Care Home: Mondial

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What the care home does well People spoken with are happy living at Mondial and made positive comments about their lifestyle and how they are supported. Some of these comments are reflected throughout the report. The service treats people as individuals, getting to know their needs, wishes and hopes for the future and developing care plans that meet these needs in a person centred way. The competent and experienced small staff team know people well. The culture of the home encourages and promotes people`s independence. People are supported to develop and maintain skills to cope with daily living and to be as independent as possible. People`s healthcare needs are well met, including their specific needs around mental health, and ensures they are supported to access relevant health care professionals. The environment is bright, clean and well maintained and people told us they like living there. The service provides opportunities for people to take part in a range of activities and leisure pursuits of their choosing. Staff encourage and support people to take part so that their lifestyle is enhanced. The manager and staff deal with concerns and complaints promptly and thoroughly. Minor concerns are addressed when they arise so that they do not escalate and become a greater problem. This ensures people`s mental health and emotional welfare is promoted. The service is well managed and there is a robust quality assurance process in place that demonstrates the home is managed in the interests of the people who live there. What has improved since the last inspection? The one statutory requirements and all the good practice recommendations made at the last inspection have been acted upon in the interests of people who live in the home. The staff team should be complimented on the efforts that they have made to implement these significant improvements. Since the last inspection care plans and risk assessments have been developed further and now contain better details of people`s needs, wishes and aspirations. In the past year people living in Mondial have been encouraged to take more responsibility for the day to day running of the home such as cooking, shopping and laundry. Since the last inspection there has been some redecoration and refurbishment of the environment. In particular double glazed windows have been installed throughout the home and some individual rooms have been re-decorated. The back garden has been landscaped to a high standard and the new patio area is enjoyed by the people living in the home. There have been improvements in the training programme in place which ensures staff`s skills are updated and people living in the home can be confident their needs are met by staff who have the skills and knowledge to provide the support they need. What the care home could do better: The service should continue with the ongoing programme to develop and improve record keeping. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Mondial 3 Old Road Clacton On Sea Essex CO15 1HX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ray Finney     Date: 2 5 0 9 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Mondial 3 Old Road Clacton On Sea Essex CO15 1HX 01255420995 F/P01255420995 Mondial3oldroad@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Robert Clarkson care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following categories of registration: Care Home - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD. Mental Disorder - Code MD. the maximum number of service users that can be accommodated is: 3. Date of last inspection Brief description of the care home Mondial provides a service for three people with learning disabilities or mental health conditions. It is situated in Clacton on Sea, close to a large supermarket and a few minutes walk from the town centre shops and amenities. The seafront promenade is also within walking distance of the home. Mondial is a detached bungalow with three single bedrooms, all with en-suite toilets. Communal areas include a bathroom, Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 3 3 2 3 0 9 2 0 0 8 Brief description of the care home kitchen, lounge and conservatory. There is a laundry room upstairs and a room for staff. A large garden is situated to the back of the house and the small front garden has off road parking. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as care plans, rotas, menus and personnel files. The manager completed an Annual Quality Assurance Assessment, which services are legally required to submit, with information about the home and sent it to us at the Commission when requested. Throughout the report this document will be referred to as the AQAA. Completed surveys were received from people living in the home, relatives, members of staff and a visiting health care professional. A visit to the home took place on 25th September 2009 and included a tour of the premises, discussions with people living in the home and members of staff. Observations of how members of staff interact and communicate with people living in the home have also been taken into account. Care Homes for Adults (18-65 years) Page 6 of 30 On the day of the inspection we were given every assistance from the assistant manager and the other member of staff on duty. What the care home does well: What has improved since the last inspection? The one statutory requirements and all the good practice recommendations made at the last inspection have been acted upon in the interests of people who live in the home. The staff team should be complimented on the efforts that they have made to implement these significant improvements. Since the last inspection care plans and risk assessments have been developed further and now contain better details of peoples needs, wishes and aspirations. In the past year people living in Mondial have been encouraged to take more responsibility for the day to day running of the home such as cooking, shopping and laundry. Since the last inspection there has been some redecoration and refurbishment of the environment. In particular double glazed windows have been installed throughout the home and some individual rooms have been re-decorated. The back garden has been landscaped to a high standard and the new patio area is Care Homes for Adults (18-65 years) Page 8 of 30 enjoyed by the people living in the home. There have been improvements in the training programme in place which ensures staffs skills are updated and people living in the home can be confident their needs are met by staff who have the skills and knowledge to provide the support they need. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People choosing to live at Mondial can be confident they understand what the service provides and that their needs will be met. Evidence: The manager told us in the AQAA, service users have their own copy of the Service User Guide, Statement of Purpose and contract and Individuals needs are assessed and reviewed regularly to ensure that Mondial continues to provide a service that is appropriate to them. They also told us, We provide a home that is small enough to be flexible to an individuals changing needs. There are only two people currently living in the home and we examined both files. They each contained a copy of the Service User Guide and the Statement of Purpose. These documents are clearly written and provide the information people need to understand what the service provides and what is expected of people living there. There have been no new admissions since the last inspection but there is one vacancy. There is a process in place to assess the needs of anyone wishing to move in to the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: home. We discussed this at length with the assistant manager who demonstrated a good awareness of the importance of having a good assessment process. She explained that not only do they need to meet the needs of any prospective resident but that the person must also fit in with the others living in the home. This is particularly important because of the size of the home; with only two residents currently living there another person will change the dynamics of the home. A person living in the home who completed a questionnaire told us, I would like a third person to come and live in the house. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are confident that their needs are met in ways that they want. Evidence: The manager told us in the AQAA, Staff have attended care planning training and care plans are reviewed regularly and updated as necessary. Since the last inspection staff have put considerable effort into developing the care plans. Each person has their own copy of their care plan. These are clearly written from the perspective of the person. There is good background information that gives a picture of the person as an individual. There is ample detail of the persons physical needs, their likes and dislikes and their wishes for the future. The manager told us in the AQAA, Service users do not have choices made for them. They are encouraged to choose their own activities and friends (with support if needed). The home is flexible to their wants and needs and service users are Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: encouraged to be as involved as they want to be when decisions are made and Service users have their own possessions and choose their own clothes, meals, furnishings etc. It was evident from our observations throughout the day that people living in the home are listened to and encouraged to make decisions, choices and express opinions. One persons records stated, I am a member of the Advocacy Service Speakeasy Group. The manager told us in the AQAA, We have introduced a suggestion book. We talked at length throughout the inspection to the people living in the home. They confidently told us about their choices and how staff support them. Individual records examined contained risk assessments relevant to the individual including risk assessments relating to epilepsy and behaviour. Through discussions the assistant manager explained that they are currently working on updating all the risk assessments and identifying any other areas they may need to cover. She demonstrated a good awareness of the importance of carrying out thorough risk assessments, particularly as the people living in the home are able to go out independently. Promoting independence is valued and risk assessments are in place to enable people to do things more safely and do not restrict what people can do. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Mondial enjoy a lifestyle that meets their wishes. Evidence: The manager told us in the AQAA, We support and encourage service users to be involved in various leisure and community activities and access local groups that they wish to be part of and The manager told us in the AQAA, We have had a holiday and arranged visits and activities that the service users have wanted to do. One person has stated in their care plan, I am happy going to the occupational workshop. I dont want to go to college as I have already done the courses that are offered to me many times. On the day of the inspection this person was out at the occupational workshop and on their return told us that they enjoyed going there. They told us they enjoyed how they spend their time and they are pretty easy going. Another care plan records that the person stated, I dont want to get a job. I dont Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: want to go to college. These choices have been given to me and I have refused. They told us, I like being at home. I want to stay at home and watch the television and chat with whoever is here. I like going on the trips that we do here and I enjoyed our holiday. Another person told us, I enjoy trips and outings. A person living in the home who completed a questionnaire told us, We went to the zoo and a holiday in Caister and another person said, I am happy. Community links for the people living at Mondial are good. One person spoken with told us what they liked to do locally and how they independently go out into the town. On the day of the inspection we observed the people who live there going out and about. One person went out and on their return told us they had gone to their favourite cafe on the seafront and had some refreshments. Care plans examined confirmed that people use a range of local facilities including Dorson House drop in centre, the local bookmakers shop, church and meet friends at local cafes. Through evidence recorded in the care plans and discussions with the people living in Mondial, it is evident that they enjoy a fulfilling lifestyle and choose how they spend their time. One persons care record states, We have many interests in common, especially football which we watch together when it is on the TV. The manager told us in the AQAA, The families and friends of service users are always welcome at Mondial and service users are given privacy during visits and Service users maintain friendships and family inks. They are active people who are members of community groups and enjoy being so. It is evident that people living in the home have good networks of friends and relatives. Staff spoken with told us how they actively encourage and support people to maintain these relationships and family links. One person told us that they have a relative who visits the home and they regularly go to visit their relative as well. The manager told us in the AQAA, Staff encourage discussion on topics which help service users to understand the diversity of their community and this helps promote ideas of equality. Staff spoken with explained that they encourage people to get involved in the daily routines around the home, although this sometimes is on their own terms and they may not choose to help sometimes. One person told us that they had changed their bed linen that morning and helped staff to hang out the washing. People are encouraged to help plan meals, do the shopping and get involved in cooking. The set up around mealtimes is very homely and domestic. Both people living in Mondial are able to discuss what they like and what they want to eat on a daily basis so there is no Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: formal set menu. On the day of the inspection we observed staff discussing with people what they would like for the evening meal and both chose different meals. Daily records of meals show that people have a wide range of home cooked foods, pies, casseroles, salad, sweet and sour chicken with rice, chicken, vegetables, jacket potatoes and desserts such as pudding and custard and fruit. A person living in the home who completed a questionnaire told us that what the home does well is, very friendly and cook some good meals. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Mondial are confident they are supported as they would wish with their personal and healthcare needs. Evidence: The manager told us in the AQAA, The health and happiness of our service users is paramount to what we do here, as service users know their safety and well being always comes first and We pride ourselves on the relationships we have with our service users and this means they are confident that their wishes and views will be listened to and acted upon. Both people currently living in Mondial are capable of managing their personal care independently. The assistant manager explained that on the whole people managed very well with just some encouragement and prompting. Staff spoken with demonstrated a good awareness of peoples skills and abilities as well as what support they needed. Care plans examined document where any prompting may be necessary. One person living in the home has diabetes that is diet controlled. The assistant manager explained how they have encouraged this person to follow a health diet. The Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: person told us that they have lost some weight and are pleased about that. Records of one person with epilepsy confirmed that they are supported to manage the condition appropriately with medication and regular appointments with relevant health care professionals. A health care professional who completed a survey made positive responses to the survey questions and told us that what the service does well is, meeting the needs of the residents. Since the last inspection there have been improvements in the homes systems for the storage, administration and recording of medication. The home has a monitored dose system in place. In particular there have been improvements in the storage of medicines and there is also a new controlled drugs cupboard in place. No one currently manages their own medication. MAR sheets examined were completed appropriately. A relative who completed a survey told us that what the service does well is, administer and monitor the medication very well. [My relative] can be very difficult but they seem able to cope with this. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are confident that any concerns they may have are listened to and acted upon. Evidence: The manager told us in the AQAA, We have a comprehensive and up to date complaints procedure and safeguarding policy. We have received no complaints and We have built up good relationships with service users and their families and are confident that they would tell us if they felt something was wrong. As previously reported there is a robust policy and procedures in place for dealing with concerns and complaints. This is a very small service currently supporting only two people and we observed that both people living in the home are able to talk to staff and make their needs, wishes, likes and dislikes known. We observed that their interactions with staff were good and they were seen to be confident in discussing things with members of staff. The assistant manager explained that all minor concerns on a day to day basis are dealt with as they arise and it was evident from our observations that was happening. There have been no formal complaints recorded by the home since the last inspection and we have not received any concerns or complaints about the service. The manager told us in the AQAA that in the past year, Safeguarding training has led Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: to a new Safeguarding Policy and our complaints procedure has been revised. The small staff team remains as it was at the time of the last inspection. As at that time, staff were able to demonstrate an awareness of their responsibilities around recognising and reporting any signs of abuse. Personnel records confirm that staff have Criminal Record Bureau enhanced disclosures and since the last inspection there has been training around Safeguarding Vulnerable Adults. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy living in a homely environment that meets their needs. Evidence: The manager told us in the AQAA, The home is clean and welcoming and [peoples] rooms are decorated and furnished in the way that they choose and Mondial is a safe, clean, comfortable and inviting home, with large pleasant gardens which service users and their guests have unrestricted access to and The windows have all been replaced with new double glazing, all having the required fire escape hinges and restrictors. A tour of the premises confirmed that Mondial is a homely and comfortable place to live. People benefit from the small, domestic nature of the home and the family atmosphere. The manager told us in the AQAA, Service users are comfortable in their own space and confident that their belongings will not be interfered with and that their privacy is respected and One service user requested his room was decorated and this has been done to his taste. Peoples individual bedrooms are personalised and decorated how they like them. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: There is ample evidence of personal possessions, photographs and things that reflect peoples interests and tastes. The standard of cleanliness throughout the home is high with no unpleasant odours. The laundry room is small but contains all the necessary equipment and facilities to meet the needs of the people living at Mondial. Furnishings, fixtures and fittings are of good quality and are well maintained. Since the last inspection extensive work has been carried out landscaping the back garden and this is now an extremely pleasant area that people living in the home told us they enjoy. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Mondial are confident that staff support them as they would wish, meet their needs and keep them safe. Evidence: The manager told us in the AQAA, Individual service users lead their own lives content in the knowledge that they are supported by well trained staff who genuinely care about them and that they trust and Communication between staff members and between staff and service users is excellent. All three staff at the home have a National Vocational Qualification. One person has now completed NVQ level 2 and the assistant manager is currently doing NVQ level 4. There have been no new staff employed since the last inspection but, as reported at that time, there is a robust recruitment process in place. The assistant manager was able to demonstrate a good awareness of the importance of carrying out appropriate and robust checks when recruiting staff. The manager told us in the AQAA, Training is, as always, our main barrier to improvement. We have always struggled to find good quality yet affordable training for the small number of staff we have but We have made contact with the Essex Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Brokerage Service and are finding we can access some training through them. The assistant manager explained that the small size of the home makes accessing training a challenge as it can be extremely costly. However, they are making good progress with accessing a range of training. The assistant manager has completed a Train the Trainer course for TOPS induction training. Personnel records confirm that people have completed training around Managing Behaviours that Challenge and Care Planning. They have had a two day Health and Safety course that covered Health and Safety, Fire Safety and Infection Control. Other training included Mental Health Medication Administration and Mental Health training, Safeguarding Vulnerable Adults, Protection Management Skills and training around the Mental Capacity Act (MCA). A member of staff who completed a survey told us, Mondial has given us many opportunities this year to expand on our training and knowledge. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Mondial are confident that the service is managed in their best interests. Evidence: The owner of the home, who is also the registered manager, runs the home on a day to day basis with the support of the assistant manager and the other member of staff. It is evident that this small staff team work closely together to ensure the smooth running of the service. Since the last inspection the assistant manager has improved much of the record keeping and is enthusiastic about further developing their processes and building on the improvements they have already made. The manager told us in the AQAA, We will continue to work with and listen to everyone involved in the home - staff, service users and families and implement any changes and suggestions practicable. As previously reported there is a Quality Assurance process in place for seeking the views of people using the service and their relatives. They have team meetings Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: involving the people living in the home and record peoples opinions and wishes. They have sent questionnaires to relatives and other interested parties and all contained positive comments. One person stated, I have every confidence in Mondial and the wonderful care it offers. It was evident from our observations that there has been significant developments in the past year of the involvement of the people living there in the day to day running of the home. As before peoples opinions, thoughts and wishes are valued, respected and taken into account when making decisions about the service but staff are now actively encouraging people to take greater responsibility and to do more for themselves. The assistant manager has implemented a book for to write down things that they would like and they make plans to ensure these things happen for the person. Although the nature of the service is small, homely and domestic, as at the last inspection staff spoken with were well aware of their responsibilities around maintaining robust Health and Safety records and keeping people safe. A sample of Health and Safety documentation examined was in order and up to date including Portable appliance testing, the gas certificate, maintenance of fire appliances and electrical installation. There are updated risk assessments in place which have been improved since the last inspection, including COSHH (Control of Substances Hazardous to Health). Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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