Inspection on 05/03/08 for Tosh Lodge

This is the latest available inspection report for this service, carried out on 5th March 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tosh Lodge 09/02/06

Tosh Lodge 20/09/05

Tosh Lodge 21/03/05

Tosh Lodge 16/03/05

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 Tosh Lodge 215 Faversham Road Kennington Ashford Kent TN24 9AF Lead Inspector Michele Etherton Unannounced Inspection 5th March 2008 09:40 Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 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 Tosh Lodge DS0000049316.V359508.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 Adults 18-65. 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. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tosh Lodge Address 215 Faversham Road Kennington Ashford Kent TN24 9AF 01233 629225 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) Fola Omotosho Vacant Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users over age of 65 years to be restricted to one (1) who’s DOB is 14/09/1940. Date of last inspection Brief Description of the Service: Tosh Lodge is registered to provide residential care for up to five people with mental health problems and service users are currently settled and have low dependency needs. The home is a detached house on two floors, with a usable garden. Service users have their own bedrooms, four of which have en-suite facilities, and access to an additional toilet, a lounge, kitchen/diner, laundry, garden/smoking room and a quiet room. The home is not suitable for those with mobility problems. The home, which has access to all necessary healthcare services within the community, is situated in a residential area on the outskirts of Ashford. There is car parking to the front. It is within easy travelling distance of local amenities such as health centres, shops, churches, pubs, clubs, colleges, a cinema, library, bowling alley and a bus stop just outside. The Owner, Mrs Omotosho is also the registered manager. There are currently four service users and one vacancy. The range of fees is currently £500.00 to £700.00 per week. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good, quality outcomes. A Key inspection of this service has been carried out, this has included an unannounced site visit to the home on the 5th March 2008 lasting 4 hours; this has also included an appraisal of any information received by CSCI about the home and from the home since the last inspection in August 2006. All key inspection standards have been assessed for this inspection; some additional standards have also been assessed where information became evident during the site visit. The site visit comprised a partial tour of the premises including some bedrooms (with residents permission) and communal areas. Samples of documentation including support plans, risk assessments, medication administration records (MARS), and a staff recruitment file were examined. Survey information has been distributed to people living in the home, care staff, and care managers and other professionals. People living in the home were observed and spoken with throughout the site visit; discussions were also undertaken with support staff, and the provider/manager. Feedback from survey responses from people in the home, some staff and a health professional has also been assessed. All these responses and observations have been influential in the compilation of this report. What the service does well: The service offers people who live there comfortable, homelike, and well maintained accommodation. The home ensures through its comprehensive assessment and admission process that only those people whose needs can be met by the home will be offered a placement. People feel relaxed and able to talk with staff. They can be as independent as they would wish to be There is no pressure of expectations to take on responsibilities; or a level of sustained independence that may impact on their ability to cope and overall mental well being. People who live at the home speak positively about living there: Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 6 “The home is always clean and tidy, “They always listen to what you have got to say and tell you the best way to go” “Place is very nice” “Have a good time and get to do what I want” “I like the staff they are very helpful” “I am fine I am contented” The provider/manager is experienced and trained in mental health and is able to utilise this knowledge and skills in the quality of care and support offered to people in the home. She has forged good working relationships with mental health professionals outside the home who provide professional health and social care support to residents. Feedback from a consultant psychiatrist has been positive about the home. What has improved since the last inspection? What they could do better: The majority of people in the home travel independently outside the home and should be encouraged to have a front door key whether they choose to use this or not and this is a recommendation. There is resistance amongst residents to attend routine health care checks. It is recommended that when refusals occur, this should be more clearly evidenced within home records’ as should discussions with other health and care professionals involved regarding these issues. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 7 Further consideration should also be given to ways of overcoming resistance to healthier eating by individual residents and re-introducing them to a wider range and variety of food in their diet. 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. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who come to live at the home can be confident that their needs are assessed prior to admission to ensure these can be supported appropriately. EVIDENCE: The manager reported that admission to the home is only following receipt of the necessary documentation from referring health and/or social care professionals, in addition to a prospective resident spending a two day assessment visit at the home. The manager reported that she does take account of the views of existing residents and staff when considering new people and would not accept anyone who was likely to upset the stability of the household. Files of two people living in the home were examined and provided evidence of assessment information. Regular CPA meetings for people in the home provide opportunities for a review of needs. CPA documentation is not routinely forwarded to the home who should pursue this with the relevant CPA co-ordinators to ensure consistency in agreed needs and support. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6.7.9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People in the home are consulted with and listened to about the kind of life they wish to lead and how they’ prefer to be supported, they make decisions and choices in their daily routines and are supported to take responsible risks. EVIDENCE: There are currently four people living in the house and one vacancy. All of the current residents have a care plan and this is developed with them from CPA meetings and the homes own assessment of how needs’ are to be supported. There is evidence of updating. Goals are in place, these are simple and linked to daily routines, and people in the home have opportunities to be as independent as they want to be but no pressure is placed on them to actively promote this. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 11 Clearly there are aspects of daily routines that residents can be responsible for themselves e.g. cooking, making drinks and snacks, although this was not in evidence on the day of the site visit. Whilst there is no expectation that individuals will undertake domestic tasks the facility exists for them to do so when they want to. One resident who the manager reports does sometimes make his own lunchtime snack was asked during the site visit why he was not cooking his own lunch and responded “because I don’t want to”, clearly this was OK with the resident and the staff and the routines within the home are sufficiently flexible to accommodate changes in residents mental health and levels of motivation. Additional comments from residents are: “Have a good time and get to do what I want” Staff surveyed reported that: “The manager and staff understand the needs of the people and provide good support whenever they want” Survey responses and discussion with people living in the home highlighted they feel able to make their own decisions and choices each day, and this was supported in observations made during the course of the site visit. Residents spoken with indicated no specific aspirations for their future or any desire to move onto more independence, having previously had negative experiences of this. Risks assessments are in place and reflect those needs highlighted, these would benefit from improved clarity around how risk has been minimised, and these are reviewed within CPA mtgs. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are enabled to live the lifestyle they wish, they are encouraged to access the community and make use of facilities, they are supported to maintain important relationships, and make decisions and choices in their daily routines. People in the home would benefit from being encouraged to eat more healthily. EVIDENCE: At the site visit, people who live in the home were observed coming and going. Two people confirmed they make good use of the local community, accessing daytime clubs centres, and leisure facilities independently and in one case with staff. Two of the current residents spend much of their time out of the home, a third is enabled to spend time in the community with staff support, the home Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 13 tries to be flexible with this to ensure that the person concerned does not feel restricted by having to be accompanied. This works well at present. Two people are independent travellers and make good use of public transport or walk. One person spoken with said he had enough to do but had signed a petition at his day centre for similar facilities to be provided in the Ashford’ area as there are currently not enough places. One person said he didn’t like holidays and didn’t want to go on one as they had always proved a disappointment for him since early childhood, whilst holidays or days out have proved difficult to achieve for some residents, the home should ensure this features regularly in discussions with residents about their future aspirations. Residents spoke openly about their families and the importance of these relationships to them, the home has been supportive and enabling in facilitating home visits and maintaining these contacts. The home has also ensured that where some personal relationships have been abusive the residents concerned have been suitably safeguarded. Two people in the home have been offered keys and have returned these to the manager saying they no longer wish to have these, it is recommended that all residents with capacity should have the front door key even if they choose not to use it, one resident spoken with who the manager reported had previously returned his key said he thought he would like a key. People in the home undertake some household tasks for themselves e.g. cooking lunch for themselves, Hoovering their room, making their own bed, when they feel able to, this is a flexible arrangement rather than an expectation that can be responsive to individuals and their ability to cope at different times. Resident meetings are held but not often. People in the house are consulted about what they eat and their preferred choices are incorporated into a week’s menu, whilst this menu structure is repeated every week over a monthly period until reviewed, changes to meals occur on a daily basis dependent on resident’s choices. Whilst the menu appears repetitive and lacking in variety, the manager reports this has been developed through trial and error with residents who have refused a more varied range of meals. The manager is aware of healthy eating initiatives and is monitoring residents weights informally, however, she reported that there is some resistance amongst residents to eating healthier options, and to force the issue may drive residents to eat unhealthily outside of the home. One resident was asked whether they thought they were eating healthily and responded by saying “but its what we like”, another reported he liked to eat at a café in the town. The manager tries to strike a balance between what the residents will eat and Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 14 eating healthily. Fruit is available for dessert options. The manager reported she tries to reintroduce healthier options from time to time without much success but should continue with this practice. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People in the home receive support flexibly in their preferred manner. Their health needs are monitored, but improved recording in this area is needed. Systems are in place for the safe administration of medication EVIDENCE: The majority of people in the home undertake their own personal care with prompting in some cases. Feedback from people surveyed and discussions with two people at the site visit confirmed that they feel happy with the level of support they receive from staff, staff spoken with indicated they had a good understanding of the individual needs of residents and how they wished support to be delivered. The manager reported that there is a resistance from all of the current residents to attend routine healthcare checks e.g. dentists and to comply with measures to safeguard their health e.g. healthy eating, diabetes treatment, these issues are discussed within CPA meetings and recorded. All of the people in the home have capacity to make their own decisions, they understand the Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 16 consequences of their actions and have the right to choose to comply or not. The home is able to evidence visits to the GP, and the manager reported that because the residents are more accepting of GP appointments she schedules a routine healthcare check for each resident every 3 months when health issues can be discussed. The G.P has had some success in persuading residents occasionally to access other health care appointments e.g. chiropody even if on a one off basis. It is recommended that the manager evidence more clearly within home records routine health care checks for residents and where these have been refused, a record should also be made of discussions with other health professionals about refusals particularly where this may pose a health issue for the person concerned. The manager reported a good working relationship with the CMHT and the Crisis intervention team; also the consultant Psychiatrist has been very helpful. Survey responses from a psychiatrist supporting residents at the home indicated a positive view of the home with additional comments being: “Happy with current care for current needs” “General level of care is good,” and “ the home addresses the level of need” The manager reported that the people in the home had all experienced a period of stability within their mental health since admission to the home. Medication for all residents is reviewed regularly through the CPA process. All have histories of compliance issues with medication, and currently all medications are administered by staff. Consideration should be given by the home to enabling people in the home to become more involved in their medication regimes under staff supervision without compromising their current compliance. The manager reported that only trained staff can administer medication, competency checks are routinely undertaken and the manager reported that issues highlighted through observation of practice would be raised within individual supervision. Current medication Administration Records (MAR) sheets have been examined; recording on these sheets is satisfactory. The manager stated that staff’ undergoing induction also receive some medication training in respect of the medications used by the current residents, making staff aware of side effects, etc. A previous requirement that medication entering and leaving the premises be recorded has been addressed, in that MAR sheets viewed evidenced medications received, the manager reported they have a returns book for medications but this is rarely if ever used and was not viewed on this occasion. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home feel listened to by staff, and that their’ concerns will be acted upon. People’ who live in the home are safeguarded by the improved training and knowledge of staff. EVIDENCE: The Commission has received no notification of any outstanding complaints or adult safeguarding alerts since the last inspection. Survey information indicates people feel confident of raising issues and that these will be acted upon, there is an overwhelming consensus that people in the home felt able to talk to staff who they found helpful. “Can go and speak to staff when I want” “Can tell staff when I want to” “They always listen to what you have got to say and tell you the best way to go” Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 18 People in the home are responsible for their own finances. Where they may be at risk of financial abuse from others the home ensures appropriate safeguards are in place to protect them. Staff spoken with confirmed they had received adult protection training and staff training records viewed and certificates supported this. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a well maintained, safe and comfortable home. EVIDENCE: We undertook a tour of the premises that incorporated communal areas of the home, and some bedrooms with resident’s permission. The home is well maintained, decorated and furnished to a good standard and clean and tidy. Bedrooms viewed are spacious, and reflect the taste and interests of the respective residents, who reported that they had everything they currently needed. Communal areas are comfortably furnished and uncluttered. The garden is well kept and accessible to residents. The manager reported that the fire risk assessment has been updated and records to evidence this were noted. The manager has a service development plan. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’ in the home are supported by enough suitable staff, whose practice and performance is routinely monitored. A staff-training programme is in place. EVIDENCE: The home is still to achieve 50 of staff trained to NVQ level 2; staff’ are not usually supported to attend this training until they have been in post for a period of 12 months. Staff reported that there is always two staff on duty during daytime shifts and one sleep in at night. The majority of people in the home are independent travellers, and do not require staff support, however staff are available to escort one resident and ensure that a replacement staff member is in place before leaving the premises. The manager reported that staffing is flexibly arranged to respond to the needs of residents who at times may require additional support. Residents indicated that they felt well supported by staff’, who are always available when needed. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 21 The manager stated that only one new staff member has joined the team since the last inspection. An examination of their recruitment file highlighted that all necessary checks have been undertaken and the content of the staff file is compliant with schedule 2 and Regulation 19 of the Care Homes Regulations 2001. The manager reported that discussion of employment history with candidates at interview where application forms lack clarity is routinely undertaken but should be more clearly evidenced within recruitment files . Staff responses through survey and discussion at the site visit reflect positively on the home, they report being well supported by the manager and other staff; they feel they have access to an appropriate level of training to enable them to effectively support people in the home. They commented that: “Excellent training, support, good management” “Manager and staff understand the needs of the people and provide good support whenever they want” “Staff understand their roles and responsibilities” “Trained staff and good quality service for betterment of home and care workers” Staff spoken with confirmed they had completed induction and workbooks linked to this. The manager has implemented staff training profiles and these evidenced some in house and external courses undertaken by staff. Staff’ have reported through survey and discussions at the site visit that they are provided with a good level of training. Records viewed indicated that staff have completed core skills training within induction and in house courses, not all staff have first aid training but the manager ensures that every shift has someone trained in first aid on duty. The home manager reported difficulties with current training providers cancelling courses or courses being oversubscribed. Staff who have not previously worked with people with mental health needs or in a care setting thought that the manager had given them a good introduction and awareness of individual resident needs, this has given them confidence to work effectively with people in the home. Staff reported that they are well supported and receive regular individual supervision with the manager; some staff supervision records were noted at the site visit. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from living in a well run home where their views are listened to and their health and safety is promoted and protected. EVIDENCE: The registered provider/manager is a qualified psychiatric nurse who has worked in the field of mental health for more than sixteen years. Discussion during the site visit highlighted her continued commitment to her own professional development through undertaking additional professional qualifications and training. She has also made arrangements to receive professional supervision from a health practitioner. Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 23 She continues to demonstrate a dedication to improving and maintaining a good quality lifestyle for people in the home, but has a sensible approach to the support they receive, ensuring they are enabled to experience the lifestyle they want to lead, but are not overburdened with responsibilities or expectations that may place undue strain and impact on their fragile state of mental health. People in the home are routinely consulted about their views on the home and the manager was able to evidence an analysis of the findings from the last survey undertaken, this has been incorporated into the service development plan for 2008/2009. People in the home reported through survey responses and discussion during the site visit that they feel listened to by the manager and staff. A training programme for staff is in place although due to circumstances outside the control of the home timescales for completion of all mandatory training are drifting and will need review, this has been commented on elsewhere in the report Checks of equipment and servicing were examined and found to be in date. A fire risk assessment has been updated according to correspondence from the fire service in September 2007. Records viewed indicate that fire equipment has been serviced. A check of water fittings and supply has been undertaken. A visit by the Environmental officer was last made in November 2007 and no requirements were issued at that time. The Home has appropriately notified CSCI of any significant events since the last inspection. Tosh Lodge DS0000049316.V359508.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 2 Refer to Standard YA16 YA19 Good Practice Recommendations People living in the home should be provided with front door keys where they have demonstrated the capacity to use these responsibly The home should maintain clear records of routine health care checks and evidence where this’ has been refused by people living in the home. The home should be able to evidence that discussion of resistance to healthcare appointments has taken place with other involved professionals and the individual concerned Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Tosh Lodge DS0000049316.V359508.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!