Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 14/07/05 for Mrs Anita Gungaram

Also see our care home review for Mrs Anita Gungaram for more information

This inspection was carried out on 14th July 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

After spending time with the residents there was no doubt that they were very happy with their lifestyles at Tenby Lodge. There were very friendly relationships between the staff and residents. The residents were able to tell the inspector how they enjoyed their days at the day centre or when receiving one to one care. They were very satisfied with their rooms and eager to show the inspector. Residents were able to confirm they had good contact with their families and this was evidenced in their files also. There were well detailed care plans and risk assessments at the home ensuring the residents` needs were met. There were no unreasonable rules or routines in the home. Any restrictions on movement for any resident was well documented and had been agreed with the resident concerned. Residents were being encouraged to make choices and take control of their lives wherever possible. The home offered residents a comfortable, well maintained environment that was run much like a family home.

What has improved since the last inspection?

The safety of the residents and the staff had been improved by the purchasing of a new fire extinguisher, mounting the fire blanket on the wall, developing a fire procedure and undertaking fire drills. The records for the resident receiving one to one care had improved greatly. These were being done on a daily basis and gave details of how he spent his time and what he chose to do. The complaints procedure had been improved and gave the correct contact details for the CSCI however further development was still required.

What the care home could do better:

The manager needed to ensure that the care plans were reviewed at least every six months to ensure they detailed the resident`s current needs and how they were to be met. The CSCI needed to be notified of any event which affected the well being of the residents to ensure the event had been managed appropriately. To further enhance the safety of the residents the bathroom lock needed to be changed to one that could be opened by staff from the outside in case of emergency and the areas of worn or fraying carpet needed to be repaired or replaced.

CARE HOME ADULTS 18-65 Tenby Lodge (Mrs Anita Gungaram) 180 Hobs Moat Road Solihull West Midlands B92 8JZ Lead Inspector Brenda ONeill Unannounced 14 July 2005 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 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 Stationary 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. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tenby Lodge (Mrs Anita Gungaram) Address 180 Hobs Moat Road Solihull West Midlands B92 8JZ 0121 247 1501 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Anita Gungaram Mrs Anita Gungaram Learning Disabilities 3 Category(ies) of Learning Disabilities (3) registration, with number of places Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 January 2005 Brief Description of the Service: Tenby Lodge is a privately owned small residential home, owned and run by Mr. and Mrs. Gungaram, providing accommodation for up to 3 persons with a learning disability. The home is situated is a semi-detached house in a residential area, just off a main road into Solihull. There are a number of shops nearby and the town centre is a short bus/car ride away, making it readily accessible to amenities such as shops, places of worship and public transport. The home has a lounge, dining room and domestic style kitchen. There are three large upstairs bedrooms for the residents, a smaller staff sleep in room that is also used as an office. There is a bathroom upstairs with a shower over the bath, toilet and wash hand basin. There is an additional toilet downstairs. There are gardens to the rear and front of the property with parking space available for two vehicles at the front. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a late afternoon in July 2005 and was the first of the statutory visits for 2005/2006. During the inspection a tour of the house was made, 2 of the residents’ files and a small amount of other records were inspected. The inspector spoke with all the residents and the owners of the home who are also the registered manager and the assistant manager. What the service does well: What has improved since the last inspection? The safety of the residents and the staff had been improved by the purchasing of a new fire extinguisher, mounting the fire blanket on the wall, developing a fire procedure and undertaking fire drills. The records for the resident receiving one to one care had improved greatly. These were being done on a daily basis and gave details of how he spent his time and what he chose to do. The complaints procedure had been improved and gave the correct contact details for the CSCI however further development was still required. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 6 What they could do better: 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. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home was meeting the needs of the residents whilst taking into account their likes dislikes and preferences. EVIDENCE: There had been no admissions to the home since the last inspection and the existing residents had lived in the home for a number of years. It was evident throughout the inspection that the manager/proprietors of the home were well aware of the needs of the residents and able to demonstrate how these were met. The inspector spoke to all residents and they were able to confirm that their needs as identified on their care plans were being met and they were very happy with their lifestyles. There was documented evidence at the home of how the resident’s health and social care needs were to be met and evidence that this had been followed. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9 There was a good system in place for care planning and assessing risks that involved consultation with the residents and ensured staff knew the needs of the residents and how to manage risks. Residents made decisions about their everyday lives wherever possible. EVIDENCE: Two of the residents’ files were sampled and contained detailed care plans that included all aspects of care and support that were to be offered to the residents. The files also included extensive risk assessments covering each activity as necessary and daily planners. The manager needed to ensure that the care plans were reviewed six monthly, or earlier if required, to ensure they reflected the current needs and lifestyles of the residents. Residents were encouraged and supported to make decisions and where support may be needed in this it was documented in the care plan. Any limitations as to residents making their own decisions were only set with the resident’s agreement and after consultation with other social care professionals or because of health and safety. None of the residents had advocates but all had close links with families and two attended day centres which gave them avenues to discuss any issues that may arise. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 10 Two of the residents continued to handle their own money on a daily basis. The manager was the appointee for all the residents and this had been a long standing arrangement. The financial records were not inspected during this visit. The manager informed the inspector that the requirement made following the last inspection had been met. This was to ensure the residents signed for their money daily as they received it rather than on a weekly basis. There were risk assessments in place on the residents’ files for all their activities where any risks had been identified. These included details of how the risks were to be minimised and how any presenting challenging behaviours were to be managed. One of the risk assessments restricted the amount of time one of the residents could spend in the community alone and he was well aware of this and able to tell the inspector about it. There had been two recent incidents with one resident whilst out in the community alone and the appropriate action had been taken in respect of these. The managers of the home, day centre and social care and health professionals had met to decide how best to handle the situation and this had then been discussed with the resident. A contract had been drawn up with the resident restricting his use of some public transport and this was under ongoing review. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 15, 16, 17 Residents were encouraged to make decisions and choices about their every day lives and to keep in contact with their families. The preferred daily routines of the residents were known by staff and their movements were only restricted where it had been agreed with them or for health and safety reasons. EVIDENCE: Residents were encouraged to help around the house with tasks such as vacuuming, keeping their rooms tidy and loading the washing machine. The home had in the past used the service of a speech and language therapist however all the residents were able to express themselves verbally supported with gestures. Two of the residents continued to attend a day centre five days a week. They were able to tell the inspector what they were involved in, for example, art and writing. Both also ‘worked’ on the reception at the day centre for half a day which they evidently enjoyed. One of the residents travelled independently to the day centre. The home continued to provide one to one support for the Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 12 other resident as despite several attempts a day placement was found not to be suitable for him. He decided on a daily basis what he wanted to do and went out every day. He informed the inspector he had been out shopping in the car, he also went to the park and liked the airport. All residents had close links with their families and the staff encouraged this. Two of the residents spent time away from the home with their families on a regular basis. One of the residents was very proud of his photograph album that contained pictures of all his family and was able to tell the inspector about them. There appeared to be limited routines in the home however all the residents had their preferred routines and these were detailed in their care plans. They made every day choices such as, when to go to bed, when to get up, what to wear, what to eat and how they wanted to spend their time. At the time of the inspection the residents were trying to decide where to go for their annual holiday and staff were helping them with this. The residents were seen to move freely around the house the only restriction being they did not enter each other’s rooms without permission. As stated previously some restrictions had been placed on the movements of one resident but he had agreed to these and they were in place due to health and safety reasons. All the residents appeared happy with the meals on offer at the home. The staff were well aware of any likes, dislikes and preferences. Since the last inspection food records were being kept which demonstrated a varied diet. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 The resident’s personal and health care needs were being met whilst maximising the resident’s independence and control over their lives. The medication system was safe and ensured the residents received the correct medication at the prescribed times. EVIDENCE: Residents’ needs in relation to personal care were clearly detailed in their care plans. The care plans included what the residents were able to do for themselves, what staff needed to do for them and also what staff needed to check to ensure it had been done. All residents were registered with a local G.P., chiropodist, dentist and optician. When speaking to the inspector they confirmed they had recently had a check up at the doctors. There was documented evidence of attendance at hospital appointments. One of the residents enquired when he was going to see the chiropodist and the date and time was given to him as this had already been booked. One resident had a skin complaint which he said was much better since he had been at the home as he had cream for it which staff helped to apply. When asked all the residents said they were in good health. One of the residents had had a fall since the last inspection which required hospital out patient treatment. This was appropriately documented and he was able to confirm he was fully recovered. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 14 The medication being administered in the home was minimal. The records evidence that the residents were receiving their prescribed medication at the correct times. Since the last inspection the amounts of medication received into the home were being recorded and any balances added to ensure there was a complete audit trail. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The complaints procedure needed to be amended to ensure complainants were aware they could refer a complaint to the CSCI at any point and did not have to raise it at the home. EVIDENCE: During this inspection only the complaints procedure was checked. It had been amended since the last inspection and gave the correct contact details for the CSCI. However it needed to be further amended to ensure complainants were aware they could refer a complaint to the CSCI at any point. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 27, 28, 30 The home provided a comfortable, well maintained environment requiring only some minor repairs to ensure the safety of staff and residents. EVIDENCE: The home was well maintained and generally safe with the exception of some small amounts of carpets in the bathroom, one bedroom and on the stairs which were beginning to wear and fray. These were potential tripping hazards and needed to be repaired or replaced. Furnishings and fittings throughout the home were of an acceptable standard, domestic in style and very comfortable. The current resident group did not require any specialist aids or adaptations. All residents had a large single bedroom and these were appropriately personalised and adequately decorated and furnished. As at the last inspection bedrooms did not have locks or lockable facilities however this had been discussed with the residents and they did not want these facilities. Bedrooms did not have wash hand basins but all were in very close proximity to the bathroom where there was a wash hand basin. The bathroom appeared to meet the needs of the residents and there was an additional toilet downstairs. The manager needed to ensure that the lock on the bathroom door was Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 17 changed for one that could be opened from the outside by staff in cases of emergency. There were two communal rooms at the home which were well furnished and comfortable. The garden at the rear of the home was accessed via the lounge doors and had furniture available for the residents use. The home was clean and hygienic with no issues raised in relation to infection control. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The staffing levels met with the needs of the current resident group. EVIDENCE: There had been no changes in the staff team since the last inspection. The owners of the home were also the manager and assistant manager and there were two care assistants. There was always one member of staff on duty and one person sleeping in. As two of the service users were out all day Monday to Friday these levels appeared appropriate. If additional staff were required due to illness of one of the residents or for an individual leisure pursuit at weekends this was arranged. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 41, 42 The manager ensured the smooth running of the home in a competent manner with health and safety of the residents and staff well maintained. EVIDENCE: The owners of the home are also the registered manager and the assistant manager. They both demonstrated a very good knowledge of the residents in their care. The home was run very much like a family home but with an awareness of the requirements of regulation. The registered manager needed to ensure she enrolled to undertake a qualification in management this year and to complete as soon as possible. There was an open and inclusive atmosphere in the home with the manager have contact with the staff and residents on virtually a daily basis. There was evidence of ongoing contact between the home and the families of the residents. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 20 The records inspected were generally up to date with the exception of the care plans which were in need of review. Since the last inspection the daily records for the resident who received one to one care on a daily basis had greatly improved and demonstrated how he was spending his time and where he chose to go. It was noted that two incidents had occurred in the home that should have been notified to the CSCI as required by regulation. Health and safety were well maintained. All the requirements made in relation to health and safety at the last inspection had been met, a new fire extinguisher had been purchased, fire drills were being carried out, the fire blanket had been mounted on the wall, records were being kept of the smoke detector checks and a fire procedure had been written and was on display. The assistant manager checked all the portable appliances and records of this were being kept. Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 2 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tenby Lodge (Mrs Anita Gungaram) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x 2 3 x E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 22 Are there any outstanding requirements from the last inspection? Yes some were not assessed for compliance at this visit. 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. 2. Standard 6 22 Regulation 15(1)(b) 22(1)(7) Requirement Care plans must be reviewed at least six monthly and updated as necessary. The complaints procedure must be amended to ensure complainants are aware they can refer a complaint to the CSCI at any point. Any worn and fraying carpets must be repaired or replaced. The lock on the bathroom door must be changed to a type that can be opened by staff from the outside in case of emergency. The manager must enusre that all the documentaion detailed in schedule 2 of the Care Homes Regulations 2001 is obtained for staff prior to their commencing their employment. (Previous time scale given 01/03/05. Not checked for compliance at this visit.) Timescale for action 01/09/05 01/09/05 3. 4. 24 27 13(4)(c) 13(4)(c) 01/09/05 01/09/05 5. 34 19 schedule 2 01/09/05 Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 23 6. 35 18(1)(a) 7. 8. 37 41 9 37 The manager must ensure that there are detailed records of the induction and foundation training underataken by staff and that these are compliant with the specifications laid down by The Care Skills Council. (Previous time scale given 01/04/05. Not checked for compliance at this visit.) The manager must be qualified to NVQ level 4 in care and management or the equivalent. The CSCI must be notified of any events that affect the well being of the residents. 01/09/05 31/12/05 01/09/05 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 Good Practice Recommendations Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Birmingham and Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tenby Lodge (Mrs Anita Gungaram) E54 S4542 Tenby Lodge (Mrs Anita Gungaram) V228307 140705 Stage 4.doc Version 1.30 Page 25 - 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!