Inspection on 28/06/06 for Mundy House Care Centre

This inspection was carried out on 28th June 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 02/02/06

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 08:00 28th June 2006 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.V292499.R01.S.doc Version 5.1 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.V292499.R01.S.doc Version 5.1 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 Manager post vacant 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.V292499.R01.S.doc Version 5.1 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. 2nd February 2006 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.V292499.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on 28th June 2006 between the hours of 08.00 and 21.15. Carolyn Delaney, lead inspector and Michelle Love, inspector for the home, carried out the inspection. Records including care plans and assessments in respect of residents’ needs and risks to health, safety and welfare were examined. Four residents and three relatives were spoken with during the course of the inspection. A number of residents were spoken with during the course of this inspection. A number of ‘Have your say about..’ questionnaires were sent to the home prior to the inspection so as to obtain residents views. Six were returned. The relatives of twenty-four residents living at the home were contacted by post prior to the inspection visit. Two of these contacted the inspector by telephone and ten surveys were returned by post. A summary of the comments made has been included throughout the report. Seven members of staff were spoken with during the course of this inspection so as to determine their awareness of the needs and wishes of the people living at the home and the homes policies and procedures. The records in respect of the maintenance of the premises and equipment were examined. All Key Standards as identified in the intended outcomes sections of this report have been inspected during this Key Inspection as they must be inspected at least once every twelve months. Where other standards have not been inspected on this occasion they will have been inspected at the previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. What the service does well: Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 6 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. The majority of those people who made comment about the home were generally overall happy with the home. Staff interact well with residents and generally offer support in a caring and sensitive manner. What has improved since the last inspection? What they could do better: Four of the ten relatives / friends who returned surveys commented on areas where they felt that staff could do better. These included comments made about staff’s lack of awareness of in respect of the importance of hearing aids, comments made that staff could do more to stimulate people who have eyesight and hearing problems so as to prevent them from feeling isolated and one comment made about the lack of choice of food. There were a number of areas identified at the time of this inspection, which must be addressed. The acting manager must ensure that people are only admitted to the home once a detailed assessment has been carried out and that there is sufficient Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 7 information recorded about each residents care and safety needs so as to ensure that all staff working at the home provide care and support in an effective manner. There must always be staff on duty who are trained and competent to administer medicines to residents should they need them. Staff should act more quickly to assist those residents who due to confusion may remove clothing inappropriately. Staff should ensure that resident’s wishes are considered when planning and delivering care and residents should be offered more choices about how care and support is provided. For example there should be greater choice regarding the drinks made available and staff should not make decisions about what is provided without first consulting with residents. There could also be more choices available in meals and how food is cooked. Staff must ensure that residents are offered meal portions, which are suited to their appetite. The homes acting manager must not employ people to work at the home until all of the checks regarding the persons fitness to work caring for older people have been carried, such as obtaining satisfactory references, carrying out Criminal Records Bureau (CRB) checks and interviewing staff. All staff who are employed who have no prior care experience must be trained and inducted so as to ensure that care provided to residents is not compromised. All staff must receive training and support to enable them to best care for the people living at the home. A number of these issues have not been addressed from previous inspections. It is hoped that the new management structure at the home will take appropriate action to address 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.V292499.R01.S.doc Version 5.1 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.V292499.R01.S.doc Version 5.1 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, 5 & 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information provided to people loving at the home and their representatives is not accurate. Staff do generally, but not consistently ensure that assessments are carried out in respect of persons care needs before they are offered a place at the home so as to determine that, taking into account the needs of the other people in the home and the resources available that the home will be able to meet the persons needs. Prospective residents and / or their families are offered the opportunity to visit the home prior to a person moving in. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 10 EVIDENCE: A copy of the homes statement of purpose and service users guide was assessed. It was positive to note that this had been updated in light of the recent changes in the ownership of the home. However a number of points were identified within these documents which were not evident in practice within the home. For example it stated in the documents that people who were admitted to the home would receive in writing confirmation that following the assessment carried out by staff that the home could meet their specific care needs. At the time of this inspection this was not evident. It was also noted tat while these documents had been updated that they were not readily available to residents and that residents in the home still had copies information relating to the homes former owners, Ashbourne Healthcare. Since the previous inspection the company had appointed an acting manager and care manager. Both have worked very hard so as to implement changes in practices at the home. There were improvements noted in the way in which assessments in respect of prospective residents needs are carried out so as to ensure that where people are offered a place at the home. However it was noted that there was no pre - admission documentation available for one resident who had been admitted to the home. There have been issues identified regarding the assessment of peoples needs prior to them being offered a place at the home for a considerable length of time and the regulatory requirements in relation to assessing peoples needs before they are offered a place or admitted to the home have not been addressed following the last six inspections. In light of this an Immediate Requirement notice was issued. The organisations operations manager challenged this due to the fact that the acting manager and care manager had not been in post when this person was admitted to the home. However the person in question had been admitted to the home shortly after the last inspection when the same issues had been identified and the importance of evidencing that the home carries out an assessment of a persons needs before they are offered a place at the home had been discussed. In general prospective residents do not, due to physical conditions or hospital placements etc, have the opportunity to visit the home prior to making a decision to move in. However this opportunity is offered and where prospective residents cannot make a visit to the home their relatives or representatives may do so on their behalf. Mundy House provides Intermediate care for up to 9 people who may need accommodation for a period of time whilst awaiting a more permanent placement or arrangements to allow them to move back into their own homes. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 11 Of the six residents who completed the survey forms sent to them four said that they had received enough information about the home before moving in and that they had received a contract, one said that they had not and one said they did not know. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 12 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, 9, & 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Information recorded about each person care and welfare, including safety and wellbeing needs are not recorded in sufficient detail so as to ensure that all staff act in a proper and consistent manner. Staff generally ensure that the people who live at the home receive the medicines, which have been prescribed for them. Staff do not always act promptly to maintain residents dignity EVIDENCE: Of the eleven care plans which were assessed as part of the inspection process. Of these only one plan was sufficiently detailed so as to ensure that staff would be aware of the residents care, safety and general needs and preferences. The information recorded in other care plans and risk assessments varied in terms of content and accuracy. Some records staff had ticked boxes in respect of care needs without adding any other information pertinent to the specific and individual care of the person. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 13 Many care plans contained inaccurate information about the individual and some did not include any information about the persons needs. An example of this was the plan for a resident who refused to be moved using the correct moving equipment and staff confirmed this to be so. This person’s plan did not include any information about how best to assist them whilst protecting staff working at the home. It is further noted with concern that this particular resident had made an allegation that she had been hurt when staff moved her. Following this the care plans and risk assessments had not been updated. Resident’s weights are not consistently monitored according to the care plans and records maintained in respect of daily life are not consistently maintained. An Immediate Requirement notice was issued in respect of the issues raised regarding the planning and review of care. Of the six residents who completed the survey forms sent to them all six said that they receive the support that they need, three said that staff usually listen to them and act on what they say. One relative who contacted the Commission by telephone said that in general they were very happy with the home, however that staff could pay more attention to ensuring that residents wore their hearing aids and spectacles. They also felt that staff working at the home did not always seem to appreciate the impact on residents not having these devices had and suggested that this was a training issue. There have been improvements made since the last inspection with regards to the administration of medicines at the home. The care manager has reviewed the practices for recording medicines on the Medication Administration Records (MAR) and had implemented measures to minimise the risk of staff error. For example the number of tablets to be administered is now being written rather than being recorded numerically. It was positive to note that MAR were generally signed in a consistent manner when medicines have been administered. However staff do not consistently record when topical medicines such as creams and eye drops are administered. The way in which some medicines have been recorded on MAR by the homes pharmacy supplier (BOOTS) needs to be addressed. For example some medicines were prescribed on the MAR to be administered ‘as directed’. This is not acceptable as it is not clear how the medicine is to be administered. The containers used for storing medicines, which are to be returned to the pharmacist for disposal, are also not satisfactory as medicines can be removed from them. Advice regarding this was sent to the homes operations manager following the last inspection. It was also noted when assessing the duty rotas (after the site visit) that there were occasions when there was no senior member of staff on duty at night. While on one occasion the senior on duty for the late duty prior to the night administered the night medicines, there was no one on duty during the night Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 14 to administer medicines which have been prescribed on an ‘as required’ basis such as painkillers. During the day staff were seen to act and treat residents in a respectful manner and to promote dignity and maintain privacy. However towards the end of the inspection a resident was observed to be in a state of undress close to the managers office and staff did not act promptly to move this person so as to maintain their dignity. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 15 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The routines in the home and the provision of activities appear to be for the most part satisfactory. However more could be done so as to provide more choices to people living at the home in respect of daily activities such as at mealtimes and when providing care in relation to personal care and continence needs. EVIDENCE: It was very positive to note the changes in the way that staff interacted with the residents in the home. Staff were seen throughout the day to be providing stimulation and a range of activities including exercises with a large ball, noughts & crosses, music and a quizzes. Residents were also enjoying the warm weather in the courtyard garden, which had been planted with flowers and plants by staff and residents. Residents appeared to enjoy the range of activities and many appeared animated and happy. Records maintained in respect of activities provided could be better maintained. Of the six residents who completed the survey forms sent to them one said that activities were limited due to their visual impairment, two said that usually there were activities, which they could Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 16 participate in, and three said that there were always activities which they could participate in. Staff were seen to support residents in a sensitive manner and the routines of the home appeared to be flexible. However there are a number of areas where residents could be offered the opportunity to exercise choice. For example a number of care plans for people who are incontinent referred to ‘two hour toileting’ without reference to the residents needs. It was noted in the Primrose lounge area where the more dependant residents were seated that cold drinks were not readily available on the day of the inspection, which was a very hot day. There was no choice of hot drink available, only tea, at midmorning and afternoon as staff had taken the decision to provide cold drinks without offering a choice . The serving of breakfast and lunchtime meal was observed. During both meals staff were observed to support and assist residents according to their needs and that plate guards etc were provided as required. Both mealtimes were noted to be unrushed. A menu was available with details of choices for the day’s meals. The serving of the lunchtime meal was observed. It was disappointing to note that the pork was cooked in gravy which some residents said they did not like and that the portion of meat provided in the meal was very small. Staff did not offer residents second portions of the meal. Residents who were spoken with during the day generally were satisfied with the food provided by the home and of the six residents who completed the survey forms sent to them one said that they were sometimes happy with the meals, one said that they were always happy and the remaining four said that they were usually happy with the meals at the home. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 17 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Of the six residents who completed the survey forms sent to them one said that they always knew whom to contact if they were not happy and the remainder said that they usually knew. One person commented that it was sometimes difficult to make themselves understood when trying to communicate with staff. Records maintained in relation to a recent complaint made were fairly well maintained. This was still being investigated at the time of the inspection. Records in respect of staff training regarding the protection of vulnerable adults were not up to date and did not evidence that all staff have this training. However staff who were spoken with on the day of the inspection did have an understanding of how to protect the people living at the home. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mundy House provides a homely and safe environment. The home is clean and generally maintained free from unpleasant odours. EVIDENCE: Of the six residents who completed the survey forms sent to them two said that the home was always clean and fresh and the remaining people said that the home was usually was. There are a number of communal areas, which residents can access. All areas including gardens and residents bedrooms, which were viewed, were well maintained and clean Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 19 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staffing levels are not sufficient at times for the needs of the people living at the home. Staff are not recruited in a robust manner with all of the required checks in respect of a persons fitness and suitability to work in the home having been carried out before they start work at the home. Staff are not trained and supported so as to ensure that they can provide care and support to people living at the home in a safe manner. EVIDENCE: Of the six residents who completed the survey forms sent to them four said that staff were always available when they need them and two said staff were usually available. It was not clear that when staff are absent due to sickness or planned leave that every effort is taken including the use of agency staff so as to ensure that the shift is covered. As stated before there appeared to be a number of night duties between 26th June and 9th July where there was no senior care cover for the night shift. As senior care staff are responsible for the administration and Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 20 other staff have not received training it was unclear as to what would happen if people living at the home needed medication. There were also a number of times where the hours worked by staff are unclear particularly during the weekends. Five of the ten relatives / friends who responded felt that there were not always enough staff on duty and two commented that staffing levels were not adequate at weekends. There was evidence that staff are still not being employed to work at the home according to a robust and consistent procedure. A number of people who have been employed have no prior care experience and there was no evidence that this had been considered and an appropriate plan implemented with supervision and mentorship so as to ensure that this did not impact negatively upon the care provided by the home. Staff recruitment files did not provide evidence that references had been validated so as to determine that they had come from candidate’s previous employer and not friends etc. Where there was evidence that candidates had been employed in places where they had failed to provide in their work histories this was not explored and in one instance a reference was obtained from an employer where the candidate had not indicated this person had employed them. At the time of the inspection it was of concern to note that some people had been employed to work at the home prior to them undertaking mandatory training such as moving & handling training. The records available did not evidence that all staff working at the home were trained in respect of the roles they are to perform. However there was evidence that the homes deputy manager was implementing a training plan for all staff so as to address this. It was further concerning to note that a resident had complained about the manner in which they were handled and alleged that staff had hurt them. An Immediate Requirement notice was issued in respect of the issues, which have been outstanding for a considerable length of time and must be addressed so as to avoid further action being taken. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 21 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While there have been some improvements in the management and the level of service provided by the home there are still a significant number of areas where improvement must be achieved and maintained so as to best meet the needs and protect the people living at the home. EVIDENCE: Mundy House has not had a permanent manager in post for some considerable time. An acting manager had been appointed at the time of the previous inspection but had left the homes employment shortly after. The current acting manager has been in post at the home for a short period of time during which there have been a number of very positive changes in terms Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 22 of the quality of life and overall ethos of the home. A number of members of staff who did not work in accordance with the homes policies and procedures so as to best serve the interests of the people living at the home have left the homes employment. Staff who were spoken with commented very positively about the positive changes, which have been implemented since the employment of the current acting manager and care manager. However there are still a number of issues, which need to be addressed. There are robust systems in place to safeguard monies held (at their request) by the home on behalf of the people who live there and records are well maintained so as to minimise the risk of mishandling of residents monies. Records in respect of staff supervision were generally well maintained and there was evidence that staff receive regular supervision. It was noted that where one member of staff had received a supervision session following an incident at the home that no training or development needs had been identified and that no objectives had been set so as to prevent this occurring again. There were no health and safety issues observed in respect of the premises or equipment. One of the organisations estates managers visited the home on the day of the inspection and there was evidence of regular auditing in respect of maintenance and repair of gas, electrical, fire and mechanical systems and equipment at the home. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 23 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 2 2 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 1 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 3 Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 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 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. This is a repeat requirement & the previous set timescale for action of 30/03/06 has not been met. 2. OP2 5(1)(b) The registered persons must ensure that there is a contract in place for each individual living at the home in accordance with Regulation. 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. DS0000018098.V292499.R01.S.doc Timescale for action 30/07/06 30/08/06 3. OP3 14 30/06/06 Mundy House Care Centre Version 5.1 Page 25 (Previous timescales following the last six inspections including the most recent timescale of 28/02/06 have not been met.) An Immediate Requirement Notice has been issued. 4. OP7 15 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. (Previous timescales following the last five inspections, including the timescale of 30/03/06 have not been met.) An Immediate Requirement Notice has been issued. 5. OP8 13(4)(5) (6) 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, including the timescale of 30/03/06 have not been met.) An Immediate Requirement Notice has been issued. 6. OP9 13(2) The registered persons must 30/08/06 ensure that appropriately trained staff are available at the home at all times to administer medicines to people if required. The registered persons must 30/08/06 DS0000018098.V292499.R01.S.doc Version 5.1 Page 26 30/06/06 30/06/06 7. OP14 15 Mundy House Care Centre 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. 8. OP15 16(2)(i) The registered persons must ensure that people the food provided by the home is provided in suitable quantities and served in a manner, which meets peoples needs and expectations. The registered persons must ensure that the people living at the home are so far as it is practicable protected from harm and abuse. (Previous timescales following the last two inspections including the timescale of 30/03/06 has not been met.) 10. OP27 18 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. (Previous timescale following the last two inspections, including the timescale of 28/02/06 has not been met.) 11. OP29 19&sch.2 &4 The registered persons must 30/08/06 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 Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 27 30/08/06 9. OP18 13(6) 30/08/06 30/07/06 the last two inspections including the most recent timescale of 30/03/06 has not been met.) An Immediate Requirement Notice has been issued. 12. OP30 18(1) (c) 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 including the recent timescale of 30/03/06 have not been met.) An Immediate Requirement Notice has been issued. 123. OP31 4&8 The registered persons must ensure that the home is managed in a manner, which is in the best interests of the people who live there. (Previous timescales following the last two inspections including the most recent timescale of 30/04/06 has not been met.) 30/08/06 30/08/06 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 OP9 Good Practice Recommendations The registered persons should contact their pharmacy providers and arrange for suitable containers for the DS0000018098.V292499.R01.S.doc Version 5.1 Page 28 Mundy House Care Centre 2. 3. 3. OP9 OP10 OP11 storage of medicines to be disposed of / returned to the pharmacy. There should be a system in place so as to ensure that staff signs for topical creams and eye drops when they are administered. Staff should do more so as to promote resident’s privacy and dignity. 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. This standard was not assessed at the time of this inspection. 4. OP36 Where supervision of staff identifies training or development needs this should be recorded with evidence of what actions have been taken to address these needs. Mundy House Care Centre DS0000018098.V292499.R01.S.doc Version 5.1 Page 29 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. 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