Inspection on 18/12/09 for Manchester Court

This is the latest available inspection report for this service, carried out on 18th December 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Manchester Court 07/11/07

Manchester Court 03/01/07

Manchester Court 21/06/06

Manchester Court 17/03/06

Manchester Court 30/08/05

Manchester Court 14/03/05

Manchester Court 03/11/04

Manchester Court 26/03/04

Similar services:

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

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

Key inspection report CARE HOMES FOR OLDER PEOPLE Manchester Court 77 Clarence Street Cheltenham Glos GL50 3LB Lead Inspector Mr Adam Parker Unannounced Inspection 18th November 2009 09:50 DS0000016498.V378653.R01.S.do c Version 5.3 Page 1 This report is a review of the 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. 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 older people 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. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.2 Page 2 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 Manchester Court DS0000016498.V378653.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manchester Court Address 77 Clarence Street Cheltenham Glos GL50 3LB Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01242 523510 nick.yorke@btinternet.com Raynsford Cheltenham Limited Miss Chloe Catherine Allan-Yorke Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Old age, not falling within any of places other category (10) Manchester Court DS0000016498.V378653.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of either gender whose primary care needs on admission to he home are within the following categories: Old age, not falling within any other category (Code OP) Mental Disorder, excluding learning disability or dementia (Code MD) The maximum number of service users who can be accommodated is 20 18th November 2008 2. Date of last inspection Brief Description of the Service: Manchester Court is a listed building in the centre of Cheltenham. It is near to the town centre with all its amenities, and the central library and museum are a hundred yards away. The Parish and Roman Catholic churches are near by. Accommodation is on four floors. The kitchen, laundry and some storage areas are in the basement. On the ground floor is the communal dining room and lounge. A shaft lift and stairs serve all residential floors. The bedrooms are located on all floors and are for single occupancy. There are no ensuite facilities, although washbasins are provided in each room. There is level access to the rear of the building, which opens onto a courtyard with some adjacent car parking spaces. The front door has three steps down and opens directly on to Clarence Street. The charges of the home are in the range £286-£440 per week and there are no additional charges. The home has a Statement of Purpose and a Service Users Guide and they provide the information which is required for new and existing service users The home will ensure that service users are kept up to date by providing them with the most recent inspection report. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. One inspector carried out the inspection over two days in November 2009. The responsible individual was present for both days of the visit and the registered manager for the second day. The inspection visit consisted of a tour of the premises and examination of residents’ care files. In addition training was looked at as well as medication storage and administration and documents relating to the management and safe running of the home. Two residents were spoken with to gain their views of the service. An Annual Quality Assurance Assessment (AQAA) form was received from the home prior to the inspection visit. This was gave us most of the information we asked for although lacked information in some areas about improvements to the service. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: The home has a good system in place for assessing the needs of potential residents, planning their care and working to meet their health and personal care needs. Care is delivered in such a way as to uphold residents’ privacy and dignity. There were generally good practices in place around the storage, recording and administration of residents’ medication. Where any issues are found with medication administration these were being addressed with the staff team at staff meetings. The home provides a range of suitable activities and residents maintain links with the local community. There is good consultation with residents particularly around the meals provided. The home has a high percentage of staff with a National Vocational Qualification (NVQ). Manchester Court DS0000016498.V378653.R01.S.doc Version 5.2 Page 6 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. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 People using the 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 assessment procedure ensures that all prospective residents receive a full assessment of their needs before they move into the home so that they can receive the care and support that they require. EVIDENCE: The assessment documentation for two residents who had recently moved into the home was looked at. With both residents the home had carried out their own assessment before the resident moved in to the home. These assessments had been reviewed and updated although with one of the residents the original assessment document could not be found. Information had been obtained from the NHS mental health trust where this was relevant to the resident’s needs. One of the residents had visited the home before they moved in. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 9 The home does not provide intermediate care and so standard 6 does not apply. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 People using the 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 works well to meet residents’ health, personal care and medication needs whilst upholding their privacy and dignity. EVIDENCE: Care plans described specific needs and how these would be met through staff actions. They had been generally reviewed on a monthly basis and some had evidence of good evaluation of the care and support given. One care plan for nutrition showed an individualised approach giving information about the resident’s food preferences. Another care plan for dealing with a resident’s behaviour described how medication could be used to help with anxiety. A daily record is maintained for each resident. Risk assessments had been completed for such areas as mobility, moving and smoking. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 11 Where appropriate a monthly record of weight was being kept. There was recorded evidence of residents receiving input for health needs from visiting health care professionals such as community psychiatric nurses and General Practitioners (GPs) as well as attending hospital appointments. Residents had also been receiving visits from an optician and staff had been given training in conjunction with this. One resident who had diabetes had the management of this described in a care plan that included a reference of when to involve medical attention. Medication, storage administration and recording arrangements were looked at. Storage was secure and appropriate arrangements were in place for controlled drugs although there were none kept in the home at the time of the inspection. Topical medication such as creams and ointments were being stored separately from oral medication which is good practice. Temperatures for medication stored in the medication cupboard were not being monitored; this should be carried out to check that residents’ medication is being stored at the correct temperature. A notice on the front of one of the medication cupboards reminded staff to date medication on opening however a tub of cream and a bottle of liquid medication had not been dated when opened. Examination of the Medication Administration Charts showed that some hand written directions had not signed by the staff member making the entry or checked and signed by a second member of staff. This was also the case where one course of medication had been stopped. Medication administration or omission had been consistently recorded except for a topical cream for one resident. This was discussed with the registered manager who had addressed this with the staff team at a recent staff meeting. Where medication was prescribed on an ‘as requires’ basis then the use of this medication was detailed in care plans for two of the resident’s records that were looked at. It is recommended that a check is made if there are plans or protocols for all residents prescribed medication on this basis. An audit system was in place that checked on the recording for one medication round a day. This involved checking the amounts of medication left after the round to ensure that correct doses had been given. Any problems with medication administration were being discussed at staff meetings to ensure that staff were aware of them and were improving their practice. At the time of the inspection visit there were no residents self medicating although lockable storage facilities were in place if these were needed. Residents confirmed that staff knocked on doors before entering and were polite to them. There are no shared rooms in the home. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a varied activities programme, good social contact and a selection of meals planned through consultation about their preferences. EVIDENCE: The home had an activities programme that was described as following a “loose timetable.” This included film nights; bingo, games and Karaoke. There were also trips outside of the home including trips out in the evenings. Pub lunches and shopping trips to the town were popular. Photographs were displayed in the office of a residents’ trip out to a local preserved railway. A number of residents made frequent visits to two local social clubs. Some residents were receiving visits from representatives of local churches. During the inspection visit one resident had been shopping in Gloucester. Information about advocacy services is available in the home. One resident had an advocate and a care plan was in place for this. Consideration was also being given to arranging an advocate for another resident. Residents’ rooms Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 13 were personalised to various degrees. Some residents handled their own financial affairs. Meals in the home consisted of a cooked lunch and in the evening a cooked snack or sandwiches and soup. Breakfast was cereals and toast. Information about the main meal for the day was posted on a notice board. One resident spoken to was aware of what was on the menu for lunch on that day and described the meals as “Alright”. Another described the meals as “Very Good” and commented on the varied menu. Residents were observed eating lunch in the dining room while others ate at small tables in the lounge and some in their own rooms. At the time of the inspection visit the home was providing a special diet for one resident. Records of the meals provided had been kept although there should be a more detailed record of any special diets. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available if any resident or their representative should wish to make a complaint and the home’s approach to training staff should ensure that residents are protected from abuse. EVIDENCE: The home had a complaints procedure and this was on display on a notice board opposite the office. This was in need of review to include the most recent contact details for the Commission. The home had not received any complaints in the twelve months prior to the inspection. The management of the home had received training in the Mental Capacity Act 2005 and information about the Deprivation of Liberty Safeguards was displayed on a notice board. The homes adult protection policy was looked at this made reference to the Department of Health guidelines ‘No Secrets’. The policy also referred to the local authority’s Adult Protection team although would benefit from their direct contact details. All staff had received training in protecting vulnerable adults. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 & 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean environment with personalised individual rooms. EVIDENCE: A tour of the premises was undertaken. Communal areas consisted of a lounge and dining room on the ground floor with a smoking lounge on the first floor. This had recently been redecorated. At the rear of the home there is a small patio area. During the inspection visit, the home’s maintenance man was carrying out routine maintenance. There was evidence of refurbishment and redecoration in a number of areas of the home. The responsible individual described plans for the refurbishment of the kitchen that was to include the replacement of kitchen units. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 16 Some dining room chairs were not in a good condition despite this being raised at the previous key inspection. These should be checked and replaced or refurbished depending on the condition. Residents’ individual rooms were warm and contained various degrees of personalisation. One resident commented that the lighting in his room was not bright enough and the maintenance man was looking into replacing the existing bulb with a brighter one. All individual rooms have washbasins although no en suite facilities are provided. The laundry room was looked at on the first day of the inspection visit; some work was needed on one of the wall surfaces to provide a washable surface. This work had been completed on the second day of the inspection visit. Hand washing facilities are provided in bathrooms throughout the home. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident’s needs are met by the numbers and skills of staff with good training although recruitment practices have not been robust and have potentially put residents at risk. EVIDENCE: Typical staffing arrangements in the home in the home consisted of four or five staff in the morning undertaking care duties as well as cooking and cleaning. In the afternoon there was four care staff with an additional two hours being worked from 4pm to 6pm to cover a busy time around the evening meal. In addition one resident was receiving an additional two hours care for five days a week. At night there is one waking and one sleeping member of staff. The home had twelve out of fifteen permanent care staff with an NVQ at level 2 or above. Records for two recently recruited members of staff were looked at. Examination of the recruitment files showed that all of the required information had been obtained prior to employment except checks against the Protection of Vulnerable Adults register (PoVA) or as it is now known the Independent Safeguarding Authority (ISA) adult first check. The home had started staff Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 18 working without a Criminal Records Bureau (CRB) disclosure and so were required to carry out an initial check against the PoVA or ISA register before the person started work in the home. Although it was reported that these checks had been carried out no supporting evidence could be found during the inspection visit or when requested after the inspection visit. It must be concluded that the members of staff had started work in the home without these checks being made. It was reported that staff were supervised until their CRB disclosures had been received. The home’s AQAA document indicated that satisfactory pre-employment checks had been carried out on all staff. New staff were given an induction into the working of the home. Although it was unclear if staff that are new to working in care are given induction training to the Common Induction Standards and the home should check this. Staff had also received training in conflict management, care planning and customer service. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Despite good quality assurance work in a number of areas, there is still improvement needed and management input into recruitment practices to ensure the safety and well being of the residents. EVIDENCE: The registered manager had been registered for a year and has achieved the registered manager’s award and NVQ level four in care. She had recently undertaken training in the Mental Capacity Act 2005 and the related Deprivation of Liberty Safeguards. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 20 A number of audits were in place looking at such areas as medication, cleaning, maintenance and health and safety as part of the quality assurance in the home. Despite this recruitment practices require some quality monitoring and management input to ensure the safety of residents. Feedback sheets had also been received and in the past the results had been analysed and included in an annual report. Residents meetings had also provided an opportunity for any issues to be raised and minutes of these were looked at during the inspection visit. Residents had raised issues such as meal choices, activities, staffing levels and choice of key worker. As discussed during the inspection visit, arrangements should now be made for visits and reports under regulation 26. The arrangements for looking after residents’ money was looked at and satisfactory arrangements were in place. A check on the money held for one person showed this to be accurate in relation to the records kept. Records were generally in good order although a record of an assessment made on the needs of one resident before they moved into the home could not be found. This should have been held in the resident’s care plan file. Staff had received training in infection control, fire safety, first aid, manual handling and food hygiene. Heating and electrical systems and appliances had been serviced and maintained as well as hoists and the lift. The storage of cleaning materials was checked and all containers displayed their correct original labels. Hot water temperatures were being checked and recorded on a monthly basis as were checks on window restrictors. A risk assessment had been completed for Legionella this should be checked against Health and Safety Executive guidelines to ensure that it fully addresses any potential risks. The home did not have a security risk assessment; this was discussed with the registered manager and is recommended following recent criminal activity in the area affecting care homes. The home has a fire risk assessment in place. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 2 X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 (1) (b) Schedule 2 Requirement Before a person starts work in the home, all the information and documents specified in Schedule 2 of the Care Homes Regulations must be obtained to ensure that residents are protected through robust recruitment procedures. Timescale for action 31/12/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP1 OP9 OP9 OP15 Good Practice Recommendations The current statement of purpose should be readily available in the home. A check should be made to ensure that there are plans or protocols in place to guide staff in giving medication prescribed on an ‘as required’ basis. Monitor and record the temperature in the medication storage cupboard to check that all residents medication is being stored at the correct temperature. A more detailed record should be kept of any special diets provided for residents. DS0000016498.V378653.R01.S.doc Version 5.3 Page 23 Manchester Court 5. 6. 7. 8. 9. 10. 11. OP16 OP18 OP20 OP30 OP33 OP37 OP38 Review the complaints procedure to ensure that it reflects current contact details for the Commission. Review the adult protection policy to include the contact details for the local authority adult protection team. Review the condition of all of the dining room chairs with a view to replacing or refurbishing those that require attention. Check that where induction training is given to staff new to working in care that this is in line with the Common Induction Standards. Regulation 26 visits should commence as discussed during the inspection visit. Records of assessments made before a resident moves into the home should be kept in the resident’s individual file. The Legionella risk assessment should be checked against Health and Safety Executive guidelines. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 24 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. Manchester Court DS0000016498.V378653.R01.S.doc Version 5.3 Page 25 - 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!