Inspection on 06/01/07 for Mundy House Care Centre

This inspection was carried out on 6th January 2007.

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 28/06/06

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 09:00 6th & 22 January 2007 nd 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.V329440.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 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.V329440.R01.S.doc Version 5.2 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 www.southerncrosshealthcare.co.uk 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.V329440.R01.S.doc Version 5.2 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. 28th June 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. The range of fees for accommodation is £426.09 - £ 500.00 per week. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key Inspection carried on 6th & 21st January 2007. Records including assessments, care plans, daily care notes and risk assessment documents in respect of three people living at the home were examined. The relatives of twenty-two 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. Eleven responded. In addition the general practitioners who have patients living at the home were contacted. None responded. A number of residents and relatives who were visiting the home on both days of the inspection were spoken with. Five members of staff including the homes 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 the serving of breakfast, lunch and supper were observed. Each of the Key Standards as identified in the intended outcomes sections of this report have been inspected during this Key Inspection. Other standards, which have not been assessed at this time, may be assessed at the next inspection visit. 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 Below is a brief overview of the findings of the inspection, which are covered more fully throughout the main body of the report. What the service does well: Of the eleven residents relatives who completed surveys eight commented about what they felt that the home does well. One person said that the choice of food had been increased, one person said that people living at the home are ‘well looked after...’ One person said that the home is always clean. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 6 People are only offered a place at the home once a senior member of staff has carried out a detailed assessment of their care needs. There is written information about the home made available to people so that they could make a decision as to whether the home would be suitable for their needs of the person to be admitted. There is ample communal space and the home is well maintained and clean. What has improved since the last inspection? What they could do better: More could be done so as to ensure that the people who are admitted to the home for interim care (while waiting to return home or a permanent placement in a care home) receive care and support which meets their particular needs. The people who live at the home do not always receive the care and support they need. Where a person is at a particular risk such as risk of falls, weight loss etc it is not clear that they are cared for in a way, which minimises these risks. One relative commented that staff ‘should remember that residents were not always the old and infirm people they are today..’ The Commission has raised concerns about the level of care and management of risks to people living at the home at previous inspections. The registered providers have failed to take appropriate action to address these issues and following this inspection the first steps of legal action was initiated with the issue of formal Statutory Requirement Notices. The activities provided by the home are not always suited to the wishes of the people living at the home. During the inspection there was little in the way of activities provided for residents and as observed at previous inspections staff spent very little time engaging in conversation with residents. Some staff carried out care and support without speaking to the resident. A number of resident’s relatives who completed surveys, when asked to comment on what the home could do better said that ‘there were not enough activities’ and residents ‘could have more things to do including trips outside of the home..’ One relative commented that residents should ‘get out more..’ Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 7 Staff are not always employed in sufficient numbers so as to provide the care for the people living at the home. There have been a number of complaints made about the lack of staff working at times and in particular at weekends. Temporary agency staff have not always been considered when there is a shortage of staff at the home. As a result some residents have not received meals and medication at appropriate times. The way in which people are recruited to work at the home must be improved and all of the checks as required by regulation must be carried out before a person is employed at the home so that they people living there are protected and will receive care from people who are suited to work in the care home. Staff must receive training and support for the work they are to perform in the home. The Commission has raised concerns about the failure of the registered provider to ensure that staff working at the home undertake training for the work they are to perform and the needs of the people living in the home. The registered providers have failed to take appropriate action to address these issues and following this inspection the first steps of legal action was initiated with the issue of formal Statutory Requirement Notices. The overall management of the home and staff must be improved so as to provide a safe environment where resident’s needs are met. 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. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 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.V329440.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Mundy House provides detailed information for people who may be looking for a place in a care home. People are only offered a place at the home once an assessment of their care needs has been carried out. EVIDENCE: Each of these six residents and the eleven relatives who completed surveys said that they had received enough information about the home before they moved in so that they could decide if it was the right place for them. Of the six residents who completed ‘Have Your Say About…’ surveys three said that they had received a contract when they moved into the home of the remaining three two said that they were unsure and one said that they had not. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 10 On the second day of the inspection the pre-admission assessments for six people who had been admitted to the home since the last key inspection were assessed. These documents were generally well written and they identified the care needs of the person to be admitted to the home. Southern Cross has a detailed assessment document and for some people sections of this had not been completed. This may be due to the fact that these sections were not applicable to the person, however this was not clearly identified. Since the last key inspection there have been some complaints made by visiting health and social care professionals regarding the lack of staff employed to support those people who have been admitted to the home for a period of rehabilitation. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 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. 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. Resident’s health and care needs are not fully met by the home. Risks to people’s health and safety are not managed so as to minimise the risk of injury to people. EVIDENCE: Each of the six residents who completed surveys said that they always receive the medical support they need and three of the eleven residents relatives who completed surveys said that they felt that the care home always meets the needs of the resident. The remaining eight said that they felt that the home usually did. Five of the eleven residents relatives who completed surveys said that the home always give the support or care to the residents as expected or agreed. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 12 There was a plan of care in place for each of the residents whose care notes were assessed during both days of this key inspection. However it was not always clear from the plan, the specific need of the person and what action staff were to take to support the individual. For example where it was recorded that residents were confused, distressed or aggressive it was not clear as to how staff were to manage this behaviour. A number people living at the home are at risk of falls. Where this has been identified it is not clear as to how staff are to manage the risk so as to minimise the risk of injury. The home has a policy for monitoring people following a fall or accident so as to detect any deterioration in their condition. The care notes for a number of people who has sustained falls or injury were assessed and there was no evidence that staff had monitored the person in line the homes procedures or that any monitoring of a persons condition had been undertaken. Assessments in respect of risks to the health and safety of people living at the home were not revised when the level of risk changed and a Statutory Requirement Notice was issued for the provider’s failure to manage and minimise risks to people living at the home. A number of people living at the home at the time of this inspection had been identified as being at risk of weight loss due to poor appetite. As part of the care for these people it was recorded that their dietary intake was to be monitored and recorded. However staff had failed to do so for a number of residents whose care records were sampled. There was no evidence that where people refused food that alternatives were offered or that food was offered at a later time. For some residents there were days where there were no records in respect of the person’s food intake. On the first day of the inspection residents did not receive their morning medication at the proper time due to staff shortages. Not all staff who administer medication had received training. On the second day of the inspection the medication administration records (MAR) were assessed for a number of people living at the home. These were well maintained. A recent detailed audit had been carried out by one of the organisations operations managers. The issues as identified in the audit had been addressed by the acting manager. The more capable people living at the home looked clean and well cared for. However some people who are dependent upon staff to assist them with personal care and hygiene needs looked unkempt. Some were wearing stained and dirty clothing and had dirty nails and teeth. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 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. 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. Staff practices and the routines within the home are not flexible so as to enable the people who are more capable to be independent while supporting the people who need more care and assistance. EVIDENCE: Five of the six residents who completed ‘Have Your Say About…’ surveys said that staff listens and act on what they say. Two of the six said that there were always activities arranged by the home that they can participate in, two said that there usually were, two said there sometimes were and one said that there never were. Three of the eleven residents who completed surveys said that the home meet the service always meets the different needs of people. Of the remaining eight six said that the home usually does, one said that they did not know and one said that they ‘would like to think so.’ A number of resident’s relatives commented that there were ‘not enough activities..’ that ‘staff do not appear to Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 14 spend time conversing with residents..’ and that there ‘is not enough stimulation..’ During both days of the inspection it was noted that staff did not interact or spend time with residents. Some staff did not engage in any conversation even when carrying out care or providing support to residents such as when supporting residents at mealtimes. At the time of the inspection an activities coordinator was employed at the home for fifteen hours per week. There were some planned activities however staff appeared to be too busy or disinterested in providing opportunities for residents to socialise or participate in activities to keep them occupied and stimulated. There was no evidence that residents had been consulted about the range of activities they would like to participate in and that the activities provided by the home reflected the wishes of residents. Three of the eleven residents relatives who completed surveys said that the home always supports the people who live there to live the life they choose. Of the remaining eight, six said that the home usually does and the remaining two said that the home sometimes does. There was little evidence during both days of the inspection that residents were offered any choice in how they receive their care or spend their days. The routines within the home were noted to be rigid and did not reflect the needs or wishes of the people living at the home. For example at meal times some people are left sitting at dining tables for up to forty minutes waiting for their meals. It was then noted that when the meal was served to these residents that staff proceeded to move other residents to the tables, disturbing those who had just commenced their meal. Each of the eleven residents relatives who completed surveys said that where it was appropriate that the home helped their friends or relatives who are residents at the home to keep in touch. Eight of these people said that they were always kept up to date with important issues affecting their friends of relative. Of the remaining three who said that the home usually did, one commented that when key workers are changed that they were not informed. Four of the six residents who completed survey questionnaires said that they always like the meals at the home, one of the six commented that ‘meals are always tasty and a nice size.’ Of the remaining two one said that they usually like the meals and one said that they sometimes do. One resident’s relative said that ‘the choice of food has been increased’ and that residents enjoyed the introduction of yoghurts, crisps and other snacks to the menu. During both days of the inspection the meals served were noted to be well presented and looked appetising. There was a choice of meals and residents who were spoken with indicated that they enjoyed their meal. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Mundy house has a policy and procedure for dealing with complaints however staff do not always act in accordance with the homes policies to ensure that complaints are dealt with effectively. The home and staff are not managed so as to minimise the risk of harm or abuse to residents who live there. EVIDENCE: Each of the six people who completed surveys said that they knew who to speak to if they were not happy. Five of the six said that they knew how to make a complaint. Eight of the eleven residents relatives who completed surveys said that they knew how to make a complaint if they needed to. Six said that the home responded appropriately if they or their relative had raised concerns about the residents care. Of the remaining five, four said that the home usually responded appropriately and the remaining other said that the home sometimes did. There had been two complaints made to the Commission since the last key inspection. Both had been in respect of lack of staff working at the home for the needs of the people living at the home. One complaint had been referred to local social services for investigation under the protection of vulnerable adults. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 16 This resulted in placements onto the interim care unit by social services being stopped for a period of time while Southern Cross dealt with the issues. During the inspection visit of 22/1/07 a residents relative informed the inspectors that they had referred a complaint about the home to social services. The relative said that the spoken with staff about their concerns but that no action had been taken. The acting manager told inspectors that he had not been made aware of the complaint. At the time of writing this report there had been another PoVA alert raised when one resident alleged that staff had acted in an inappropriate way towards them including entering their bedroom without knocking on the door. It is noted that just over half of the staff working at the home had received training in respect of protecting people who may be vulnerable from harm, abuse and neglect. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 17 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. 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 is well maintained and the environment is suited to the needs of the people who live there. EVIDENCE: Mundy house is a purpose built two-storey property. There is ample communal space including three dining rooms and a number of lounge areas. Resident’s bedrooms, which were seen during the inspection, were nicely decorated and some had been personalised with resident’s belongings. Five of the six residents who completed surveys said that the home is always fresh and clean, one said that the usually was. There were some isolated odours detected by one bedroom. This has been an ongoing issue with odours in one particular area of the home. However there were some improvements Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 18 noted on the second day of the inspection and a number of visiting health and social care professionals said that the odour in the home had improved. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 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. 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. The arrangements for recruiting people to work at the home, providing training and the number of staff employed puts residents welfare and safety at risk and impacts upon the quality and level of care and support provided. EVIDENCE: There have been ongoing issues in respect of the staffing levels at Mundy House for some time. At the last key inspection carried out in June 2006 serious shortfalls in the staffing levels were identified. There was little evidence that when staff are absent from work due to illness etc that measures were taken so as to cover duties. At a random inspection carried out on 17th November 2006 staff shortages were noted and an anonymous complaint had been made to the Commission about staff shortages for the weekend of 11th November 2006. On assessing staff rotas for this period it was clear that the home had been short staffed and there was no evidence that any measures had been taken such as the use of agency staff so as to provide cover for the home. In December 2006 a Protection of Vulnerable People alert was raised by social services in respect of concerns they had about the lack of staff working on the homes interim care unit where people who are awaiting a permanent Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 20 placement or a move home are accommodated for up to a period of 6 weeks. As a result of the concerns raised placements on this unit were suspended and were still so at the time of writing this report. This key inspection took place over two dates. On the 6th January 2007 when inspectors arrived at the home at 09.00 there were two members of staff short for the morning duty. The impact upon residents was evident and some residents who had been up since before 8am told inspectors that they had not had a cup of tea. These residents waited until 10 am to have breakfast. Of the six residents who completed ‘Have Your Say About…’ surveys two said that staff were always available when needed, three said that staff usually were and one person did not answer this question. There was also evidence during the visit made to the home on 22nd January 2007 that the home is short staffed on a regular basis and there was no evidence to suggest that measures were taken so as to replace staff who were absent. It was also noted that between 6th & 22nd January that a number of staff were working excessive hours. Two members of staff were noted to be working between 60 and 74 hours per week, which could have an adverse impact upon the welfare of the people living at the home. Despite the issue of an Immediate Requirement notice at the time of the last key inspection improvements in the way in which staff are recruited have not improved significantly and improvements made had not been maintained. The files for four members of staff who had been recently recruited to work at the home were assessed. While there had been some improvements staff were still not being recruited in a robust and consistent manner. Candidates employment histories were not explored for gaps and where references were obtained often these were not from a person’s previous employer. There was information on file for one candidate in respect of an employment agency indicating that they had worked previously for the agency. However there was nothing in this person’s employment history to support this. Checks in respect of persons previous employment and obtaining references from these employers are not consistently checked so as to ensure the suitability of the person to work with older people. (It is noted that there have been no new staff recruited at the home since the new acting manager has taken post.) It was also noted that some staff were recruited to work at the home were not provided with mandatory training before they commenced work in the home. This had been identified at previous key and random inspections. There have been ongoing issues in respect of staff training. A copy of the homes staff training matrix was assessed on 22nd January 2007. From this it was evident that all staff do not receive mandatory training updates in line with the organisations policy for training. For example 78 of staff had Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 21 received moving and handling training, 18 had received health and safety training, 53 had received training in respect of protecting vulnerable people from abuse and 59 had received fire safety training. There was very little in the way of more specialist training for staff working at the home. Only 29 of staff had received training in respect of care planning and 18 of staff had undertaken dementia awareness training. No staff working at the home had received training in respect of nutrition, pressure area care or continence. Three of the eleven residents relatives who completed surveys said that the care staff have the right skills and experience to look after people properly. Five said that staff usually have, one said that they sometimes did and two said that they did not know. One relative commented that sometimes ‘foreign staff can be hard to understand.’ A statutory requirement notice was issued in respect of the failure of the provider to ensure that staff working at the home receive training for the roles they are to perform and the needs of the people living at the home. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Mundy house is not managed in the best interests of the people who live there. EVIDENCE: Mundy House has not had a registered manager in post for two years and a number of people have been employed to manage the home who have only remained in post for a very short period of time. This has had an adverse impact on staff and residents at the home. At the time of this inspection the deputy care manager had applied for and been successfully recruited as acting manager. The acting manager is very enthusiastic and committed to making improvements at the home. However Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 23 due to his inexperience requires support of the organisation so that the longstanding issues in respect of the home can be addressed and managed. It was noted that there was no administrative support for the acting manager on Mondays and Fridays. This meant that on these days a lot of time was spent dealing with telephone calls and other administrative work, which detracted from dealing with management issues at the home. The organisations operations manager undertook to address this issue. The Commission receives regular reports in respect of the visits made to the home by the operations manager in accordance with Regulation 26 of the Care Homes Regulations 2001. There was evidence that audits had been carried out in November 2006 in respect of documentation, including care plans and risk assessments, management and activities. It was noted that these audits referred only to the presence of documents etc and there was no indication as to the quality or accuracy of the information recorded. The results of the audits therefore do not reflect accurately the way in which the home has been managed. The arrangements for holding monies on behalf of residents at the home were assessed. Receipts and records were not maintained up to date and it was difficult to assess when monies had been spent. Records had not been audited for some months so as to monitor and minimise the risk of mishandling. There was evidence available during the inspection visit that some but not all staff working at the home receive supervision. The home employs maintenance staff to assess, maintain and repair or replace furniture, fixtures and equipment at the home. Regular checks are carried out in respect fire; gas, electrical and mechanical equipment and systems in the home and records were well maintained. The home has policies and procedures for dealing with and storing materials, which may be hazardous to a person’s health. It is the homes policy that these materials including cleaning products should be stored in a locked space. However it was noted during the second day of the inspection that the room where these materials were stored was left open. No other health and safety issues were identified during the inspection. Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 24 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 3 X 3 X X 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 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 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 2 X 2 Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15(2) (c) Requirement Plans in respect of the care, support and treatment to be provided to residents must be revised at any time this care, support or treatment is changed. (Previous timescales following the last six inspections, including the timescale of 30/03/06, 30/06/06 & 30/01/07 have not been met.) Timescale for action 30/05/07 2. OP8 13(4)(5) (6) So far as it is practicable the risks to the health, safety and welfare of people who live at the home must be assessed and managed so as to minimise injury or harm. (Previous timescales following the last six inspections, including the timescales of 30/03/06, 30/06/06 & 30/01/07 have not been met.) A Statutory Requirement 20/04/07 Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 26 Notice has been issued in respect of the registered providers failure to ensure that risks to the health, welfare and safety of people living at the home are managed and minimised. 3. OP9 13(2) All staff who administer medication must be trained and competent to do so safely. The people living at the home must be consulted about their wishes for recreation and social interests and arrange a programme of activities taking into consideration the wishes of residents. 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 three inspections including the timescales of 30/03/06, 30/08/06 & 30/12/06 have not been met.) 30/04/07 4. OP12 16(2) (m) (n) 30/06/07 5. OP18 13(6) 30/05/07 6. OP27 18 Staff must be employed in sufficient numbers to meet the needs of the people who live at the home. (Previous timescale following the last four inspections, including the timescale of 28/02/06,30/07/06 & 30/12/06 have not been met.) 30/05/07 Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 27 7. OP29 19&sch.2 &4 People must only be employed at 30/05/07 the home once all of the checks as required by regulation have been carried out so as to ensure that they are fit and suitable to care for older people. (Previous timescales following the last four inspections including the most recent timescale of 30/03/06,30/08/06 & 30/12/06 have not been met.) 8. 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 inspections including the recent timescales of 30/03/06, 30/08/06 & 10/01/07 have not been met.) A Statutory Requirement Notice has been issued in respect of the registered providers failure to ensure that staff working at the home are provided with training appropriate for the work they are to perform. 22/06/07 Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 28 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 OP6 Good Practice Recommendations The provision of care for people admitted to the home for interim care should be reviewed so as to ensure the delivery of care and support is suited to their particular needs. More could be done so as to ensure that people who are dependent upon staff for their personal care and hygiene needs have these needs met. The routines of the home and staff practices should be reviewed so as to ensure that residents can live their lives in an as independent and fulfilling manner as possible. Records in respect of the monies held on behalf of residents and any financial transactions should be audited on a regular basis and maintained accurately so as to minimise the risks of mishandling. All care staff working at the home should receive regular supervision. All staff should follow the homes policies and procedures in respect of the safe storage of substances, which may be hazardous to health. 2. 3. 4. OP10 OP14 OP35 5. 6. OP36 OP38 Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Mundy House Care Centre DS0000018098.V329440.R01.S.doc Version 5.2 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!