Inspection on 02/02/06 for Mundy House Care Centre

This inspection was carried out on 2nd February 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 but made no statutory requirements on the home.

Other inspections for this house

Mundy House Care Centre 03/03/10

Mundy House Care Centre 06/04/09

Mundy House Care Centre 24/06/08

Mundy House Care Centre 30/07/07

Mundy House Care Centre 06/01/07

Mundy House Care Centre 28/06/06

Mundy House Care Centre 16/06/05

Mundy House Care Centre 05/03/05

Mundy House Care Centre 15/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Mundy House Care Centre Church Road Basildon Essex SS14 2EY Lead Inspector Carolyn Delaney Unannounced Inspection 2nd February 2006 09 :00 X10015.doc Version 1.40 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 Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 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 Older People. 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. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mundy House Care Centre Address Church Road Basildon Essex SS14 2EY 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) 01268 520607 Ashbourne (Eton) Limited Care Home 65 Category(ies) of Dementia (3), Old age, not falling within any registration, with number other category (65) of places Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided for older people aged over 65 years. Personal care can be provided for up to a maximum of three service users with dementia. The total number of service users for whom personal care can be provided shall not exceed 65. 16th June 2005 Date of last inspection Brief Description of the Service: Mundy House Care Centre is a large home that was purpose built in 1965. Care and accommodation is offered for up to sixty-five older people, including up to a maximum of three service users who have a diagnosis of dementia. It is close to local shops and is on a bus route with services to Basildon and Wickford.The majority of bedrooms are situated on both floors of the main building. An additional eight bedrooms are sited in the Lodge annexe, which can be reached through an internal walkway on the first floor. Single and double bedrooms are available and the majority offer ensuite facilities. Access to all rooms is available via passenger lift.The home has a number of communal lounge/dining areas. There is a courtyard and garden area accessible to service users. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine inspection carried out between 09.00 and 19.00 on 2nd February 2006. Inspector’s Michelle Love and lead inspector Carolyn Delaney carried out the inspection. Records including assessments, care plans, daily care notes and risk assessment documents in respect of seven people living at the home were examined. Five residents and two relatives were spoken with during the inspection. The relatives of four residents at the home were contacted by post so as to offer them the opportunity to make comments about the services provided by the home. Two responses were received and these responses have been included in this final version of this report. Seven members of staff including the acting manager were spoken with and a number of records including duty rota’s and staff recruitment files were examined. A tour of the premises was carried out and a number of records in respect of the general maintenance and regulatory checks for gas, electric and mechanical equipment were assessed. Key standards as identified in the intended outcomes sections of this report are inspected at least once every twelve months. Where key standards have not been inspected on this occasion they will have been inspected at the previous inspection. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. What the service does well: Mundy House provides a homely and welcoming place for residents who need assistance with care to carry out daily activities of living. The home and garden are well maintained One relative who responded to the questionnaire sent out by the Commission commented that since her mother had moved into Mundy House that she Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 6 ‘appeared to be happy’ and that ‘she looked much better that she did when she was living on her own’. What has improved since the last inspection? What they could do better: Information about the people living at the home and the care and treatment that they need could be better recorded so that all staff working at the home can have up to date and accurate information in order to be able to best care for residents. Staff could act in a more sensitive and caring manner when assisting residents, for example at mealtimes. The home could provide more activities and suitable stimulation for the people who live at the home and staff could pay more attention to residents and seek their views and wishes for example when deciding what music or television programmes are to be selected. The home must provide a suitable range of activities and stimulation for the people living at the home. The records in relation to complaints made about the home and the services and facilities provided should be kept up to date and made available to inspectors upon request. The way in which staff are recruited, trained and supported must be reviewed so that all staff working at the home have been subject to all of the required checks in respect of their suitability to work with elderly people. Staff must receive training so that they can best care for the people living at the home and protect them from harm or abuse. Staff must be employed in appropriate numbers taking into account the needs of the people living at the home and any limitations to the tasks that staff can undertake so as to ensure that residents needs can be met. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 7 Both the relatives who responded to the postal questionnaire commented that there were not always sufficient staff on duty in the home. The home must be maintained so far as it is possible free from any unpleasant odours. The management of the home must take into consideration the number of issues and concerns raised at this and previous inspections and take actions to rectify these issues. 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. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, & 5 Information in respect of the services provided by the home has not been updated in light of organisational changes and in relation to management of the home. Information in relation to the assessed needs of people to be admitted to the home was not consistently recorded so as to determine that the home could meet these needs. Prospective residents and / or their relatives may visit Mundy House so as to make a decision as to whether the home is suitable. EVIDENCE: The homes statement of purpose and service users guide had not been updated in light of the change of manager and the change of ownership. At the time of this inspection the home was undergoing a transitional period and not all of the new policies and procedures had been implemented. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 10 Pre-admission assessment records for two people who had been recently admitted into the home were sampled and examined. Records were in the main detailed, however not all of the information as identified in social services assessment was included and where some care needs were identified how these needs affected the persons abilities in relation to carrying out daily activities was clearly recorded. For example for one person admitted to the home it was not recorded that this person had glaucoma. There were no assessments in respect of individual’s dependency levels so as to determine that the home can meet the needs of the people to be admitted and those people already living at the home. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 & 11 Information in relation to the care, safety and welfare of people living at the home is not consistently recorded. Staff do not always act in accordance with planned care so as to best meet the needs of people living at the home. Residents wishes in relation to end of life issues and preferred arrangements following death are not consistently recorded. EVIDENCE: Care plans for five people living at the home were assessed. Care plans did not always clearly identify resident’s needs and how these were to be met. For example where residents were prone to weight loss it was not always clear what action staff were to take and where information was recorded there was not always evidence that staff acted in accordance with the planned care. The records in relation to care and treatment for residents who display challenging or aggressive behaviour did not indicate that staff had the skills or knowledge so as to meet these needs. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 12 Care plans were not consistently evaluated and reviewed. The documentation tool available to staff in order to record information in relation to risks to health and safety is not appropriate and does not allow for detailed information to be recorded. Assessments in relation to risks to residents of developing pressure sores, sustaining injuries from falls or the use of bedrails etc were not sufficiently detailed and were not consistently reviewed on a regular basis. It was not always evident that staff acted in accordance with the information available, for example where risks of developing pressure sores had been identified and regular changes of persons position while in bed had been planned, it was not evident that staff acted according to these plans. Some staff were observed to treat residents in a respectful manner, however others did not engage in any interaction with residents when assisting them and one member of staff was observed to speak to residents in an abrupt manner. Residents wishes in relation to end of life issues and preferred arrangements following death are not consistently recorded. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 The home does not provide sufficient planned activities or stimulation and occupation for the people who live there. Residents may receive visitors according to their wishes. Residents are not always supported and assisted in making choices and exercising control over their daily lives. Residents are not always supported or assisted in relation to their nutrition needs. EVIDENCE: The home employs an activities coordinator for fifteen hours per week. There were no planned activities on the day of this inspection and the majority of staff observed engaged in little or no interaction with the residents. It was disappointing to observe both television and radio on simultaneously in two of the lounges until staff were asked why this was. It was noted that rather than asking residents which they would prefer staff took the decision to switch off the television. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 14 During the lunchtime meal a number of residents were noted to be seated in wheelchairs at the dining tables, when staff were asked the reason for this practice it became clear that this was not residents choice. Residents and relatives who were spoken with during the day of the inspection confirmed that visitors were welcomed to the home. On the day of the inspection residents had a choice of minced beef or pasties with vegetables and mashed potatoes, followed by sponge pudding and custard. Some residents had fruit or yoghurts as an alternative. Where residents required assistance at mealtimes this was not always provided in an appropriate manner. For example one member of staff was observed to assist a resident with a drink without engaging in an conversation with the resident and without checking that they were allowing sufficient time for the resident to take the fluids safely and comfortably. Where residents were prone to lose weight and needed to have intake of food and drinks monitored these records were not consistently kept up to date. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 It was not evident that complaints are dealt with according to the homes policies and procedures and Care Homes Regulation 22. The home is not managed consistently in a manner, which protects the people living there from harm or abuse EVIDENCE: Records in relation to complaints made in respect of the services since that last inspection were examined. There had been five complaints made to the home. Records in relation to three of these complaints were incomplete and it was not clear whether these had been substantiated or what actions had been taken to resolve the issues identified in these complaints and whether the complaints were satisfied with action taken. Staff training files which were examined did not evidence that all staff had undertaken training in relation to the protection of vulnerable people living at the home. It was of concern that an incident of inappropriate behaviour by a member of staff had not been dealt with in a proper manner. An Immediate Requirement notice was issued in respect of the concerns raised on the day of this inspection. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The home is generally well maintained and in fair decorative order. The home is not maintained free from unpleasant odours. EVIDENCE: Residents have access to three lounge areas and two dining areas and these were observed to be well maintained. Resident’s bedrooms, which were observed, were well maintained and personalised with resident’s personal items. There were unpleasant odours detected throughout the day in one particular corridor and one resident’s bedroom. The home employs dedicated maintenance staff and regular checks are carried out in relation to the services and facilities provided. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 Staff are not consistently recruited robustly, trained and supported appropriately and employed in sufficient numbers so as to best meet the needs of the people living at the home. EVIDENCE: The staffing numbers employed at the home are ten care staff during the day and four care staff during the night. The duty rota indicated that staff do not regularly work excessive hours without appropriate off duty days. It was not clear from the duty rota that each duty was fully staffed. For example for the weekend prior to this inspection a number of staff did not work the full shift and the reason for this was not clear. Both the relatives who responded to the postal questionnaire commented that there were not always sufficient staff on duty in the home. On the day of the inspection three members of staff who were pregnant and who were therefore limited in relation to the care tasks they could participate in were on duty. There was no evidence that this had been considered in the planning of the duty rotas. It was reported by the acting manager that a risks assessment had been undertaken in relation to the pregnant members of staff, however the records Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 18 for one of these staff members was examined and there was no evidence of the risk assessment. Records in respect of the seven members of staff who had been employed at the home since the last inspection were examined. It was not evident that all of the appropriate checks so as to determine the fitness and suitability of each individual to work at the home. For example satisfactory references and checks in relation to previous employment history were not consistently obtained. Some but not all candidates had been interviewed prior to being employed at the home. Staff training files did not evidence that staff had undertaken training in relation to their roles and meeting the needs of the people living at the home. There was insufficient evidence that all staff had undertaken mandatory training such as training in safe moving and handling of people and there was no evidence that staff had received specialist training relevant to the needs of the people living at the home such as training in relation to dealing with aggression, managing diabetes and illnesses associated with the ageing process. Where staff who had no prior care experience were employed at the home there was no evidence that they had received appropriate training or support in relation to being able to fulfil their roles according to the job description and meeting the needs of the people living at the home. An Immediate Requirement notice was issued in respect of the concerns raised about the recruitment and training of staff working at the home. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 The home is not managed in a manner which best meets the needs of the people who live there. EVIDENCE: There have been a number of changes in respect of the organisational and local management structures within the home. The registered manager had moved to manage another home within the organisation since the previous inspection. A new acting manager had been appointed shortly before the time of this inspection. The issues as identified within this report were discussed with the acting manager and the organisations operations manager for the region who undertook to support the new manager in affecting the necessary changes Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 20 needed to meet the regulatory requirements which have been outstanding over a number of inspections. An immediate Requirement notice was issued in relation to the concerns raised about the recruitment, training and support of staff and the protection of the people who live at the home from harm or abuse. The seriousness of the situation was made clear as were the intentions of the Commission to begin enforcement action should substantial improvements to the provision of services not be implemented forthwith. Records in respect of the maintenance of fire, gas, electric and mechanical equipment in the home were kept accurate and up to date. Records in relation to fire safety drill for staff were not sufficiently detailed and did not evidence that all staff, including staff who cover bight duties had received appropriate training or information in respect of how best to act in the event of an outbreak of fire in the home. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 2 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 2 X X X 2 Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 22 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 OP1 Regulation 4, 5 & 6 Requirement The registered persons must ensure that the information made available to residents in relation to the facilities and services provided is kept up to date & accurate. The registered persons must ensure that persons are only admitted to the home following a detailed assessment of their care and general needs have been carried out and taking into consideration the needs of the people already living at the home it is determined that the home can meet the needs of each individual. (Previous timescales following the last five inspections have not been met.) The registered persons must ensure that plans in relation to the care and treatment required by people living at the home are clear, up to date and accurate and that they are evaluated and reviewed on a regular basis and when residents care needs or treatment changes. DS0000018098.V260176.R01.S.doc Timescale for action 30/03/06 2 OP4OP3 14 28/02/06 3 OP7 15 30/03/06 Mundy House Care Centre Version 5.0 Page 23 4 OP8 13(4)(5) (6) (Previous timescales following the last five inspections have not been met.) The registered persons must ensure that risks to resident’s health, safety and welfare are identified and managed so as to minimise the impact on residents. (Previous timescales following the last five inspections have not been met.) The registered persons must ensure that staff act in accordance with the information in respect of the care and welfare and to promote choice and independence of residents living at the home. The registered person must ensure that suitable activities and stimulation is available which meets the needs of the people living at the home. (Previous timescales following the last inspection has not been met.) The registered persons must ensure that people who require assistance in relation to their nutrition needs are supported in an appropriate manner, which meets their needs. The registered persons must ensure that all records as required by legislation in relation to complaints made about the service are maintained accurately and made available for inspection upon request. The registered persons must ensure that the people living at the home are so far as it is practicable protected from harm and abuse. DS0000018098.V260176.R01.S.doc 30/03/06 5 OP14OP7 15 30/03/06 6 OP12 16(2)(m) (n) 30/03/06 7 OP15 16(2)(i) 28/02/06 8 OP16 22 28/02/06 9 OP18 13(6) 30/03/06 Mundy House Care Centre Version 5.0 Page 24 10 OP26 16(2) (k) 11 OP27 18 (Previous timescales following the last inspection has not been met.) The registered persons must ensure that the home is so far as it is practicable maintained free from unpleasant odours. The registered persons must ensure that there are appropriate numbers of competent, skilled people employed at the home so as to meet the needs of the people living there. This with reference to duties being fully staffed and the deployment of staff who may be limited in their abilities to carry out care tasks. 28/02/06 28/02/06 12 OP29 19&sch.2 &4 (Previous timescales following the last inspection has not been met.) The registered persons must 30/03/06 ensure that people are only employed at the home after all the relevant checks are carried out in respect of their fitness and suitability to work at the home. (Previous timescales following the last inspection has not been met.) The registered persons must ensure that staff working at the home receive the training and support they need so as to fulfil their roles according to their job descriptions and meeting the needs of the people who live at the home. (Previous timescales following the last inspection has not been met.) The registered persons must ensure that the home is DS0000018098.V260176.R01.S.doc 13 OP30 18(1) (c) 30/03/06 14 OP32OP31 4&8 30/04/06 Page 25 Mundy House Care Centre Version 5.0 managed in a manner, which is in the best interests of the people who live there. (Previous timescales following the last inspection has not been met.) The registered persons must ensure that all staff are aware and trained so as to act appropriately and safely in the event of an outbreak of fire at the home. 15 OP38 23(4)(a) (b)(c)&(d) 15/03/06 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 OP11 Good Practice Recommendations It is recommended that wherever it is practicable that resident’s wishes in respect of end of life issues and preferred arrangements following death be obtained, recorded and kept under review. Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Mundy House Care Centre DS0000018098.V260176.R01.S.doc Version 5.0 Page 27 - 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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