Inspection on 13/04/10 for House Martins Care Limited (Number Two)

This is the latest available inspection report for this service, carried out on 13th April 2010.

CQC found this care home to be providing an Excellent 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

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Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: House Martins Care Limited (Number Two) 2 Rivington Road Salford Gtr Manchester M6 8GQ     The quality rating for this care home is:   three star excellent 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: Susan Jennings     Date: 1 4 0 4 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 28 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: House Martins Care Limited (Number Two) 2 Rivington Road Salford Gtr Manchester M6 8GQ 01706602404 01706219646 house-martins@ntlworld.com www.housemartinscare.co.uk House Martins Care Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Geoff Godwin Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: The registered person may provide the following categories 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:- Sensory Impairment - Code SI Learning disability - Code LD The maximum number of service users who can be accommodated is : 5 Date of last inspection Brief description of the care home Number Two is home to up to five people requiring support to lead independent lives. The aim of House Martins Care Ltd is to meet the needs of people who are deaf, have learning disabilities, autism, epilepsy and minor mental health problems. The company has a commitment to providing an environment where staff are able to communicate in British Sign Language. 5 5 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home Number Two is a house with five bedrooms, situated in a residential area of Sallford, within easy reach of shops, public transport and motorways. Further information and contact details are available on the companys website. Fees at the home vary depending on the assessed needs of the individual. Care Homes for Adults (18-65 years) Page 5 of 28 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: three star excellent 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 for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. The visit was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Care Quality Commission) in relation to this service prior to the visit. The visit was unannounced and took place over the course of three hours on Tuesday 13th and Wednesday 14th April 2010. During the visit we spent time talking to people living at the home, the manager and support staff. We looked at a sample of care plans of people living at the home and staff recruitment files. This visit is just one part of the inspection process. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a Care Homes for Adults (18-65 years) Page 6 of 28 questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and to give us up to date information about the service they provided. This helps us to determine if the management of the home see the service in the same way we do and if our judgements are consistent with the providers or managers. References to we our and us throughout this report represent the Care Quality Commission. Care Homes for Adults (18-65 years) Page 7 of 28 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. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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 28 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. Peoples care needs were assessed and they were given enough information to make a decision about moving to the home. Evidence: They told us that they have not had any admissions to the home in the past twelve months. We saw that they had developed a new assessment document. The document was detailed and allowed for a thorough assessment of peoples needs prior to admission. As part of the assessment process they gather information from people who know the person best. This could be a relative or other significant people in their lives. They do this to make sure they have comprehensive information to develop a care plan. People are invited to visit the home. The duration of the visits can vary to enable the person to familiarise themselves with the home and also for staff to assess if the placement is appropriate. The have a service user guide which provides good information about what people can Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: expect from the home. The document can be produced in different formats. People have a gradual introduction to the home and staff work closely with the person and their family during this period. We received four completed survey forms from people living at the home. Each person told us that they were asked if they wanted to move to the home and that they received enough information about the home before making a decision to move in. Care Homes for Adults (18-65 years) Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff to make decisions about their day to day activities. Evidence: We saw that care plans were detailed and person centred. This means that people receive support in the way the preferred. Care plans included information about peoples communication needs, preferences, interests and any specific intervention plans. The plan contained information such as who and what is important to them, how they keep safe, their goals and aspirations, their skills and abilities, and how they make choices in their life. The care plan included information about peoples health, this was called a health action plan. We saw that they sought peoples views and opinions about the home. This was achieved with easy read feedback sheets and people were supported by staff to complete them. The results are analysed and an action plan is drawn up. This means that the home listens to and acts on what people say. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: We saw that people were involved in developing and reviewing their own care plans. This means that they were able to make decisions and choices about the support they received. We saw that the care plans were regularly reviewed and where necessary the information updated. This means that people received the support they need. The method of communication used by people living at the home was British sign Language. We saw that staff continued to sign when talking among themselves. This means that people living at the home were not left out. We looked at the financial records kept of peoples personal allowances. We saw that they were well kept and accurate. We saw that peoples money was kept individually and securely and records of any transactions were kept. People had access to their personal allowances at all times. Where staff accessed money for people the records were signed by two members of staff. Care Homes for Adults (18-65 years) Page 14 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to maintain links with the local community and to lead a fulfilling life. Evidence: We saw that people were supported to make use of local community resources such as going for walks, bowling, swimming and eating out. Staff have access to three pool cars, this means that people can take part in activities outside the local community. On the second day of our visit two of the people living at the home were out with staff walking in Heaton Park. Another person was out shopping for clothes. We saw that people were supported to maintain contact with family and friends. A number of people living at the home went home at weekends or for holidays. People were encouraged to make choices about their day to day lives and to be as Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: independent as possible. During our visit we saw people making drinks and sandwiches whenever they wanted. People decided what meals to cook. They have an allotment and use the produce grown when cooking. They told us that people living at the home competed an agricultural course at Trafford college and the skills learnt at college have been transferred to the allotment. We saw that people were supported to do their own laundry. There were a number of photographs near the washing machine in the cellar. These photographs gave a step by step instructions on how to fill the machine, where to put the detergent and how to switch the machine on. The manager told us that they have regular home meetings where people are involved in the day to day running of the home. They kept minutes of the meetings so that everyone was kept informed in any developments in the home. Peoples rights and responsibilities were respected and the staff are committed to enabling people to make choices so that they live fulfilling and active lives. We received completed surveys from people living at the home. They told us that people can do what they want to do and make decisions about what they do each day. Peoples preferences about daily routines and how to spend their leisure time is respected. We saw that people were able to choose to spend time alone or in the company of others. This means that staff respect peoples right to make choices and respected privacy. Care Homes for Adults (18-65 years) Page 16 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples individual healthcare needs are identified and met to keep them safe and healthy. Evidence: We saw that peoples personal healthcare needs were recorded separately in a Health Action Plan. They were detailed and regularly reviewed and gave sufficient information to show how peoples personal, medical and social needs were to be met. The plans covered a diverse range of needs such as hospital checks, optical checks and well man checks. Peoples preferences were respected, for example if people express a preference for particular support staff this could be accommodated as far as possible and if it is in the persons best interests. Staff are knowledgeable about peoples personalities and are able to identify changes in mood or behaviour and respond appropriately. There are no strict routines at the home. Support staff assist people to develop a care plan based on their wishes and preferences and these include social and leisure activities. This means that people can make choices about what they do during the Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: day. We saw that staff responsible for administering medication had received training. We spoke to some of the staff on duty who told us medication training is ongoing. We saw on staff files that training is provided for specialist procedures such as administering rectal Valium. We saw that lockable storage was provided for medication. We saw that peoples care plans contained risk assessments to show how support is to be provided. We looked at the storage and management of medication. Medication was dispensed in blister packs and stored. They were found to be generally well maintained and safely managed. The Medication Administration Sheets (MAR) were signed and up to date with no gaps in recording. We saw that they were signing for receipt of medication on a separate sheet. We recommended that they sign for receipt of medication on the MAR. This is to make sure that there is a clear audit trail for each person. We also saw that two peoples medication had been handwritten onto the MAR but the sheet had not been signed by two members of staff. This is a double check to make sure that information copied from the original container regarding dose and frequency is accurate. Care Homes for Adults (18-65 years) Page 18 of 28 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. Peoples concerns were listened to and acted upon and policies and procedures were in place to safeguard people from harm. Evidence: We saw that they had a procedure in place for dealing with complaints and concerns. the complaint procedure is given to people and their relatives on admission to the home. They told us they have not received any complaints in the past twelve months. They have a system in place for recording any complaints or concerns this includes, details of the complaint, any investigation and the outcome for the person making the compliant. We saw that staff had attend training in the protection of vulnerable adults. This means that they have the skills and knowledge to identify poor practice and report it to the appropriate people. We looked at a sample of financial records which were well kept and accurate. Each person had a financial record that included how their money was being managed. This means that peoples financial interests were being safeguarded. Care Homes for Adults (18-65 years) Page 19 of 28 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 safe, comfortable and well maintained home. Evidence: The house was situated on a quiet residential street and looked no different to other properties in the area. There was a small garden to the front and a larger private garden with a patio area to the rear of the house. They told us that one person enjoyed sitting out during the fine weather on the swing seat in the garden. The garden was well maintained and the gardener was working in the garden during our visit. We spoke to one person with the assistance of staff who told us they were very happy with the home. Survey forms received indicated that the home was kept clean and tidy. We walked around the home and looked at a sample of peoples bedrooms. We saw that people were encouraged to bring personal belongings and to individualise their rooms to reflect their own interests. The home was clean and tidy and staff told us that they supported people to clean their own rooms and do their own laundry. We saw that they had policies and procedures in place for the control of infection including protective clothing, liquid soap and paper towels in toilets and bathrooms. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The lounge was comfortable with modern furnishings and fittings. The kitchen/dining room offered domestic style facilities for people. We saw people coming and going making drinks and snacks. The home was nicely decorated to a good standard and offered a homely and well presented environment to live in. We saw that regular safety checks were carried out in relation to the gas and electrical appliances. This means that the home is well maintained and that people are kept safe. Care Homes for Adults (18-65 years) Page 21 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected by the homes recruitment and selection procedures. Evidence: We looked at a sample of staff recruitment files and training records. We saw that a clear job description was provided. This means that staff were clear about their roles and responsibilities. We spoke to staff who told us that they had to complete an application form and attend a face to face interview. Two written references were seen on staff files and an enhanced Criminal Records Bureau check (CRB) is obtained for each member of staff before they commence working at the home. Once appointed all staff are employed on a six month probationary period. This is to make sure that they are suited to the role. As people living at the home were deaf, new staff were required to use British Sign Language (BSL). All new staff have an induction based on the Skills for Care induction standards. We saw that there was a questionnaire completed following induction to check the individuals understanding and knowledge. We saw that each member of staff had a record of training on their personal files. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: These records showed that staff had received training in safe working practices such as, NVQ levels 2 and 3, safeguarding, medication, food hygiene, first aid, care planning, epilepsy, BSL and deaf awareness. These records show when updates are due. They told us that they also take advice from healthcare professionals such as dietitians and therapists and receive specific training in relation to autism. We saw that staff were knowledgeable and have good working relationships with health and social care professionals. The home is staffed according to the needs of the people living there. There is a low turnover of staff, some have been employed at the home since it opened. This means that people benefit from the consistency provided by a well established staff team. Staff told us that they received regular supervision with the manager. The manager told us that there were two types of supervision provided, one to discuss and review care plans and the other to discuss personal development and training needs. They told us that regular team meetings are arranged. We received six completed surveys from staff. Staff told us we support people with dignity and respect and provide a homely place to live. Another said we give people more opportunity to go out on a one to one basis. One member of staff told us we give people Independence where needed and lots of different files, may be shortened so times not taken up doing paperwork. Another told us care planning is of a high standard, we provide a homely environment for people and offers good training opportunities for staff and general high standard of care for people. One member of staff told us it supports people in allowing them to carry out their lives the way they want to and problems are deal with quickly and peoples needs are very important. Care Homes for Adults (18-65 years) Page 23 of 28 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 excellent 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 in the best interests of the people who live there. Evidence: The registered manager has been employed at the home for 19 years. He holds the Diploma in Social Work, NVQ level 4 in care, the Registered Managers Award and is in the process of completing British Sign Language level 3. People living at the home benefit from a manager who has the values, skills, knowledge and experience to manage and develop the service. The home is effectively managed and any development is in the best interests of the people who live there. The manager also has management responsibilities for House Martins number 1 which is a short walk away. We saw that the manager has an open and positive management approach. They have daily contact with people living at the home and staff and it is clear that people have access to the manager at any time. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The manager meets with support staff on a regular basis to keep people up to date with the developments of the home. This is either as supervision meetings, team meetings or team days. We received completed surveys from six members of staff. Three members of staff told us that they regularly get enough support from and are able to meet with the manager to discuss how they were working, two members of staff told us they sometimes get enough support and one person said they often received support from the manager. We saw that they had a quality assurance process, this was in the form of questionnaires in an easy to read format and discussions with people living at the home and their representatives. The information received is analysed and a written plan of action produced to show how issues raised will be addressed. We saw last years plan displayed in the hallway. The manager told us that he was in the process of analysing this years questionnaires. We saw that policies and procedures were reviewed on a regular basis and when there are changes to legislation. This means that staff are kept up to date with the latest information. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 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 20 To make sure the information is accurate it is recommended that where medication handwritten onto the MAR sheets two people sign to confirm the information regarding dose and frequency. To provide a clear audit trail it is recommended that receipt of medication is signed for in the section provided on the MAR sheet. 2 20 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - 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!