Inspection on 07/11/06 for Mondial

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mondial 23/09/08

Mondial 10/10/07

Mondial 20/12/05

Mondial 18/05/05

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 Key Unannounced Inspection 7th November 2006 2:20 Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 1 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 Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 2 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 Stationery 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 DS0000017889.V319216.R01.S.doc Version 5.2 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 Provider Web 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 DS0000017889.V319216.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 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. Mondial is a detached bungalow with three single bedrooms, all with en-suite toilets. 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 the back of the house and the small front garden, has off road parking. The current weekly charge for a room is £520.87. Residents pay for their own transport and newspapers. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector went to the home without telling anyone she was going to visit on the morning of Monday 21 August 2006. During this visit the inspector • • • • • • spoke with residents spoke with the person in charge spoke with a visitor watched how residents and staff got along together looked around some of the home looked at some records. In writing this report, the inspector also used records she already had about the home including relatives’ comments. Over all, 21 Standards were inspected. • 11 Standards were ‘met’. These are the things the home does well for residents. • 10 Standards were ‘nearly met’. These are the things that need some improvement. What the service does well: Here are some of the good things about Mondial, according to residents, staff, visitors and relatives. Residents liked • • • • their home their meals having contact with the important people in their lives the people who supported them at Mondial Staff showed that they • • knew how to support residents enjoyed working at Mondial Visitors and relatives thought that • • • • • • Mondial provided good care visitors were welcome staff were helpful staff and residents got on well the atmosphere was happy residents always seemed content DS0000017889.V319216.R01.S.doc Version 5.2 Page 6 Mondial • residents liked routine What the inspector saw showed that • • • Mondial is like a family home for residents and staff Residents felt comfortable and secure at Mondial Residents liked their settled lifestyles What has improved since the last inspection? What they could do better: • Care plans should tell staff all the ways residents need to be supported and what residents want to do in their lives. Residents should have a copy of their care plan to help them work towards their goals. Residents’ personal money should be paid straight into their own named accounts and not go through an account used for the business of the home. The person in charge should make sure that house rules do not stop residents learning to do things for themselves, if possible. A more suitable place is needed to keep residents’ medication and the home should have a record of each person’s current medication. The person in charge should make sure that the house is warm. People who spend a lot of time sitting need a warmer home than those who keep warm by being active. It is also important that hot water is at a safe and comfortable temperature for residents to use. The home should have enough staff so that residents can have more outings and holidays, if they like, and so that staff can take time off for holidays too. They must also keep a record of who is on duty every day. The person in charge must make sure everything is done to keep residents and staff as safe as possible. At least every year they also need to think whether there is anything they can do to improve the quality of care at Mondial. • • • • • • Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is adequate. This judgement has been made using evidence from previous inspections, as there had been no new admissions to the home. • Residents’ individual needs and aspirations had been assessed. EVIDENCE: The Statement of Purpose was last reviewed in July 2005 and so the arrangements for residents to attend religious services of their choice had not been added, as required, following the last inspection. There had been no changes to the resident group. Existing residents had been admitted on the basis of individual assessments of need. Service users should have, as part of their contract, a copy of their care plan and details of any part of this that is to be provided outside the home. This was highlighted at the last inspection but had not been addressed. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • Residents’ needs were not fully covered in their individual plans In some areas residents were not fully supported to make decisions for themselves or be independent. EVIDENCE: Two care plans were sampled. One person’s care plan showed how they were to be supported with their personal hygiene, behaviour, finances and social life. The other person’s care plan covered their appearance, behaviour, finances, smoking and health related topics. These plans, therefore, did not form a complete picture of the support residents were receiving individually or evidence how significant needs were being met. Care plans had been evaluated every month but were a little overdue for review. Risk assessments were either not dated or had not been reviewed since July 2003. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 11 It was evident that residents were supported to take responsible risks in accessing local community facilities. However, discussion with residents and the member of staff on duty showed that, in some areas of their home life, residents were being ‘cared for’ and not supported to take responsible risks and develop independent living skills. This applied particularly to the preparation of meals, drinks and snacks. A planned approach, with regularly reviewed, identifiable goals for all assessed needs and risks, would help residents make and measure their progress and take more control of their lives. Mr Clarkson had been Department of Work and Pensions appointee for all residents since 8/9/05 and it was reported that residents’ personal allowances were paid through the home’s account. Residents’ personal money should be paid straight into their own named accounts and not go through an account used for the business of the home. Residents had personal savings accounts for money they accrued. Records and comments from residents indicated that they were aware of the arrangements for safeguarding their personal money and fully involved in related transactions. One resident had just bought a television for their room. Records, receipts and balances were in order. Given the tendency for residents’ savings to accrue, it is recommended that the amount of money residents have available to spend on a daily basis is regularly reviewed and documented, and linked to plans that promote independence and enrich lives. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. • • • • The lifestyle at Mondial suited the people living there. Residents maintained some contact with family and the local community. The daily routines did not always promote independence, diversity and choice. Residents were offered a balanced diet and enjoyed their meals and mealtimes. EVIDENCE: Residents’ lives outside the home continued in the same pattern as at the last inspection. They all went out and about independently in Clacton and took themselves to the particular occupational, training or drop-in centres they regularly attended; one went to the library and two attended different churches. One resident used public transport independently to a known destination; otherwise any trips and outings they had were with family or through the units they attended during the week. Although residents seemed Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 13 satisfied with their present lifestyles their personal aspirations should be covered in their care plans and reviewed periodically to ensure they are gaining the most from available opportunities. (For example, one resident said it would be nice to have a holiday some time.) To this end it might be necessary to review how staffing arrangements can support residents to broaden their links with the community and have holidays and outings that suit their diverse needs and interests. Support for residents to maintain links with people who mattered to them had not changed since the last inspection, when the Standard was met. Relatives confirmed that they were welcome at Mondial and that their involvement was encouraged. One resident completing a survey for the Commission said that they could do what they wanted to do during the day, in the evening and at the weekend. However, it was evident during the inspection that residents were discouraged from entering the kitchen (except for meals), from making drinks for themselves, helping themselves to food, being involved in the preparation of meals and drinks or washing up. Residents also indicated that they went to their rooms at 9 p m, although they did not have to go to bed and could watch television, if they wished. Although residents seemed very comfortable with these routines, it was also clear that they accepted and did not question longestablished practices. The registered person should ensure that residents choose their own lifestyles and that routines and rules respect the diverse needs, strengths and interests of residents. The person on duty stated that they had a weekly budget of £80.00 for food shopping, which they did as needed, given the home’s close proximity to the supermarket. Records showed that residents had 4 daily meals, including a choice of breakfast cereal and a snack for supper. One visitor said that food was plentiful. The member of staff on duty had prepared dinners for each of the residents, based on one person’s choice of ‘chicken’. These meals were covered and ready to microwave when residents wanted them and one resident opted to have their meal before the others. This flexible arrangement recognised residents’ differing needs. Residents were asked what they would like to drink when they came in but were not supported to make drinks for themselves. Residents confirmed that if they wanted something to eat or drink they had to ask. The member of staff indicated that snacks were discouraged, mainly in response to one person’s dietary needs. The registered person should continue to explore ways of promoting independence, choice and diversity in this area. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • • Residents received personal support appropriate to their needs. Residents’ physical and emotional health needs were met but not fully documented. Residents were not fully protected by the home’s procedures for storing medicines. EVIDENCE: It was evident from discussion with the member of staff on duty that arrangements to protect residents’ personal space and support them with personal hygiene and bathing promoted their independence and dignity. Residents confirmed that they were involved in choosing their clothes. Arrangements for supporting residents to remain healthy had not altered since the last inspection. Records and discussion evidenced that residents had annual medical reviews, arranged by the GP practice. Although the member of Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 15 staff on duty was familiar with the particular health care needs of residents, these were not fully documented in their care plans. General Practitioners responding to the Commission’s survey indicted that residents’ medication was appropriately managed in the home. Residents’ medication and medication administration records were stored in hanging files in a metal filing cabinet alongside various unrelated papers. The filing cabinet was not locked at the time of inspection and the use of the cabinet for nonclinical purposes compromised the security of the medication. The location of this filing cabinet in the conservatory meant that the medication could be subject to high temperatures in the summer. The administration of medication was not observed but medication administration records had been satisfactorily maintained. Apart from these records, the home did not have an up to date reference of current medication prescribed for each resident, which might be needed in an emergency or to provide a full and complete audit trail. The member of staff on duty said they would obtain the Royal Pharmaceutical Society of Great Britain guidelines for the administration and control of medicines in care homes. Staff had training from the pharmacy they use in June 2004. The inspector was advised that refresher training was planned for next year. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. • • Residents’ could expect their expressed views to be listened to and acted on. Residents were protected from abuse. EVIDENCE: Relatives and GPs indicated that they had never had cause to complain about any aspect of care. One resident said they would speak to a particular member of staff if they were not happy or had a complaint. It was evident that residents found the staff member on duty approachable and talked with them about various matters during the inspection. Residents also said that staff always treated them well and listened and acted on what they said. One person who visited had observed a happy atmosphere in the home, with residents seeming content and getting on well with staff. The Protection of Vulnerable Adults policy had been reviewed on 1/7/06. This and related staff training were covered at the last inspection, when the Standard was met. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • Residents were living in very pleasant and homely surroundings although room and hot water temperatures posed some risk to residents. The home was clean and hygienic. EVIDENCE: Mondial continued to present just like a family home and be well maintained, comfortably furnished, fresh, clean and tidy. One resident said their home was always clean and fresh. The garden was also attractively and neatly maintained. As at the last inspection, the home felt cold on entry. On this occasion the temperature was 18.1o C when the inspector arrived and dropped to 15.9o C during the afternoon. The member of staff said that the manager set the thermostat at 16o C. Room temperature had risen to 19o C by 5.45 p m. The registered persons should ensure that temperature settings take account of the Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 18 age and sedentary lifestyles of residents. Residents should also be able to control the temperature of their bedrooms. The bedroom inspected was comfortable, suitably furnished and personalised. The central light in this room was low wattage and there was no bedside lamp. However, the resident said they did not need the room to be any brighter. Hot water, sampled at the hand basin in the en suite facility, was 63.2o F and the resident warned the inspector to be careful because it was hot enough to burn. The registered person needs to ensure that hot water is at a safe and comfortable temperature for residents to use. Separate laundry facilities suited the needs of residents and suitable arrangements were in place for the control of infection. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • • The staff complement was too small to provide residents with regular and flexible support outside the home. In the absence of the manager, it could not be evidenced whether residents were fully protected by the home’s recruitment and supervision practices. Residents were supported by suitably trained staff. EVIDENCE: The home did not have a staff roster, which is required by regulation. Staffing arrangements had not changed since the last inspection. The provider/manager continued to employ 2 staff and the three covered all the shifts between them. This meant that they continued to have limited opportunity for taking breaks and holidays. However, the member of staff on duty during the inspection stated that they were content with the current situation, as Mondial felt like home from home and they all worked flexibly to support one another with off duty commitments. Essentially though, shifts started at 10.00 or 12.00 noon and ran for 24 hours. They said they could use agency staff in an emergency, but the need had never arisen. With the Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 20 existing arrangement residents could not be supported off the premises without a member of staff doing overtime and only one member of staff had taken annual holiday. At the last inspection, not all the documents required by The Care Homes Regulations 2001 Regulations 17, Schedule 4 and 19, Schedule 2 had been retained on staff files (although they had been seen by the provider for the purpose of obtaining Criminal Record Bureau disclosures). The member of staff on duty stated that the manager had asked staff to provide the missing documentation but, in the absence of the manager, it was not possible to access staff records to verify that they were all in place. Induction training was found to be satisfactory at the last inspection and no new staff had been taken on in the interim. Should the home employ new staff, the manager/provider should introduce the new Common Induction Standards, developed by Skills for Care (organisation that sets standards for social care training). It was also not possible to inspect training records as these were on staff files. The member of staff on duty reported that they had completed the National Vocational Qualification (NVQ) in care, Level 3 in July 2006 and were waiting for their certificate to be issued. They also reported that the other member of staff had nearly completed NVQ 2. Since the last inspection, when it was noted that one member of staff had not completed food hygiene training, two staff had attended a two day food hygiene course at an accredited place of training. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. • • • In the main, residents were benefiting from a well run home. Residents were consulted but assumed and accepted that the people in charge would make decisions. The health and safety of residents and staff were not protected in all areas. EVIDENCE: The manager was not on duty for the inspection but continued to cover an equal number of shifts as the two staff and mostly work at different times from them. However, it was evident from discussion with the member of staff on duty that whilst they were in charge for their shift, they remained accountable to the manager. Despite the shortfalls highlighted by this inspection, in the main, the home continued to provide mostly good outcomes for residents. Residents confirmed this themselves, both in discussion and the surveys they had completed. However, whilst residents are clearly benefiting from stable Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 22 routines, this inspection has highlighted a need to review some practices to ensure that they are promoting diversity and independence. Some policies and procedures lacked original and review dates. All such documents should be signed by the registered manager, dated, monitored, reviewed and amended as necessary. All 3 people working at Mondial had valid Appointed Persons first aid certificates. The person on duty reported that, since the last inspection, two out of three staff had attended food hygiene and moving and handling training. They indicated that, as such a small home, Mondial did not qualify for advisory/inspection visits from the fire service and that fire safety training was conducted by the manager, using fire drills and discussing various scenarios that might occur. Fire extinguishers had been serviced in October 2006. Records continued to evidence fire drills and routine testing of fire equipment. One service user recalled being involved in a fire drill. The manager, qualified to test the safety of portable electrical appliances, had tested the home’s appliances on 13/10/06; the certificate of safety for electrical installations was still valid. Gas appliances and installations, were overdue for testing (last certificated dated 22/9/06), although the member of staff stated that arrangements for the annual service and inspection were in hand. Risk assessments had been completed for household products used in the home. Not all had been dated but those with dates had not been reviewed since July 2003 and therefore could affect the safety of residents. Room and hot water temperatures were covered under the section on the environment. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 23 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. 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 Standard No Score 1 2 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA1 Regulation 4, Schedule 1 Requirement The registered person must ensure that the Statement of Purpose includes the home’s arrangements for service users to attend religious services of their choice. This requirement has exceeded the timescale agreed following the last inspection. The registered person must ensure that residents’ care plans fully cover the health and welfare needs of residents. The registered person must ensure that, if a resident’s money is paid into a bank account, this account is in the name of the resident concerned and is not used for the purposes of the care home. The registered persons must ensure that medicines in the custody of the care home are suitably stored and secured. The registered person must ensure that the premises are sufficiently heated at all times. This requirement has exceeded the timescale agreed following the last DS0000017889.V319216.R01.S.doc Timescale for action 31/12/06 2. YA6 YA19 15 31/01/07 3. YA7 20 31/12/06 4. YA20 13(2) 15/12/06 5. YA24 YA42 23 08/12/06 Mondial Version 5.2 Page 25 6. YA33 YA41 17(2) Shed 4 7. YA34 17,18,19 8. YA39 24 inspection. The registered person must also ensure that unnecessary risks to the safety of service users are identified, kept under review, and so far as possible eliminated. The registered person must ensure that a duty roster is maintained of persons working at the care home, including a record of whether the roster was actually worked. The registered person must ensure that staff records include all the documents and information listed under Regulation 19, Schedule 2 and Regulation 17, Schedule 4 of the Care Homes Regulations 2001. This requirement has not been met within agreed time-scales. In the absence of the manager, this requirement could not be inspected and has been brought forward. The registered person must evidence a system for reviewing and improving the quality of care provided at Mondial, and supply a copy of any related report to the Commission and to residents. 08/12/06 08/12/06 31/03/07 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 YA5 Good Practice Recommendations The registered person should ensure that, as part of their contract, service users have a copy of their care plan and details of any part of this, which is to be provided outside the home. The registered person should ensure that service users are DS0000017889.V319216.R01.S.doc Version 5.2 Page 26 2. Mondial YA6 3. YA9YA17 4. YA12 YA33 5. YA40YA41 YA6 as involved as they can be in their care plans and that the plans are sufficiently detailed to reflect their progress in identified areas. The registered person should ensure that, wherever possible, residents are supported to take risks as part of an independent lifestyle and that house rules accommodate residents’ diverse needs and abilities. It is recommended that the registered person review staffing arrangements to ensure they support residents to broaden their links with the community and meet their personal aspirations. The registered persons should ensure that all records are signed and dated and that policies and procedures are periodically reviewed. Mondial DS0000017889.V319216.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000017889.V319216.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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