Inspection on 30/06/05 for Tomswood Lodge

This inspection was carried out on 30th June 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.

Other inspections for this house

Tomswood Lodge 26/11/07

Tomswood Lodge 01/11/06

Tomswood Lodge 11/05/06

Tomswood Lodge 01/12/04

Tomswood Lodge 24/06/04

Tomswood Lodge 10/07/03

Tomswood Lodge 29/04/03

Tomswood Lodge 21/05/02

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

CARE HOME ADULTS 18-65 Tomswood Lodge 154 Tomswood Hill Hainault Ilford Essex IG6 2QP Lead Inspector Edi OFarrell Unannounced Inspection 30 June 2005 13:00 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. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tomswood Lodge Address 154 Tomswood Hill, Hainault, Ilford, Essex IG6 2QP 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) 020 8500 7554 020 8262 5295 Mr Jackdeo Meetaroo Mrs Sushita Meetaroo Mr Jackdeo Meetaroo LD Learning Disability 8 Category(ies) of LD Learning Disability (8) registration, with number of places Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to eight adults with low to moderate learning disabilities, excluding adults exhibiting severe challenging behaviours. May include residents with associated mental health problems and a maximum of two residents who are wheelchair bound. Date of last inspection 23 April 2005 & 9 May 2005 Brief Description of the Service: Tomswood Lodge is a care home for eight people who have low to moderate learning disabilities and are aged between 18 and 65. They may also have associated mental health problems. The home is privately owned and one of the proprietors is also the registered manager. The house is detached and in keeping with others in the street. It is situated in a residential part of Hainault, on a bus route, approximately 20 minutes walk to a tube station. Shops and local community resources are within walking distance. There are three bedrooms on the ground floor, along with two toilets and a shower. Also on the ground floor is a dining/lounge area, domestic style kitchen, conservatory, staff room, and office. The upper floor has five bedrooms, two toilets, a shower, and a bathroom. There is parking space to the front of the house, a large garden to the rear, and a utiliyu room accessed via the garden. Activities are organised both within the home and in the local community, and service users are encouraged to do voluntary work, and to attend day centres and local clubs. Personal care is provided on a 24-hour basis, and health care needs are met by staff supporting service users to attend appointments with health professionals. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This, unannounced, inspection took place on a weekday afternoon. The visit focused mainly on the planning, delivery and recording of care, as this has been a matter of on-going concern to the Commission. The Requirements (things that the Commission told the owners/manager they had to do) set at the previous inspection were checked for action. Since the last inspection a specialist pharmacist inspection has taken place and the results of this were also checked during this visit. Some service users were asked for their views, but gave limited information. What the service does well: What has improved since the last inspection? What they could do better: Some changes are needed to some documents that anyone thinking of moving into the home would need to see. These are called the Statement of Purpose and the Service User Guide. They need to be accurate, and up to date, so that people can make informed choices about where they live. Some changes also need to be made to the medication administration procedure, but the manager is already doing this. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 6 The owners of the home need to think about the best way for it to be managed so that it provides the best quality of care for the people living there. 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. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 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 Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 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) 1 & 3 Prospective service users, and their representatives, have most of the information they need to be able to make an informed choice about where to live. The Statement of Purpose and the Service User Guide are not up to date, and some required information is missing. Prospective service users know that the home will meet their needs. EVIDENCE: The Service User Guide was examined and discussed with the manager. Part of this document, such as the section on how to complain, uses symbols in order to be as accessible as possible to all service users. The document needs to be reviewed so that it is up to date and accurate. For example, it still states that there are seven places, whereas there are now eight, and it states that a video about the home is available, when this is not yet the case. It is important that the guide is accurate as prospective service users, and their representatives, would use this information in making a decision whether to move into the home. This is Requirement 1. The Service User Guide is also used as the Statement of Purpose, but does not include all the information that it should do, for example, what should happen in the event of fire. This is Requirement 2. At the last inspection two Requirements were set in relation to assessment and care plans, one of which had been brought forward from the previous three inspections. The concerns were about how the home identifies and records Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 9 individual needs, which should be done prior to any admission, and be reviewed as any new service user settles in the home. There have been no new admissions since the last inspection, but the Commission is satisfied that the new care planning system would identify the needs of prospective service users, and set out how these were to be met. This aspect of care is commented on further in the other sections of this report. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 Service users’ assessed and changing needs and personal goals are reflected in their individual plans. The new care planning system details individual needs, and how these are being met, in a clear and concise way, which will enable all staff to be more effective in meeting all needs. Service users are consulted on, and participate in, the life of the home, and are supported to take risks. EVIDENCE: Five of the seven care plans were examined along with the daily records and compared with the service being offered. Four service users were at home for a part of the visit and gave limited views. Care planning at this home has been of concern to the Commission for some considerable time, for example at an inspection in December 2004 the system of recording was found not to provide clear information indicating how assessed needs were to be met on a day-to- day basis. A deadline of 1 March 2005 was set for compliance, but this was not met. The Commission followed up that report on 17 January 2005 by issuing a formal written warning to the registered persons that continued failure to demonstrate compliance with this, and two other repeat Requirements, would result in enforcement action. The concern was that the Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 11 system being used was cumbersome and inconsistent, and could result in service users’ needs, preferences, and wishes about their lifestyle being ignored, or not known. At the last inspection in May 2005, there was some evidence that the system had started to be reviewed, and also some evidence to show that service users’ needs were being met on a day-to-day basis. The Commission therefore gave a further one month period for compliance. This visit therefore focused particularly on this aspect of care. A new care planning system has been introduced, with one of the senior carers taking lead responsibility. The detailed information about assessed needs that was previously recorded in several different formats has been used to develop a new care plan for each individual service user. These cover health and personal care needs, as well as social and recreational needs. Service users preferences and choices are taken account of. The system is concise and clear, so that all members of staff can see at a glance what they need to do for, and with, each service user. The daily log is now being written to reflect the care being given on a day-to-day basis. Other records, such as those of meals taken, now indicate where service users have made choices. The daily logs also show how service users are being involved in the life of the home, for example by working alongside staff in cooking and cleaning. The Commission will continue to monitor these aspects of care, as they must underpin all aspects of the service provided by the home. Appropriate risk assessments are in place, so that each service user has as independent a life style as possible. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 & 17 Service users have opportunities for personal development, and are able to take part in appropriate activities. They are able to engage in leisure activities within the local community. Service users’ rights are respected and responsibilities recognised in their daily lives. The home is paying greater attention to the dietary needs of the service users. EVIDENCE: The care plans, daily logs, and activity and food records were checked. The fridge, freezer and cupboards were checked, along with the menus and the record of food provided. At the start of the visit two service users were out at lunch with one member of staff, and two were out at regular daytime activities, such as voluntary work or day centres. Two other service users were asked about their lifestyle and gave a limited amount of information. The care plans identify individual lifestyle choices, such as going to church, clubs, and meals out, and the daily logs now record whether these have taken place or not. Where they have not, Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 13 the reasons are now recorded. The home also uses a `daily living plan’ recording system, which gives a good picture of the lifestyle of each service user. This includes contact with families and friends, including visits to the family home for one service user. The home recognises that service users have the right to refuse to take part in organised activities, and where this happens, this is now being recorded. The last inspection took place over two days, between which the service users had been on holiday. In checking service users’ money it became apparent that no money had been withdrawn out of the individual accounts for holiday spending money. The manager had stated that this was not needed, as the holiday was all in, including small purchases such as postcards and stamps. He further stated that none of the seven service users had any concept of the value of money, and that in some cases relatives had specifically stated that they did not want the service user to handle money. The Commission was concerned about this as the national policy for services for people with learning disabilities has several underlying principles, including choice, independence and rights; having to ask a member of staff for money to buy even the smallest item does not sit very well with these principles. On this visit the Commission was pleased to note that staff at the home are providing sessions on money recognition, and on a future visit look forward to a demonstration. A Requirement was set at the previous inspection in relation to service users who need a special diet due to health needs, such as high cholesterol. The manager had reported that one of the service users refused to follow such a diet, but there was no evidence of this. In response to this Requirement a new diet has been drawn up, and where this is refused a record is now being kept. Further advice on how to deal with this has also been sought from the GP, and is being followed. Also at the last inspection it was noted that there was little food available for snacks, and that the menu did not correspond with the food in the fridge. In addition the potatoes for the evening meal were sprouting and there was no other fresh vegetables or fruit. On this visit there was fresh fruit and vegetables, and food for snacks, though no lamb chops, as was on the menu for the evening meal. As at the previous inspection the manager reported that he shops on a daily basis, and had not yet been shopping that day. The Commission will continue to monitor this Standard on all future visits. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 14 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 Written records show that service users receive personal support in the way they prefer and require, and their physical and emotional health needs are met. The home’s policies and procedures for dealing with medicines are currently being redrafted in order to ensure that they fully protect service users. EVIDENCE: The care plans and daily records were examined and discussed with the manager, and cross-referenced with other records, such as the accident book. The new care planning system clearly identifies health and personal care needs, and how these should be met. The daily log is now written to show how each of the needs have been met during the day. The logs are currently mainly being written by one senior carer, who has taken the lead for setting up the new care plans. This means that they are not always written up on her days off. In addition this visit started at 1.00pm yet the logs for the day had already been written up. The manager stated that this was because the staff member had taken two service users out and may not have been back in time to write them before going off duty, later in the afternoon. The Commission is concerned about this practice as it could lead to misleading information being recorded. For example, one log entry stated that a toileting programme had been followed throughout the day, but there could be no way that the writer Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 15 could predict that this would be the case. It is important that all daily logs are an accurate reflection of what has actually happened, not predictions of what should happen. This is important for service users, staff, and management, as these types of records can be needed as supporting evidence in complaint investigations, adult protection investigations, staff disciplinary proceedings and litigation. This is Requirement 3. A Commission specialist pharmacist inspection was carried out on 26 May 2005, following which a letter was sent to the manager informing him of the outcome. This was discussed with the manager during this visit, and action to date checked. Practical changes, such as the relocation of the medication cabinet, have already been made. Other Requirements related to changes needed to the written procedures, with a deadline of 26 August 2005. Requirement 4 has covered these in this report. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 16 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) 23 in part Service users cannot always know that they are protected from abuse, neglect and self-harm EVIDENCE: Because the main focus of this inspection was on the care planning and delivery, this Standard was not fully assessed during this visit. The judgement above is based on discussions held during the last visit, which is documented in that inspection report, and minimal discussion with the manager during this visit. The Requirement set at the last inspection has been taken forward as Requirement 5 with a new timescale, and this aspect of care will be fully assessed at the next inspection. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 17 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 Service users live in a homely, comfortable environment, but their safety may be put at risk by current practice. EVIDENCE: All the environmental standards were met at the previous inspection, when the building was toured, including visiting all bedrooms. The judgement above is based on the fact that on arriving at the home for this visit the front door bell appeared not to be working, as it was not answered despite repeat ringing. On going to the back of the house, the kitchen and the conservatory doors were open but no one was immediately around. A service user then appeared and informed the inspector that the manager was not there, but that there was a member of staff. This member of staff then appeared and, following introductions, got the care plans out of the file for inspection. The manager arrived at the home a few minutes later. The Commission is concerned at the ease with which anyone could walk into the home and suggests that when the back doors are open then the gate to the side of the house should be closed/locked. Requirement 6 has been set in broad terms, as it is up to the proprietors/manager to decide how best to ensure the safety of the service users, the staff and property. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 18 Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 19 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) 34 The recruitment procedure used by the home has greatly improved since the last inspection, with more attention being given to required checks, thereby increasing protection to service users. EVIDENCE: Three Requirements were set at the previous inspection relating to recruitment. These covered the lack of references for one member of staff, the number of hours that staff with student work permits were working, and accurate records of hours worked by staff. During this visit the files relating to these Requirements were checked, along with the duty rota. The recruitment files of two new members of staff, one of whom has not yet started, were also examined and discussed with the manager. In response to one of the Requirements the manager had forwarded payroll details for February to April inclusive to the Commission, and these had been examined prior to this inspection. The evidence seen supported the view expressed by the manager during the visit that clarity about permission to work, previous experiences, and references are now being given close attention. The Commission will continue to monitor this aspect of the service on future visits. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 20 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 & 43 in part The management approach to the running of the home has improved since the last inspection, but some Regulations are still being breached. The Commission remains concerned about the current management arrangements for this home, as it places service users at risk if the Commission has to take action. EVIDENCE: Prior to the previous inspection a repeat Requirement had been set, spanning a two years period, that the registered manager must demonstrate a clear sense of leadership. The Commission had also had repeated discussions with the manager/proprietor as to what was required. This was not taken forward at the last inspection as the manager had taken some steps to address this issue by implementing staff meetings and supervision. During this visit the Commission noted the improvements in care planning and daily records, and in the recruitment process, but also that the Service User Guide, and the Statement of Purpose, and the medication procedures all needed updating. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 21 This home is jointly owned, with one owner being the registered manager, and the other working as a member of the care staff, both are therefore very `hands on’. This type of arrangement can often disadvantage a home, in that there is no one taking a more objective view, such as the Commission does. This was discussed with the manager/proprietor during this visit, who indicated that he is considering alternative management arrangements for the future. The Requirement set at the previous inspection has therefore been taken forward as Requirement 7, and the Commission will continue to monitor the management of the home. Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 22 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 2 x 3 x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tomswood Lodge Score 2 2 2 x Standard No 37 38 39 40 41 42 43 Score 2 2 x x x x 2 G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 23 Yes 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. 1. Standard 1 Regulation 5 Requirement The registered persons must review the Service User`s Guide to ensure that it provides accurate information for current and prospective service users. The registered persons must ensure that the Statement of Purpose includes information listed in Schedule 1 of the Care Homes Regulations. The registered persons must ensure that all records relating to service users, including the daily log, are a true and accurate account of events that have happened. The registered persons must ensure that all the Requirements set by the specialist pharmacy inspector following the visit on 26 May 2005 are met. The registered manager must ensure that the whole of the staff team have a thorough knowledge and understanding of adult protection theory, policy and procedure. This must include recognising that key decisions must not be made by staff, as the local authority has lead responsibility in this area. Timescale for action 30/09/05 2. 1 4, Schedule 1 17 30/09/05 3. 18 & 19 31/08/05 4. 20 13 (2) 26/08/05 5. 23 13 (6) 30/09/05 Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 24 6. 24 13 (4) 7. 37, 38 & 43 7, 8, 9 & 10 Previous timescale of 30/06/05 set, but not fully assessed at this inspection, so a new timescale has been set. The registered persons must 31/08/05 ensure that the home provides a secure and safe environment for both service users and staff at all times. The registered persons must 30/09/05 ensure that arrangements are in place for the home to be managed by a fit person. This person must be suitable to manage the home, including having a demonstrable and thorough working knowledge of all relevant legislation. Previous timescale of 30/06/05 not fully met. 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 Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Tomswood Lodge G55_S0000025932_Tomswood Lodge_V235593_300605_Stage 4.doc Version 1.40 Page 26 - 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!