Inspection on 06/07/09 for Lingwell Approach

This is the latest available inspection report for this service, carried out on 6th July 2009.

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

Lingwell Approach 11/07/06

Lingwell Approach 09/02/06

Lingwell Approach 22/07/05

Lingwell Approach 08/12/04

Lingwell Approach 18/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Lingwell Approach 14 Lingwell Approach Middleton Leeds West Yorkshire LS10 4TJ     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: Valerie Francis     Date: 0 6 0 7 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 26 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 26 Information about the care home Name of care home: Address: Lingwell Approach 14 Lingwell Approach Middleton Leeds West Yorkshire LS10 4TJ 01132778517 01132778517 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: None United Response care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home Lingwell Approach is a four bedroom bungalow, purpose built to accommodate people with multiple disabilities. It is situated in a development of mixed housing in the Middleton area on the southern outskirts of Leeds, with nothing to distinguish it from the other properties as a care home. The area is well served by local shopping centres, sports and leisure facilities, with good access via public transport from Leeds and Wakefield. The home accommodates up to four young women with learning disabilities and physical disabilities. The property is managed by a housing association; the care service is provided by United Response. 4 4 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 26 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 inspection process included looking at the information we received about the home since the last key inspection. This was an unannounced visit by one inspector who was at the home from 9.45 to 17.30. The purpose of the key inspection was to make sure the home is operating and being managed for the benefit and well being of the people who live there. The ladies who live at the home have no verbal capacity to engage in conversation, therefore during the visit we observed staff interaction with them. We spoke to the ladies, staff and the manager during the visit. There were no visitors at the time of our visit. We looked at various records relating to peoples care and the running of the home and we inspected the premises. During the inspection all of the key standards were looked at to assess the standard of care that people receive. Before the visit we asked the home to complete a self assessment form. An annual quality assurance assessment Care Homes for Adults (18-65 years) Page 5 of 26 (AQAA,) this was returned to us in good time. We also sent surveys to people living in the home, the manager told us before the inspection visit that these surveys would have to be completed by staff and the response would be staffs and not the ladies; so they were not completed. We also sent surveys to staff and health and social care professionals. We received seven completed surveys from staff and one from a health care professional. Their comments and information from the self assessment form are included in this report. Care plans, risk assessments, health care records, minutes of meetings, staff recruitment and training records were looked at. Feedback on the findings of the inspection was given to the manager. We were told at the visit, that the fees for living at the home is one thousand four hundred and twenty pounds per week. Chiropody, hairdressing, personal clothing are not included in the fees. 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 service 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 6 of 26 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 7 of 26 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 8 of 26 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. People are given good information about the service the home provides. This mean that they can decided if the home is right for them. Evidence: People wanting to to use the service and their representative is given a copy of the home and organisations statement of purpose along with other written information that is available from the home. This make sure that people and their representative is made aware of the service that they will receive. Since the last key inspection one new person has moved into the home.The other people have lived at the home for many years. It was evident that the admission process was robust to make sure peoples care and support needs can be met by the homes staff team and they will fit in with others living there. The admission process for the new person was looked at, and it was found that the home carried out a rigorous assessment, which involved health care professionals and family, who were involved in the persons care. It was clear that the person and their relatives were consulted and time was given to make sure that they wanted to come and live at the Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: home and would be compatible with the other people living at the home. The admission process normally involves people having day visits and short stays. Care Homes for Adults (18-65 years) Page 10 of 26 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. Everyone works hard to make sure people who use the service receive person centered care and are supported to achieve their personal goals, which help maintain and develop their skills. Evidence: Three peoples care records were looked at. There were several different documents that provided information about peoples care and support needs. Records explained what people like and dislike and any potential risks and how they would be managed. There was information on how people should be supported during activities at home and in the community. We saw good information, such as body map charts for skin care. There was good Information in one person care plan of the action staff must follow when assisting with their gastric feed. There was clear information of the action staff must take if the tube was accidental removed. There was evidence to show that relatives had been involved in peoples care planning process. We found, in the main care and support plans were person centered to each person. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: We saw good information which gave an overview of the care people had received in the last twelve months and what changes were made for the care and support given. Care plans are regularly evaluated by each persons key work and six monthly reviews are held with all persons such as the key worker at the day centre who are involved in the persons care. Peoples care and support plan had information on what has worked and what does not work for the person; This is part of the monthly review, including the learning log which is completed by staff when something new is used for an individual; which may have caused some changes in them. We were told that this tool is used for lessons learned about the task staff had undertaken with people when supporting them. Staff are very knowledgeable about people and their individual care needs. They were able to provide very specific details about how they looked after them. These were generally consistent with what had been recorded in care plans and assessments. We saw good practice; all staff had signed the care and support plan of the person who last came to live in the home. This indicated that they had read and knew how to care and support this person. The manager said, when it is possible, someone other than staff and relatives, advocate on behalf of people using the service. This good practice protects peoples interest. The manager said her and staff continually look at ways to communicate with people. This they hope give people the opportunity to have their say. Interaction between the people and staff was observed. Staff were seen to offer choices and give the person time and encouragement to respond. Daily records provided evidence that people were given choices and encouraged to make decisions. For instance all people are given a choice of what they want to wear, and we were told that through body language staff has observed that one person liked the colour red. Detailed risk assessments are in place, providing staff with good instruction on how to manage any identified potential risk. Care Homes for Adults (18-65 years) Page 12 of 26 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 who use the service have a varied and fulfilling lifestyle that is based on their individual needs. Evidence: There was evidence that people have an active lifestyle with family contact and health appointments. People are supported in their recreational activities including meals out, swimming, and shopping trips. An aromatherapist visits the home fortnightly for people who wish to have a massage. All efforts are made for people to have contact with family and friends. We saw in plans that people are supported to develop their independence and preferences, for example staff work with people to choose what they would like to wear. Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: We saw that staff had created a sensory area in one persons room, which this person use to have a quiet time and enjoy the peace and tranquility of the background music . There is an activity plan for each person, which involves holidays, day trips and outings to the local shops, which people appeared to like. During our visit one person accompanied a member of staff to the local supermarket for the weekly food shopping. Risk assessments are carried out to make sure that people are safe at all times. It was evident that people are encouraged and supported to take part in recreational activities outside of the home. During our visit one member of staff supported one of the people to an activity in York. The manager told us that people have good contact with their neighbours in the community. Staff said they provided a very person centred service and thought they successfully met the different needs of the people who live at the home. Staff had good knowledge about the people living at the home. They were able to talk about their likes and dislikes, their family and their current needs. Any contact with family and friends is documented this enables staff to have an overview of contact people had with families and healthcare professionals. Four weeks menus were looked at and these were varied and nutritious. All staff work closely with people to put together the weekly menu. which were told were based on peoples preferences; this is done by staff showing people photographs of meals and staff noting peoples reaction. People are supported at meal times in line with their risk assessment. There were no formal nutritional risk assessments carried out to make sure that nutritional needs were being met. However, peoples weights are monitored monthly and we were told and we saw, that the home works closely with dietitians, to ensure that people nutritional needs are monitored if a problem occurred. Care Homes for Adults (18-65 years) Page 14 of 26 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 health and personal care that people receive is based on their individual needs. Peoples care and support are provided with respect and in a way that takes into account their privacy and dignity. Evidence: We saw staff providing people with care and support that was sensitive to their needs; with their privacy and dignity respected at all times. From discussions with staff it was clear that they were knowledgeable about people and their health needs. All peoples needs are identified in their care and support plan, their health plan is well managed. Health assessments are clear with the action to be taken to support the individual, making sure that no health needs are overlooked. Peoples health plan covers manual handling, chiropody, GP, Optician, dental and other specialist health needs. There was written evidence that external health professionals are consulted about people care . The home is visited regularly by a clinical specialist nurse to support staff to deliver peoples care. Health care professionals told us that they visit the home regularly and they are always impressed by how well staff knew residents, they always seem to have the residents best interest in mind and I feel the staff are good Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: advocates. Three ladies were in when we arrived at the home, two were getting ready to go out. During this time, we saw that staff sensitively supported people. The atmosphere was relaxed and friendly. During our visit we looked at the homes medication and found that the home uses a monitored dosage system and manages the system safely. The records were good with evidence of stock control and any drugs returned to the chemist. Care Homes for Adults (18-65 years) Page 16 of 26 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 home have procedures in place and staff have had training which protect the people that use their service. Evidence: We have not received any complaints since the last key inspection. The complaints procedure is available to peoples representatives in the home statement of purpose. We were told that a copy of the homes complaint procedure is given to relatives, when their relative came to live in the home. The procedure is also available in the office displayed on the wall and in the homes policy procedure manual. All new staff have a POVA (Protection of vulnerable adult ) first check carried out and full CRB (Criminal Record Bureau ) check is also completed before employment is started. Staff confirmed that they had attended training relating to adult abuse as part of their induction training. It was apparent that they knew what action they must take if they were aware of an abusive situation. All personal allowances are recorded and any purchases made on behalf of people are recorded in the financial documents. People have access to their personal money at all times. Care Homes for Adults (18-65 years) Page 17 of 26 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 who use the service are comfortable in their surroundings and have specialist equipment to maximize their independence. Evidence: During our tour of the building we saw communal sitting areas, bathrooms and bedrooms. The home was clean and tidy, we found that generally there were no malodour. People who use the service could walk freely around the home and use all communal areas. Bedrooms were very personalised, it was clear that careful consideration had been given to the decoration to reflects the preferences of the people who live there. Different equipment were available to help people maintain skills and promote independence, and health and safety when moving and handling. One person had a sensory area in their room; where a soft mat, background music and interactive equipment were in place. Assessment is made for people needing any specialist moving and handling equipment. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: The sitting room furnitures are suitable for needs of the people living in the home. The garden was well maintained, one area had been made into a sensory area with plans and flowers with diffrernt scents. Care Homes for Adults (18-65 years) Page 19 of 26 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. The staff team work well together and everyone works hard to provide good individual care. Evidence: During our visit we saw that staff work well together and communication was good. They have a daily handover where information is passed on to staff who are starting their shift. Staff meetings are held every month. Staff said these were good opportunities to discuss anything that was relevant to the home. The minutes from the meetings were detailed and a good source of information for staff who were not present. It was apparent from staff recruitment files that staff received regular supervision and had opportunities for personal development. Staffing levels are two during the day. However, we were told that five times a week there are three staff; sometimes on occasions there are more, depending on what people were doing. These extra staff provide opportunities to take people out or spend quality time with people and support people to appointments. There are two staff in the home at nights one awake and one sleep-in staff. On the day of the visit we saw that two people were taken out by staff thus leaving one member of staff and the manager. There was one staff vacancy of thirty hours; recruitment process had started to fill this post. We looked at two staff recruitment records and found that all the relevant information Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: was available. Staff said they had opportunities to attend a good range of training courses. Training records were looked at. Staff had attended various training courses including, person centred planning, health and safety, adult protection, complex behavior, epilepsy and working safely. Seven staff had completed NVQ level 2 or above, one had almost finished and five were in the process of completing it. The manager had identified that some staff needed updated training and had produced a training plan, for such as basic food hygiene. One new member of staff was able to explain their induction training, with further training in manual handling, first aid, medication, health and safety. They also confirmed that they had regular reviews and support of their work with a probationary six weeks supervision session. Care Homes for Adults (18-65 years) Page 21 of 26 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 well managed and run in the best interest of the people living there. Evidence: Staff and health care professionals were complementary about the manager and they thought the home was very well managed. Staff said the home provides a high standard of care and support to the ladies who live there, it is managed well and all staff receive training and knowledge from a good manager. The home has transformed. we have had a change of management who is totally focused on providing top quality care for the people we support and the service as well as staff. Staff told us that the manager is well supportive to the ladies and staff, she set a high standard and always put the ladies first. It was clear at the visit from looking at records, talking to staff and observation, that home was well managed, and that manager give clear direction and staff knew their role and what was expected of them. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The manager told us that there is a information pack need to know, which all new staff to the home are given the opportunity to read, in the pack there is information such as Adult protection procedure and whistle blowing; staff sign to indicate that they had read it and understood the documents. Staff meetings are held monthly and outside of this forum regular discussions are held with staff concerning the home and peoples care and support. There is an annual audit by the organisation, questionnaires are sent to people who use their service, staff, relatives and any others who are involved in the service and people who live there. The feedback of the audit and other information about the organsation is shared with all participants in a quarterly magazine. The home also carry out an audit of their service; eight weeks before peoples individual review, questionnaires are sent to their relatives and health care professionals about the service the person is receiving. The manager has monthly supervision with her area manager. For most of the year the Regulation 26 visits are undertaken by a Representative of the company or a manager from another home within the company, but on some occasion the home manager is asked to complete regulation 26 visit report. Information in the AQAA told us that policies and procedures are available and regular maintenance and health and safety checks are carried out by external agencies. We saw records that confirmed that all checks had been carried out within their given timescale. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 22 The homes complaint procedure should be displayed in a place other than the office where it is accessible to visitors to the home. This mean that if they had any concern they know what action to take. Care Homes for Adults (18-65 years) Page 25 of 26 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). 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