family home. One service user, whose bedroom was inspected, said it was as they wanted it. The small team of staff worked flexibly and well together, helping the home run on family lines and seeing that information was shared, as necessary, between shifts. The member of staff not on duty on the day of inspection came in specially to support the one who was. Service users said they got on well with staff and they appeared relaxed together during the inspection. Mondial Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mondial Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Mondial Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 5 Service users had the written information they needed about their home, although some minor additions were needed. Service users’ contracts were inadequate for their purpose. EVIDENCE: The Service Users Guide contained within a Service Users Information Pack, and had been reviewed in April 2005. This contained most of the necessary information although service users’ comments and a description of the communal space were lacking. How the home meets the physical environment standards in relation to communal space and bathrooms should also be included in the Statement of Purpose, as per National Minimum Standard 1.1. Each service user had their own copy, which had been explained to them, as confirmed by one of the service users. In his written response to a requirement, arising from the last inspection, the manager indicated that service users’ contracts had been amended to incorporate the information detailed under Standard 5.2. However, the contracts available for inspection were dated August 2003, so the requirement has been brought forward into this report. Mondial Version 1.10 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Service users could be enabled to take greater ownership of their care plans. Service users were encouraged to make decisions for themselves. Service users were supported to take acceptable risks. EVIDENCE: One member of staff explained that each service user was given opportunity to consider and discuss their care informally, and the care plans were usually updated, following further discussion between the three people working at the home. Service users confirmed that they were consulted but not directly involved in their care plans. The inspector highlighted the value of writing and agreeing care plans with the service users present, hereby giving them clearer ownership of the goals and a greater sense of achievement from the outcomes. It was also suggested that, in some cases, service users would benefit from more detailed plans. By identifying with the service users in their care plan, the particular tasks involved in achieving the goal, they would be more able to chart and build on their own progress. For example, one care plan evidenced that the service user was achieving greater independence with their personal care, but the detail of this only became clear in discussion. Mondial Version 1.10 Page 10 One service user’s care plan focussed on their difficulty in making decisions and the role of staff to provide the necessary support. Staff were familiar with this situation and, during the inspection, had occasion to put the care plan into action, giving the service user the permission and encouragement they needed to see a decision through. Arrangements for supporting service users to access their personal allowances were found to be satisfactory and the two service users present indicated that the arrangements suited them. They were able to request and sign for money as needed and were fully involved in the process of transferring money to their savings accounts. Discussions took place with staff about ensuring that service users were made aware of the value of their savings and could make full use of the money that was theirs. All three service users were used to going about independently in their locality, and a missing persons procedure and appropriate risk assessments were in place to cover this. Other risk assessments had been completed on an individual basis, such as in relation to smoking. By their manner, comments and comings and goings, service users indicated that they were not unduly restricted. Mondial Version 1.10 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 17 Service users go out and about locally and conduct themselves as part of the community. Service users are offered healthy meals that suit them. EVIDENCE: Nothing about Mondial’s appearance marked it out as a care home. Although the position of the home, next to a retail park, meant that they had neighbours only one side, links with the community were assisted by the fact that staff were local people and brought family and others into contact with the service users. Service users also went out and about independently in the neighbourhood, using the library, shops and eating places, and also to their chosen activities. Two service users had chosen different churches to attend. Service users indicated by their completed satisfaction questionnaires that they approved the meals in the home. Staff prepared for service users the meals they ate themselves and nutrition records evidenced balanced menus, which included salad and a range of frozen and fresh vegetables. The home ran on family lines, with service users often deciding what they fancied from the Mondial Version 1.10 Page 12 fridge and freezer on the day. One service user’s particular dietary needs were covered in their care plan and another demonstrated during the inspection that they felt free to make their requests known. Mondial Version 1.10 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 21 Appropriate arrangements were in place for meeting the health care needs of service users. Service users’ wishes in the event of their death had been explored. EVIDENCE: Service users’ medical and health-related appointments had been recorded in their individual diaries, providing the necessary overview of their health contacts, as requested at the last inspection. Staff were advised that, to maintain a continuous record, these diaries must remain available for inspection from year to year. From the records it was evident that service users health care needs were monitored and addressed. One service user’s weight loss, though made known to the general practitioner, could not be evidenced from their records. This highlighted the need for the home to monitor and record the weight of all service users routinely. Service users’ care plans evidenced that consideration had been given to their wishes in the event of death. Mondial Version 1.10 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home had adopted an open approach to complaints. Staff treated service users well but a more robust adult protection policy could enhance their protection. EVIDENCE: Clear and appropriate guidance about making a complaint was contained in the Service Users Guide. One service users knew about this and confirmed that they each had a copy. The service users’ survey indicated that they were more than satisfied with all aspects of living at Mondial. A very good rapport was observed between service users and staff and service users separately affirmed that they got on well with the present staff and found them approachable. The home was run on family lines with service users coming and going at different times and having frequent opportunities to talk with the person on duty on their own. The same service users were also positive about the manner in which staff treated them. However, some amendment and clarification was needed to the home’s protection of vulnerable adults procedure to bring it in line with the procedures issued by the Essex Vulnerable Adults Protection Committee (EVAPC). Copies of this had been obtained for staff and they indicated they would refer to the procedures in the event of an allegation or suspicion of abuse. They indicated that they had covered the topic with the manager and that it had been arranged for them to attend EVAPC’s free training session in September 2005. Staff demonstrated understanding of the procedures in discussion. Mondial Version 1.10 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28, 29 and 30 Mondial was providing service users with a good standard of environment, which was safe and suitable for their needs. EVIDENCE: The property was in keeping with the local community, well-maintained inside and out, with a neat, attractive garden. Furnishings and fittings were domestic in character and of good quality. Compliance with the Environmental Health Department’s requirements was evidenced and records showed that smoke detectors and fire extinguishers were being checked at appropriate intervals. One bedroom was viewed in the presence of the service user. It was bright and fresh and suitably decorated and furnished for their needs, with their own belongings in evidence. The service user clearly took pleasure in their own space and confirmed it was as they wished it to be. Staff affirmed that the bath, situated downstairs, was accessible to all service users. One service user was not able to use the stairs but all facilities they used were on the ground floor. The home should continue to keep the need for equipment for promoting independence, such as grab rails, under review. Mondial Version 1.10 Page 16 Service users could choose to relax in the lounge, conservatory or garden. Meals were taken in the kitchen, but, in accordance with related risk assessments, service users were permitted here only under supervision. A suitable room was available for staff, sleeping in. The laundry, situated upstairs, was appropriate for the needs of the home and the home looked very clean. Infection control procedures were not inspected on this occasion. Mondial Version 1.10 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 Staff had a clear understanding of their roles and responsibilities and service users’ support needs. The home provided sufficient staff to meet the needs of service users. Further staff training would have potential benefits for service users. EVIDENCE: One member of staff was involved in the pilot of a new National Vocational Qualification in care, Level 3, which, they reported, included modules of particular relevance to those involved with people with learning disability. The other member of staff advised that they would be commencing NVQ Level 2 in September 2005. Although more than 50 of staff had achieved NVQ 2, anyone working on their own, with full responsibility for a shift, as at Mondial, should attain this level of training, as a minimum. Staff were, in fact, rostered to cover shifts on their own. Each 24 hour shift started in the evening, so that the sleeping night provided a natural break. Staff confirmed that they and the manager were in contact with one another almost on a daily basis to share information and understanding and that this was an effective for continuity. Their good working relationship was demonstrated on the day of inspection when both members of staff, in the Mondial Version 1.10 Page 18 absence of the manager, were present to support one another. Service users appeared comfortable approaching staff and initiating conversation. Communication between staff and service users was relaxed. Staff listened with interest and engaged appropriately with each service user’s particular agenda. In the absence of the manager, staff records were not available for inspection and, therefore, the requirement relating to National Minimum Standard 34, arising from previous inspections, has been repeated in the appropriate section at the end of this report. One member of staff said that they had supplied the reference that was needed. Staff confirmed that they were encouraged to develop through training. The newer member of staff, who had not had a background in care, indicated that their induction training had prepared them for the work they had to do. Their training records were, however, not available for inspection. The need for staff to receive mandatory training at the appropriate level and frequency has been covered under National Minimum Standard 42. For example, there was no evidence to show that the in house fire safety training had conformed to TOPSS (Skills for Care) guidelines. Mondial Version 1.10 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 Service users had been consulted about their experience of living at Mondial as a basis for planning how the service should develop. Arrangements for the health, safety and welfare of service users were mostly satisfactory, as sampled, although gaps in mandatory training posed potential risks for service users and staff. EVIDENCE: The home’s policies on involving service users in the development of their home and quality assurance were included in the Service Users Guide (Service User Information Pack). Service users had participated in a quality assurance survey. Their completed questionnaires were available for inspection and evidenced their satisfaction with arrangements and provision at Mondial. Letters and responses received from families were also positive. The results were being analysed to inform any necessary action. Staff and service users confirmed that they all met regularly to talk about the issues that affected them. Mondial Version 1.10 Page 20 In the main, measures taken to promote the health and safety of service users and staff were satisfactory and proportionate to the size of the home. However, the gas safety inspection carried out by a Corgi Registered service engineer, was not certified in the standard way and the manager should follow this up with the person concerned. Fire extinguisher and portable appliance testing were up to date. Policies relating to health and safety and appropriate risk assessments were in use. Both members of staff had completed their statutory medications and first aid training and said they had covered fire safety with the manager. Both members of staff were responsible for food preparation but only one held a food hygiene certificate and this was dated April 2004. They advised that a date had been set for manual handling training. Neither had completed formal training in infection control although one indicated that they had covered various aspects of health and safety during their induction. It is necessary for the home to evidence that all persons on the roster, including the manager, are keeping their mandatory training up to date and that it conforms to the specifications set by Skills for Care (TOPSS). Mondial Version 1.10 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x x 3 x x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x Mondial Version 1.10 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 Schedule 1 and 5 Requirement Timescale for action 31 July 2005 2. 5 3. 42 4. 34 The registered person must ensure that the Statement of Purpose and Service Users Guide contain all the details required by these regulations and as set out under National Minimum Standard 1. 5 The registered person must ensure that all elements of National Minimum Standard 5 (2) are included in service users contracts. THIS REQUIREMENT HAS BEEN REPEATED OVER SUCCESSIVE INSPECTIONS. 13, 18 The registered person must arrange for staff to undertake training to meet Skills for Care training targets in all the mandatory health and safety topics. 17, 18, 19 The registered person must ensure that staff records include all the documents and information listed under Regulation 19, Shedule 2 and Regulation 17, Schedule 4 of the Care Homes Regulations 2001. THIS REQUIREMENT COULD NOT BE INSPECTED DUE TO LACK OF ACCESS TO STAFF RECORDS IN THE MANAGERS ABSENCE. Version 1.10 31 July 2005 31 July 2005 31 July 2005 Mondial Page 23 5. 35 18 The registered person must formulate a training plan for the home. THIS REQUIREMENT COULD NOT BE INSPECTED DUE TO LACK OF ACCESS TO STAFF RECORDS IN THE MANAGERS ABSENCE. 31 July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations The registered person should ensure that service users are as involved as they can be in their care plans and that the plans are sufficiently detailed to reflect the progress achieved by service users in identified areas. The registered person should discuss periodically with service users and/or their representatives how they wish to use their savings and record the content and outcome of these discussions. The registered person should ensure that service users body weight is monitored regularly. The registered person should enhance the current adult protection policy by setting out the procedures to be followed in the event of an allegation or suspicion of abuse. 2. 7 3. 4. 19 23 Mondial Version 1.10 Page 24 Commission for Social Care Inspection Fairfax House Causton Road Colchester CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mondial Version 1.10 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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