Inspection on 27/01/10 for Ebdon Lane Care Home

This is the latest available inspection report for this service, carried out on 27th January 2010.

CQC found this care home to be providing an Good 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.

Extracts from inspection reports are licensed from CQC, this page was updated on 11/04/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Ebdon Lane Care Home 2 Ebdon Lane Sunderland Tyne And Wear SR6 8ED     The quality rating for this care home is:   two star good 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: Sam Doku     Date: 2 8 0 1 2 0 1 0 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 30 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 30 Information about the care home Name of care home: Address: Ebdon Lane Care Home 2 Ebdon Lane Sunderland Tyne And Wear SR6 8ED 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Choices Community Care Service Ltd Name of registered manager (if applicable) Ms Ann Elizabeth Stobbart Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD, maximum number of places 6 Date of last inspection Brief description of the care home Ebdon Lane was an established NHS service, and was taken over by Choices Care in September 2009. The service provides personal care and accommodation for 6 people with learning disabilities. The service is located in the Fulwell area of Sunderland, and is near to local facilities and aminities. It is a purpose built bungalow and has is good access into the home and Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home within the home. There is a good size garden with sitting facility to the back of the building. All bedrooms are single occupancy and are well equipped to meet the needs of the residents. The scale of charges for the home is difficult to calculate at the moment as Choices Care is still in negotiation with the local authority as to the appropriate charges to be made to the residents. Care Homes for Adults (18-65 years) Page 5 of 30 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: two star good 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: The quality rating of this service is 2 Star. This means the people who use the service experience good quality outcomes. The inspection was unannounced and commenced on 27 January and completed on the 28 January 2010. Before the visit the inspector looked at: Information we have received since the last inspection visit on 19 May 2008. How the home dealt with any complaints and concerns since the last inspection. Any changes to how the home is run. The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQAA). During the visit the inspector did the following. Talked to the people who use the service, the assistant manager and the care staff who were on duty at the time of the inspection visit. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that Care Homes for Adults (18-65 years) Page 6 of 30 staff have the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it is safe and secure. Checked what improvements have been made since the last inspection. Consider the comments made by the residents. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: There are gaps between the bathroom and shower/toilet doors and people can be seen from the corridors using these facilities. Action should be taken to address these as it compromises the residents dignity and privacy. A medication recording system should be put in place for medication that are administered only occasionally. This should show when medication is administered and the balance left. The provider should consider making application to the Commission for a registered manager as the current manager has been on sick leave for several months now. This is to make sure that the home continues to meet its legal obligations. Choices Care should provide residents with up to date service user guide, and also terms and conditions of residence as soon as this is availble. Care Homes for Adults (18-65 years) Page 8 of 30 The gaps in the bathroom and shower/toilet doors should be addressed to preserve the dignity and privacy of the residents. 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 9 of 30 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 10 of 30 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. The company policies and procedures provide information to staff on the general admission processes, although there need to be a service specific service user guide for the residents and future prospective residents. Evidence: Since Choices Care took over the running of the home, there has been no admissions but the staff and the deputy manager were able to give a good account of the admission process that the home would follow in any future admissions. It is the homes policy to offer the opportunity for prospective residents to visit the home, spend time with staff and other residents, arrange for overnight stays if this is considered necessary and flexible admission arrangements to suit the needs of the prospective resident. The deputy manager also indicated that admission would only take place when the home has carried out their assessment of the prospective resident needs. This is to make sure that good information about the person is obtained so that support plans can be put in place for the person before coming to live at Ebdon Lane. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Choices Care has a contract in place but this has not yet been issued to the residents as the fees levels have not yet been set by the local authority. The deputy manager and the divisional manager, both confirmed that as soon as the fees are set, each resident will be issued with a contract, detailing the terms and conditions of residence. Some residents have contracts with the previous provider. Care Homes for Adults (18-65 years) Page 12 of 30 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. Support plans reflect the assessed needs of the residents, thus promoting their welfare and wellbeing. Evidence: The previous providers support plan documentation are gradually being replaced with Choices Care own support plans. The support plans, both old and new, provide details of each residents needs and goals. The needs and aspirations of the residents are further established through meetings with residents to find out from them what they would like to do, and also to seek their views on the running of the home. Such consultation is documented in the residents meeting minutes. The inspector looked at three residents files. The files contain details of risks that have been identified with individuals and plans about how best to manage those risks. These include risks in the home, eating, drinking, mobility, transport use and community activities. These risks plans are reviewed on a monthly basis and where necessary changes are made to reflect the residents current care needs. Staff said Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: that they feel reassured knowing that the risk support plans provide them with advice on how best to handle a particular situation. Care Homes for Adults (18-65 years) Page 14 of 30 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. There are good arrangements for the residents to engage in social and recreational activities which enhance the quality of their life. Evidence: The inspector had discussions with the staff about social and recreational activities that the residents engage in. They stated that the arrangements remain the same as they were when Choices Care took over from the previous provider. The staff said that the residents continue to enjoy good social and recreational activities. Records and minutes of meetings show that the staff consult regularly with individual residents about daily activities and what they would want to do. The inspector spent some time in looking at the records that relate to the residents social activities and these show that the residents take part in numerous community activities, which include shopping, visit to local pubs, restaurants, community centres, theatres, Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: cinema, library, social clubs and the Alan Shearer sensory and Hydrotherapy Centre. All the residents have complex communication needs and staff used other sources of communication to determine what the individuals wishes are. These are reflected in the support plans, and where necessary risk management plans are put in place to minimise any risks associated with particular activities. The residents are offered choice of meals on daily basis. The residents are consulted when the menus are being planned. Examination of past menus show that the home continues to provide the residents with nutritious, home made and balanced meals. There are good arrangements in place to enable residents to have snacks and drinks throughout the day. Care Homes for Adults (18-65 years) Page 16 of 30 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. The healthcare needs of the residents are fully met. This promotes the health and welfare of the residents. Evidence: The residents records show that each resident has their own GP. Each resident is supported to attend GP appointments and other specialist appointments when needed. Records also show that the residents receive medical support from other healthcare professionals and agencies such as physiotherapy, speech and language therapy, psychiatrist, clinical psychology, chiropody, epilepsy specialist nurse and other medical support. The inspector examined the residents support plans and these highlight the health and social care needs of the residents. Discussion with the staff showed that they are all aware of the healthcare needs of each resident and how those needs are to be met. The daily report record provides details of each residents health and social care needs and how these are met. There is a monthly review process in place to make sure that the support plans continue to reflect the current care needs of each resident. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: The support plans that have been introduced by Choices Care are accompanied by risk assessment and risk management plans for all staff to follow. These risk assessments and support plans are very detailed so that staff can support the residents appropriately and safely. The Choices Care has good policies on medication but these policies need to be reviewed to reflect specific legislations or guidance that relate to practices in England. The medicines in the home are appropriately stored. A random check of medicines in the home showed that on the whole staff adhere to safe administration of medicines in the home. However, discrepancies were noted with one of the residents medication. The records show that eight syringes of Midazolam Buccal liquid was prescribed to be administered to the residents as and when needed. Two have since been administered but there is no record to show exactly when these doses were given. The assistant manager later found an entry in the office diary which showed the date when the resident received one dose of the medicine. The assistant manager was advised to put suitable recording system in place which should show when the medication was given and the amount left. Care Homes for Adults (18-65 years) Page 18 of 30 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. The homes polices and staff practices protect the residents from all forms of potential abuse, thus safeguarding the residents safety and welfare. Evidence: Choices Care has a general safeguarding policy and the assistant manager stated that staff have covered this in the induction training program for staff when Choices Care took over the running of the home in September 2009. One staff member who was recently appointed by Choices Care described the induction training he received from the company, and this included safeguarding awareness training. The inspector discussed the training relating to the Mental Capacity Act and Deprivation of Liberty Safeguards. The assistant manager indicated Choices Care is planning to provide this training as a priority to the staff. This was confirmed by the divisional manager for Choices Care when the inspector met with her at the companys offices as part of the inspection process. There are other policies which are designed to protect and safeguard the residents. These are well written and staff who were spoken with had good understanding of the polices. These include policies on whistleblowing, residents finances and, recruitment and selection. The inspector spoke with staff about complaints and safeguarding matters. Staff had Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: good understanding of their role and what actions they need to take to address any complaints and safeguarding matters. The residents have regular meetings to discuss matters relating to the running of the home. Minutes of these meetings are kept. Last October, the assistant manager arranged a consultation meeting with all relatives with the view to seeking their views on how the home is performing and if they are happy with the care that the home provides. There are good records in place showing how the residents finances are managed. There were no discrepancies noted when the inspector carried a random check of monies held in the home for the residents. Care Homes for Adults (18-65 years) Page 20 of 30 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. The home is clean and suitably mainitaned and equipped to meet the needs of the residents. However, the design of bathroom and shower doors compromise the dignity and privacy of the residents. Evidence: Ebdon Lane is a purpose built home with facilities that meet the need of the residents. The corridors and doorways are wide enough to allow easy access for people with wheelchairs and other mobility devices. There are grab rails along the corridors for people with mobility problems to hold on to when walking round the home. All bedrooms, communal areas, bathrooms and toilets have call systems in place for residents and staff to use when assistance is required. The inspector had discussions with the assistant manager about the bath facility in the home. She agreed that this is not appropriate for the people who live in the home. She also indicated that the matter had been raised before with the previous provider but nothing had been done about it. She stated that she would raise this with the divisional manager. The inspector observed that there are gaps in the doors of the bathroom and the shower/toilet. People using these facilities can be seen from the corridor and this compromises their privacy and dignity. The assistant manager, again said that she Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: would raise this matter with her line manager. The home is appropriately decorated and furnished to a good standard. All part of the home were clean and well maintained. Care Homes for Adults (18-65 years) Page 22 of 30 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 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 and competent staff team to meet the needs of the residents, thus promoting their health and welfare. Evidence: Staff rotas show that there is always sufficient staff on duty to meet the needs of the residents. A new rota has been arranged to commence on the 28 February 2010. This new rota is meant to end the twelve hour shifts which staff were unhappy about. Staff who were spoken with were very pleased with the new rota system and said they are looking forward to the new working hours. The new rota also makes provision for four staff to be on duty three days a week. This is to enable staff to involve residents in more community activities. The home had kept the training files for each staff member under the previous provider, and the records show the training that staff have received. These include food hygiene, fire safety training, moving and handling, POVA, break away techniques, first aid, infection control. However, some staff could do with a refresher training on some of these. The assistant manager indicated that Choices Care have plans to provide refresher training for all staff on statutory training. A number of staff have NVQ Level 2 or above. Others are in the process of undetaking their NVQ training. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The new staff files created by Choices Care were examined at the providers regional headquarters. These show that the Choices Care has been following proper recruitment procedures, including taking references, CRB checks, completed application forms and interview notes. Staff who were spoken with stated that they receive good support from Choices Care, and also commented positively on the support t that they receive from the assistant manager in the absence of the manager. The assistant manager maintains a record of staff supervision which is carried out on regular basis. Care Homes for Adults (18-65 years) Page 24 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent person who ensures that the needs of the residents take precedence over all else. This promotes the residents safety and welfare. Evidence: The home has recently been taken over by Choices Care, and is currently being managed by the assistant manager in the absence of the registered manager who is on long term sick. Staff are very confident about the assistnat manager and described her as supportive, caring and good at her job. The inspector looked at the companys written policies and procedures. A large number of these policies relate to Scotland but the assistant manager advised the inspector that a team of managers have been set up to reveiw these policies to make sure that they relate to English standards, guidance or regulations. The policies in their current form can be confusing to staff of homes or services that operate in England. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Observation of staff practices and interaction with the residents show that the staff put the residents first. The staff showed good professionalism in the way they relate to the residents. Staff are very motivated and showed good commitment to promoting the welfare of the residents. Choices Care health and safety policies are of good standard, except that there is a lot of references to Scottish regulations. A record is maintained of regular servicing of fire equipment, bath lifts/hoists, overhead tracking hoists, gas and electrical appliances. These have been serviced and certificate of inspections have been maintained. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 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 1 13 The home must have a 19/03/2010 system in place for accounting for all medication in the home. There was no record of when two doses of medication was administered. 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 1 The provider should produce a service user guide and a statement of purpose that is relevant to people who use the service. The provider should ensure that each resident receives a copy of the term and conditions of residency as soon as this is completed. All staff should receive awareness training on the Mental Capacity Act and Deprivation of Liberty Safeguards The current bath facility should be reviewed to make sure that it serves the needs of the residents by promoting independent use. 2 5 3 4 23 26 Care Homes for Adults (18-65 years) Page 28 of 30 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 5 27 The gaps in the toilet and bathroom doors should be attended to as this compromises the privacy and dignity of the residents. Care Homes for Adults (18-65 years) Page 29 of 30 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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