Inspection on 26/08/09 for Ashlea Hostel

This is the latest available inspection report for this service, carried out on 26th August 2009.

CQC found this care home to be providing an Adequate service.

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

Ashlea Hostel 31/05/06

Ashlea Hostel 06/01/06

Ashlea Hostel 16/08/05

Ashlea Hostel 08/11/04

Ashlea Hostel 13/04/04

Ashlea Hostel 05/06/03

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Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

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Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Ashlea Hostel Ashlea Hostel 53 Coronation Avenue Alvaston Derby Derbyshire DE24 0LR     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Rehana Rashid     Date: 0 4 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Ashlea Hostel Ashlea Hostel 53 Coronation Avenue Alvaston Derby Derbyshire DE24 0LR 01332718105 01332718108 dawn.repton@derby.gov.uk Derby.gov.uk Derby City Council care home 22 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Ashlea is a 22-bedded care home for adults aged between 18 and 65 years old with learning difficulties. The home provides short term and respite care, and accepts emergency placements for up to eight weeks. Ashlea has gardens to the front and rear of the building and is located in a residential suburb of Derby. Accommodation for residents is located over two floors. Lounge and dining facilities are located on the ground floor only. Access to the first floor is via stairs. Ashlea is located close to main bus routes in the city centre. Ashlea has well established links with the community in which it is situated and residents regularly use the local amenities. There are also good links with day services, which are used throughout the week by residents. Transport to and for the day centres is either arranged through community transport or by taxi. Admission to the home is done through a referral process undertaken by Derby City Council; information regarding the home and the fees can be obtained by contacting the service. The weekly subsidised fee at the time of this inspection was Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 22 Brief description of the care home £69.90. Items that were not covered by this fee included all personal items, which were included in the information provided within the Service User Guide. Information about Ashlea is avaliable at the service. Copies of inspection reports are at the home and are avaliable on the Care Quality Commissions website at www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection carried out by one inspector on 26 August 2009 which place over six hours. A further visit to the service was made on 4 September 2009 for over one hour to speak with staff and people using the service. The main method of inspection was case tracking, which involved sampling two people and examine their care records. Case tracking is used to establish if the needs of the people living at the home are being appropriately assessed and their needs are being catered for. The acting manager was present during the inspection visit. Discussions were held with two staff members and one person living at Ashlea. Two staff recruitment files were examined. A partial tour of the building was carried out which included viewing communal areas. Care Homes for Adults (18-65 years) Page 6 of 27 Before the visit the acting manager submitted an Annual Quality Assurance Assessment (AQAA), which is a self assessment detailing what the home was doing well, what has improved since the last inspection and any plans for improving the service over the next twelve months. Information from the AQAA was used within this inspection report. We also sent out five surveys asking for views about the care and support people receive at Ashlea. Five surveys were sent out to members of staff working at Ashlea. We received no surveys back from people who use the service and we had three completed surveys back from staff. Prior to this inspection visit time was spent looking at information we had received since the last key inspection which was undertaken 23 May 2007. To assist with planning the AQAA, notifications from the provider and any other information received about the service were examined. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is sufficient pre-admission information available which ensures that the service is able to meet peoples needs. Evidence: On the day of this inspection there were 13 people at Ashlea Hostel. Six of the people had moved to the home following the closure of their residential home and were at Ashlea Hostel on a temporary basis. People are admitted to the service through the local authority care management system. In the information supplied to us about the service the acting manager stated that assessments are made before admission to ensure the persons needs can be met. We looked at two peoples care and support files. Records for both of these people showed that there were detailed assessments in place, completed by the placing Social Worker or Care Manager. These assessments are in place before the person comes to the home. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: Where the stay is planned a phased introduction to respite care is provided to ensure that the individual is introduced to the service. Through the phased introduction approach the key worker from the service visits the person and their family/Representative providing information about the service. In addition to this people are able to visit the home to have a look around before they stay for planned respite. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans and risk assessments are in place ensuring that staff are able to meet the needs of the people who use the service. Evidence: In the annual quality assurance assessment (AQAA) completed by the service, they told us that support plans are in place which have been developed with the person coming for a stay at Ashlea Hostel and their family/carers. Two peoples care files were viewed at this inspection, these contained support plans which demonstrated how individual needs would be met. These were person centred covering information about their personal care needs and describing the support needed. These were clear and detailed informing staff how to meet these peoples individual needs. Following discussions with staff it was clear that staff were committed in ensuring Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: individuals were supported to take control of their own lives and to make informed choices. Observation of staff working at the home showed that they were encouraging people to make decisions and choices about what they wanted to do relating to daily routines. People were seen carrying out activities of their own choice. Risk assessments were in place in the care files we looked at. These mainly focused on keeping people safe. Risk assessments were in place regarding going out into the community and the support required within the home ensuring the safety of the individual person and other people in living at the home. These enabled individuals to live as independently as possible. Staff spoken with were aware that people are able to take risks within a risk management framework. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service supports people to take part in appropriate activities and participate in the local community ensuring their social needs are met. Evidence: In the information supplied to us about the service the acting manager told us that church services are held at the service every other Sunday. Also people staying at Ashlea are encouraged to attend their local place of worship. She also told us that a variety of activities are provided which include shopping, accessing local community facilities and visits from family and friends. Discussions with two members of staff and one person staying at Ashlea confirmed daily routines at the service were flexible. Observation at the inspection confirmed this and people seen moving around the building on their own or if required with support from staff. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: At the time of this inspection some people were at the service, whilst others were out attending day services. Observation of people during the inspection visit demonstrated that they were supported by staff to make choices about how they wanted to spend the day. At this inspection one person was colouring, another person was playing a board game and somebody else were having their nails painted. One person told us that they are supported to access local facilities they told us that staff take me out to places like the local shops or pub for lunch. The two care plans viewed showed that people are supported to take part in appropriate activities. Staff interaction with the people at the service was observed. Staff were respectful and friendly towards the people they were supporting. One care plan gave details of the level of support a person required when accessing facilities in the local community. People staying at Ashlea are able to receive visitors and visiting arrangements were flexible. One person told us that the food provided was nice, and that they had choices. Observation of lunch showed that people who required assistance, were supported in a respectful and dignified manner. In one support plan there was an entry under the eating and drinking care plan stating my drinks needs to be cool. We looked at the menu which showed that people are provided with a varied and nutritious diet. One person told us choices were available at meal times. A file was kept in the kitchen to assist the cook with meal preparation, this contained information about peoples dietary needs and their likes and dislikes. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care support plans contained appropriate information and they have access to a range of professionals ensuring their health care needs are met. Evidence: It was stated in the information about the service that discussions take place with individuals regarding their preferred method of support and this information is then used to devise individualized support plans. Two files viewed evidenced that people have contact with health care professionals such as doctors, dentist and opticians. Most people access Ashlea for respite, so usually their carers or family arrange health care appointments. On one persons file it showed that staff had worked very closely with them for a planned hospital admission One person at the service told us that staff have supported them to attend appointments at the dentist and with the GP. The written information supplied by the service stated that the service supports people to attend health appointments as necessary. They also told us that specialist Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: equipment is provided with advice from Occupational Therapists for people who require equipment. During the inspection we observed that peoples privacy and dignity was maintained. Staff interaction with people was polite and in a dignified way. In the information supplied by the service they stated that they are aware of gender issues and try to match staff with people where possible. They also stated that routines were flexible. Examination of the arrangements in place for storage and administration were satisfactory. Medicines were stored securely. Medication administration records (MAR) were seen for two people, all entries were completed properly and there were no gaps on the MAR sheets. In the information we received it stated that medication training is now rolled out on a regular basis. One member of staff confirmed they have undertaken medication training, they told us I went on medication training which was delivered by Derby City Councils Pharmacist and nurses come into the home to explain procedures. On the three staff surveys returned to the Commission they told us that they receive training which gives them enough knowledge about peoples health care and medication. On the day of the inspection visit none of the people at Ashlea were self administering their medication and there were no controlled drugs in storage at the time of this inspection. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ashlea Hostel are safeguarded by the homes complaints and safe guarding procedures. Evidence: In the written information supplied by the service they told us they have a complaints procedure in place and that they action complaints immediately. The Commission has not received any complaints regarding the service since the last inspection. In their AQAA the service have stated that have received five complaints in the last 12 months, which have all been upheld. A copy of the complaints procedure was displayed within the home. Information in the AQAA stated that the service has a pictorial form of the complaints procedure for easy reading. On a monthly basis an advocacy service is used. One person living at the home was spoken with said that if they were unhappy for any reason they would be able to tell staff. There is a policy for responding to suspicion or evidence of abuse, or neglect in place. Two staff members were spoken with both demonstrated an understanding of safeguarding adults and their responsibility to alert the manager of any disclosure or suspicion of abuse. Both commented that they had received training in adult Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: protection. The AQAA stated that in the last 12 months two safeguarding adults referrals had been made and investigated during the last 12 months. It also told us that all staff have received training in safeguarding adults (recognizing and alerting) training. In the Information about the service supplied to the Commission the service told us that they use Derby City Councils guidelines and policy for handling monies for people who use the service. We examined the system in place to manage the personal finances of people living at Ashlea and these were found to be satisfactory. Receipts for all purchases were maintained for audit purposes. Records for two people were seen which provided details of all transactions made and the balance remaining. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and homely environment. Evidence: In the written information supplied to the Commission the acting manager told us that they maintain a good standard of hygiene and provide a homely, comfortable and safe environment for people who live at the home. She also told us that specialist equipment is provided to ensure peoples independence and dignity. During our visit we carried out a brief tour of the building. The communal areas seen including the dinning area, lounge and reception area were clean and tidy. Since the last inspection the passenger lift has been installed and is being used. The home was clean and there were no unpleasant odours. One person living at the home told us that the home was always clean. The laundry facilities were seen and were satisfactory. These were appropriate for the needs of the people using the service. The acting manager told us in the written information about the service that staff have been trained in infection control. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not supported by the services recruitment practice, which could have an impact on the way people are safeguarded. Evidence: In the three staff surveys received, staff told us that there were usually enough staff to meet the individual needs of people who use the service. Two members of staff spoken with at the inspection told us that staffing levels were usually ok, but due to staff sickness it is not always possible to cover the shift. They said if someone rings in sick at times it is problematic to get someone to cover a shift due to short notice. We looked at recruitment records for two members of staff. Both files contained two written references and full employment histories. We found that one member of staff had commenced employment without Criminal Records Bureau (CRB) checks or the Protection of Vulnerable Adults (POVA) First check. New staff should not commence employment until all necessary employment checks including a POVA First check and a satisfactory CRB have been carried out. This will ensure that people living in the home are protected from poor practice and harm. During the inspection we issued an immediate requirement about this matter. Since the inspection we have received information from the service confirming the action Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: they have taken to comply with the immediate requirement. In the written information supplied to us the service told us over 50 of staff are qualified to National Vocational Qualification (NVQ) 2 or above. Two members of staff spoken with stated that they have received training in various areas such as safeguarding adults and autism. In the three staff surveys respondents stated that training received is relevant to their roles, helping them to understand and meet the individual needs of people. Comments on the surveys included the training and support received is second to none. Staff training information looked at showed that training in mandatory areas was undertaken. Staff members spoken with stated that they receive supervision on a regular basis, which was evidenced on staff records. One person using the service told us that the staff team were ok and supported them. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, safety and welfare are not protected. Evidence: In the annual quality assurance questionnaire completed by the service in June 2009, under the section regarding the conduct and management of the home they did not tell us about the management of the service. The acting manager is currently not registered with the Care Quality Commission. Since this inspection visit the service have not submitted an application to register the manager. Robust staff recruitment procedures must be followed at all times for every member of staff recruited to promote peoples safety and welfare. As mentioned in the staffing section evidence at this inspection supported that recruitment practices and procedures are not adequate. At the inspection the service were not able to provide information about their quality Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: assurance system. They did tell us that meetings take place for people who use the service and these meetings are chaired by an advocacy service. Records viewed showed that monthly monitoring visits by the provider have been undertaken. Copies of these reports were seen at the inspection. The service are unclear under what circumstances they need to send the Care Quality Commission (CQC) notifications. The registered person must ensure that any significant incidents, which have a negative effect on the health or welfare of any individual resident, or all residents. They must notify the CQC by means of a Regulation 37 notification without delay. It was observed at this inspection that the sluice room door was left unlocked for a period of time. This was addressed by the service and a member of staff locked the door during the inspection. In the information supplied to the CQC by the service they told us that maintenance checks were undertaken regularly. We looked at some records, these confirmed that portable electrical appliances were tested May 2009, the hoist and lift were serviced August 2009. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 34 19 Staff must not commence employment in the home without proper confirmation of satisfactory POVA/CRB checks. This is to protect people who use the service. Immediate Requirement has been complied with. 28/08/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 37 The registered person must appoint a suitable manager and submit an application for registration to the Care Quality Commission. The registered person should ensure that systems are in place to obtain feedback from people who use the service regarding the care and service they have received. The registered person must ensure that the health, safety and welfare of people using the service is promoted and protected. 2 39 3 42 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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