Archived: Mundy House

We found the following examples of good practice:

All visitors were screened for symptoms of acute respiratory infection before being allowed to enter the home.

There were prominent signage and instructions to explain what people should do to ensure safety.

Information was easily accessible on arrival or before visits to ensure visitors follow government guidance, procedures or protocols to ensure compliance with infection prevention and control.

Risk assessments had been carried out on people using services and staff belonging to higher risk groups in relation to COVID-19 and actions had been taken to reduce the risks.

Cleaning schedules were monitored by management regularly to ensure all tasks were completed in accordance with the home's policy and procedure.

The home operated 'consistent assignment' practices which meant that the same staff generally worked with the same group of residents. This way of working not only contributed to minimising the spread of infection, but also enabled relationships to be built.

Regular infection prevention and control audits were carried out and actions addressed in a timely manner.

The communal rooms had been re-configured to enable social distancing. For example, in the lounge area, a lot of the chairs had been removed and the ones that remained were placed a safe distance apart.

Mundy House provides care and support for up to 58 people, some of whom may be living with dementia. At the time of our inspection, 51 people were using the service. The service is set over two floors in the local community.

At the last inspection, the service was Good. At this inspection, the service remained Good.

A registered manager had been in post for a number of years. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was safe. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. There were systems in place to minimise the risk of infection. People’s medicines were dispensed by staff who had received training and were competent to do so.

The service was effective. People were cared for and supported by staff who were well trained and understood how to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People had access to a balanced diet and were supported to eat and drink in a safe way. Referrals to other health professionals were made when required. The environment was appropriately designed and adapted to meet people’s needs.

The service was caring. People were cared for by staff who were kind and compassionate towards them. Staff had a good understanding of people’s preferences of care. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. Care plans were reviewed on a regular basis, and people and their relatives were involved in the planning and review of their care. People were supported to follow their interests and participate in social activities. The registered manager responded to complaints received in a timely manner. People were provided with the appropriate care and support at the end of their life.

The service was well-led. The service had systems in place to monitor and provide good care. These were reviewed on a regular basis. Staff, people and their relatives spoke very highly of the registered manager. The registered manager had good links with the local community and looked at ways they could participate in activities that promoted good practice.

Mundy House provides accommodation and personal care for up to 58 older people. Some people also have dementia related needs.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us the service was a safe place to live and that there were sufficient staff available to meet their needs. Appropriate arrangements were in place to recruit staff safely so as to ensure they were the right people. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure theirs’ and others’ safety.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way.

Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed.

Staff received opportunities for training and this ensured that staff employed at the service had the right skills to meet people’s needs. Staff felt supported and received appropriate formal supervision. Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity.

The dining experience for people was positive and people were complimentary about the quality of meals provided.

Where people lacked capacity to make day-to-day decisions about their care and support, we saw that decisions had been made in their best interests. The manager was up-to-date with recent changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and at the time of the inspection they were working with the local authority to make sure people’s legal rights were being protected. People who used the service and their relatives were involved in making decisions about their care and support.

Care plans accurately reflected people’s care and support needs. People received appropriate support to have their social care needs met. People told us that their healthcare needs were well managed.

Staff were friendly, kind and caring towards the people they supported and care provided met people’s individual care and support needs.

People and their relatives told us that if they had any concern they would discuss these with the management team or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

There was an effective system in place to regularly assess and monitor the quality of the service provided. The manager was able to demonstrate how they measured and analysed the care provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

People told us they felt safe living in the service. They also told us that they would feel able to speak up if they had concerns or worries and felt that they would be listened to.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

Staff we spoke with were aware of individual people's needs and how to meet them safely in line with the person's plan of care and risk assessments.

People were cared for in in a clean, hygienic environment. Staff were provided with the knowledge and equipment to protect both themselves and people who used the service from the risk of infection.

Quality checking systems were in place to manage risks and assure the health, welfare and safety of people who received care at the service and the staff who supported them. We saw records which showed that the health and safety in the service was regularly checked.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs. One person said, 'The care is very good. I feel very safe with the very familiar and regular staff.' A visiting relative added, 'It's a really lovely feeling that staff know the family, and that they know [person who used the service] so well, there is great consistency in the care.'

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Our observations and discussions with the acting manager demonstrated that people who used the service received regular support from a variety of health and social care services and professionals as their conditions and circumstances required.

Is the service caring?

We saw that the staff interacted with people living in the service in a caring, respectful and professional manner. People told us that the staff treated them with respect. One person said, 'They do respect you. They keep the door closed. They are thoughtful and cover you up where they can.'

One person said, "The care is very good. They are very gentle. My key worker showers me. I think it's quite nice having the same person. I've just been to the hairdressers, I go every week." Another person said, 'The care is very good. I feel very safe with the very familiar and regular staff.'

Is the service responsive?

People using the service were provided with the opportunity to participate in activities which interested them. Information was provided in a way that made it easier to see and understand. People's choices were taken in to account and listened to.

People had opportunities to express their views and these were listened to and acted upon. We saw that where people had asked for changes to the menu and the timings of certain foods, these had been actioned. They had also been included in the planning of activities, such as going to the garden centre to choose plants for their garden.

Is the service well-led?

Staff had clearly defined roles and responsibilities. They were allocated specific tasks on a daily basis to ensure all tasks were completed properly and this was checked by their senior or head of department. Staff said that they felt well supported and were able do their jobs safely.

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system in place and records seen by us showed that identified shortfalls were addressed. As a result the quality of the service had improved.

Throughout our inspection the atmosphere at Mundy House was observed to be calm and relaxed. Staff interactions with people who used the service were noted to be positive and it was evident that staff had a good knowledge and understanding of people's care and support needs.

Each person was noted to have a care plan in place detailing their care needs and how they were to be supported by staff. Records also showed that people who used the service were supported with their healthcare needs.

Whilst we acknowledge that there were a lot of positives as detailed above and that improvements had been made to ensure that appropriate numbers of staff were now available for people living at Mundy House and cleanliness and infection control procedures had improved; further work is required in relation to staff training, supervision and appraisal.

As a result of concerns raised prior to our inspection we found that staffing levels were not always maintained. Our findings demonstrated that the provider was non-compliant with the prevention and control of infection and measures were not part of everyday practice at Mundy House.

We found that suitable arrangements had been made to ensure that any formal decisions made on behalf of people who use the service were recorded in their best interest. At this visit we found that people experienced care, treatment and support that met their needs. Staff interactions were much improved and support provided to individual's was seen to be less task and routine orientated. We also found that assistance provided by staff was undertaken in a timely manner. People told us that they were happy with the care and support provided. People were protected against the risks associated with medicines because the provider had improved arrangements in place to manage medicines. As a result of concerns raised prior to our visit we found that there was an effective recruitment procedure in place to protect people and sufficient staff were on duty to meet people's needs.

Areas for improvement included ensuring that people's care records were up to date and accurate; and that an effective quality assurance system was in place to identify non-compliance and/or risk of non-compliance.