Inspection on 22/04/10 for Wells House Care Limited

This is the latest available inspection report for this service, carried out on 22nd April 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Wells House Care Limited 2 Wells House Road London London NW10 6EE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Robert Bond     Date: 1 0 0 5 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 25 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 25 Information about the care home Name of care home: Address: Wells House Care Limited 2 Wells House Road London London NW10 6EE 02089610200 02089610200 carewells@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Wells House Care Ltd Name of registered manager (if applicable) Miss Dara Vidakovic Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: Four The registered person may provide the following category/ies 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: Mental disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 2 Wells House Road is a care home that is registered for four adults with mental health needs and associated learning disabilities. The home has been open since 1996, having been developed and expanded from an adult placement home. The home is operated by Wells House Care Ltd. The property is three storeys, with staff accommodation comprising the top floor. The home is located on a quiet residential street in an otherwise industrial area. Shops, buses and train stations are a ten minute walk away. Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 4 4 Brief description of the care home There are four single bedrooms, two bathrooms, a dining room, large lounge, patio and garden. The home is very attractively furnished and decorated to a high standard. In addition to the Manager, there is a Deputy Manager and two support workers, a parttime cook, and two volunteers. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection of a re-registered service. We considered the outcomes for the key National Minimum Standards (NMS) for care homes for younger adults, as published by the Department of Health. We obtained in advance an Annual Quality Assurance Assessment (AQAA) completed by the home. We also obtained surveys completed by the residents. We visited the home on two separate occasions in order to undertake our inspection. We interviewed the Manager and Deputy Manager, met staff on duty, and talked to the residents who were present. We toured the premises including one residents room, with his permission. Equality and diversity were considered throughout the inspection. Care Homes for Adults (18-65 years) Page 6 of 25 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 25 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 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information available about the home is up to date and is well produced. We did not judge the assessment and moving in process on this occasion as there were no new residents. Each resident has a clear and well produced contract that they sign, and which is updated annually. Evidence: We inspected the homes Statement of Purpose and Service Users Guide. No new resident has moved into the home for several years so we did not inspect any assessments of new residents, or the moving in process. We examined the contract for one existing resident and noted that it had been signed by the resident. The Deputy Manager told us that contracts were updated annually, which is commended. Care Homes for Adults (18-65 years) Page 9 of 25 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. Assessed needs and how to meet them are clearly recorded in individualised care plans for each resident. The residents are involved in drawing up the care plans, which are kept under review. Diverse procedures are in place for ascertaining residents views. Participation by residents in the running of the home is strongly encouraged. Residents where possible are supported to take responsible risks as part of the promotion of an independent lifestyle. Evidence: We examined one care plan in detail. It was dated Feb 2010 and showed a future review date of August 2010. The resident had not signed the care plan kept in the office, but he had signed the one that was kept in his room. The resident has a key worker but the key workers name did not appear on the care plan, and this is recommended. The key worker has a formal meeting with the resident each month, and the main points of discussion are recorded. Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: The care plan we examined contained details of all assessed needs, and how to meet them, in detail. Residents are involved in decision making informally on a daily basis, formally at monthly group meetings, and also at key working meetings, care plan review meetings, and by the use of annual questionnaires. The Deputy Manager reported that residents are encouraged to help in the home by cleaning their rooms, setting the dining table, and preparing food. This was confirmed by a written schedule of tasks we noted in a residents bedroom, which is commended. The file we examined contained a series of detailed risk assessments dated February 2010 and which had been signed by the resident. The Deputy Manager confirmed that responsible risk taking and the promotion of independence are part of the homes philosophy. Two residents go out alone frequently, and one resident is partially responsible for his own medication. The home has a written policy on confidentiality. It was dated 2006 so needs to be reviewed. A requirement is made under NMS 40. Care Homes for Adults (18-65 years) Page 11 of 25 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. All the residents have excellent opportunities for personal development, for leisure choices, and for developing close friendships. Family relationships are very well promoted. Residents rights are very well recognised. Excellent food is served in a lovely communal atmosphere. Evidence: On the first day of our inspection, two residents went out, accompanied by a member of staff on a swimming trip. A third resident went out alone. The Deputy Manager reported that ten pin bowling is particularly popular with all of the residents, going to the cinema is popular with three of them, and they also like going to bars and restaurants. The group has recently enjoyed a collective holiday in Yorkshire, which is commended. No one goes to college at present, but the possibilities are going to be investigated. No one chooses to go to any religious service. One resident attends social events of an ethnic nature. Two residents attend a day centre. Family contacts Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: are encouraged, and video-conferencing is used in one case, which is commended. The residents have developed friendships with others living on the same street, and attend dinner parties in other peoples house, which is also commended. Routines within the home were seen to be flexible, for example we noted that one resident was allowed to sleep in late. Residents are able to lock their bedrooms, and have a lockable cabinet. We examined the food menu, and observed a midday meal being cooked and eaten in an enjoyable communal atmosphere, which is commended. We noted that a record is kept of what each resident eats on a daily basis. Care Homes for Adults (18-65 years) Page 13 of 25 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. Residents receive personal care in the ways they prefer and require. Residents physical and mental health needs are being met, but there are gaps in their weight records. One resident partly administers his own medication. The current blister system for medication contains some fundamental flaws that must be addressed by the home with the pharmacy urgently. Evidence: We noted that the care plan we examined fully contained detailed information about how the resident wanted his personal care needs to be met. This care file also contained details of health appointments and health interventions. The Manager told us that none of the residents currently are under a CPA, or have an allocated CPN, but all see a consultant psychiatrist on a regular basis, and are reviewed by their GP annually. We noted that although the file contained a monthly weight record chart which had been completed for March, the January and February boxes were uncompleted. We checked a second residents weight record and found the same omission. Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: We checked the residents medication, which is in blister packs, and the record of its administration. The provision of medication has recently been taken on by a local pharmacy but we noted some problems. The blister packs do not name the day of the week so it is not clear to the person administering the medicine, or to the person checking that the medicine has been administered correctly, which tablet applies to which day. Thus there is no visual check that Thursdays tablet (for example) has been administered on Thursday. A problem had arisen the Manager told us back in February whereby the wrong number of tablets had been supplied by the pharmacist and this was still having a knock on effect on the tablets left in the current (April) blister packs. This resulted in a tablet remaining in the first blister at the top (day one) in some instances, but a tablet remaining in the bottom blister of the first row (day seven) in some other cases. In other words there was no consistency and it was very confusing, and liable to lead to an error being made. The blister packs for the same resident are divided by coloured plastic sheets according to the time of day that the medication within the blisters is to be given. The Deputy Manager said it is the pharmacy that sets this up each month, but there were errors with the dividers sometimes being in the wrong place thus also causing confusion about the time of day that specific tablets should be administered. A further discrepancy we spotted was where a blister pack was in the section named bedtime whereas the medication administration record (MAR sheet) showed it as 6pm, that is teatime tablet. Thus the support worker was signing that he had administered medication at 6pm as per the written instruction, but he was taking the tablet from a section of the blister pack labeled bedtime 9pm, and he was actually giving the tablet said the Manager, after supper. It is essential that medication is administered at the times prescribed, and if blister packs are used, it is essential that the pharmacy sets the packs up correctly as they are designed to be a compliance aid, as opposed to having the opposite effect. The ageing and death standard was not assessed as the residents are all younger adults. Care Homes for Adults (18-65 years) Page 15 of 25 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. Residents can be sure that if they have a complaint it will be listened to and acted on. All of the support staff and half of the managers have been recently trained in adult abuse protection. Evidence: We examined the homes complaints procedure and found it to be up to date and rwe noted that it referred to the role of the CQC. The AQAA completed by the home told us that one complaint had been received since our last inspection. We examined the homes record of this complaint which had been from a resident concerning a supposed lack of wool for an activity. The complaint had been properly recorded and dealt with. The Deputy Manager reported that both support workers had recently undertaken abuse training, and we saw the certificates for both of them. The Deputy Manager added that he had undertaken the Safeguarding adults training with the London Borough of Ealing in March 2009 and that the Manager would be receiving the training shortly. Care Homes for Adults (18-65 years) Page 16 of 25 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 excellent 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 very homely, comfortable and safe environment. The bedroom we saw was well furnished and had been decorated to the residents individual tastes. The bedroom was fully equipped. The homes two bathrooms with toilets are beautifully furnished and equipped. Communal spaces inside and out are well equipped and beautifully decorated and furnished. No specialist equipment is needed to meet the residents needs. The home is clean and hygienic throughout but the home does not have an infection control action plan. Evidence: We toured all of the communal areas of the home and garden, plus one bedroom in the company and with the permission of the resident. We tested the lighting in the bedroom, and the hot water supply in one bathroom. The homes AQAA shows that the home does not have an infection control action plan. Care Homes for Adults (18-65 years) Page 17 of 25 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. Residents should now benefit from more clarity of staff roles. The ratio of 50 of support workers having at least NVQ level 2 is met. Sufficient staff were on duty during the day and sleeping in overnight. Residents are protected by the homes recruitment policies and practices. Residents will benefit from a well supported and supervised staff team. Evidence: At the time of our first inspection, only one of the support workers had a job description, and the Deputy Manager said he did not have a job description. This had been corrected for our second visit, but the job descriptions were not dated. The Deputy Manager reported that one of the support workers was close to completing NVQ 3 and the other was soon to start NVQ level 2. We examined a series of staff rotas. There is a good mix of male and female staff. We saw the minutes of a staff meeting held 12th January 2010. The Deputy Manager said that staff meetings are held every two months but the notes of the last meeting have not yet been produced. During the first inspection, we were told that the two support workers had undertaken Care Homes for Adults (18-65 years) Page 18 of 25 Evidence: training that we had required all the staff and managers to undertake as a requirement of our last inspection. The Managers had not yet undertaken this mandatory training as it had been canceled during the extreme weather of the last winter.On our second visit we met the trainer who confirmed the managers would be trained on 7th June 2010. We checked two recruitment files. The support worker who had not produced a photograph for his recruitment had now done so, and he had signed his health declaration. There will still shortcomings concerning the recruitment of the Deputy Manager. These matters had been corrected by our second inspection visit. The staff training and development plan for the home that had been required at our last inspection was not in place at the time of our first inspection. By our second inspection, individual training plans had been created. We agreed that a collective training plan would in future be part of an annual development plan for the home. At our first inspection, we found that the support worker was now receiving formal supervision, but the Deputy Manager was not. By our second inspection this had been corrected and we were able to examine a supervision record for the Deputy Manager. Care Homes for Adults (18-65 years) Page 19 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current registered manager of the home is very experienced in this role but is not managerially qualified. There is a good atmosphere in the home. Internal quality assurance processes are improving but are not yet satisfactory. Some of the homes policies have not been reviewed for several years. Most record keeping is very good, but we have noted throughout the report deficiencies concerning medication and residents weights. Although no requirements are made under safe working practices, some further work in these areas is still necessary. Evidence: The Manager does not have a management qualification but the Deputy Manager has just started the Leadership and Management in Care award with Hayes Staff Recruitment. Their trainer told us he might obtain the award before the end of 2010. Staff surveys show that the support staff are well satisfied with the way the home is operated. Surveys are also undertaken to ascertain residents views. No internal audits Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: are undertaken. Now the home is registered as a company, Regulation 26 applies, but no action has been taken to find an external person to undertake any supervision of the the work of the Registered Manager. However, that manager is now formally supervising the Deputy Manager. The fact that requirements from the last inspection report, and in one case, the inspection report before that have not been fully actioned demonstrate the need for management systems within the home to plan and check compliance with the various improvements that the home is called upon to make from time to time by a variety of internal and external forces. Having an annual development plan that is updated on a monthly basis should help. We noted that the homes policy on confidentiality had not been reviewed since 2006. The Deputy Manager said that he was working through and reviewing all of the homes policies at the rate of two a week. We examined various records throughout the inspection. We noted that fire extinguishers were checked annually but no further action had been taken concerning the partially implemented fire risk assessment that had been undertaken in 2008. AQt our second visit, the Deputy Manager told us that a new expert fire risk assessment had been commissioned and we would be sent a copy. The homes environmental risk assessments have been updated by a member of staff but the Deputy Manager had not checked them personally and some further work on them is necessary. Care Homes for Adults (18-65 years) Page 21 of 25 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 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The Registered Provider must ensure that if medication is received in blister packs as a compliance aid, the pharmacy puts the packs together in a way that does aid compliance. Otherwise errors are more likely to be made when adminstering medication to the residents. 31/05/2010 2 39 24 The home must establish an annual development plan. This should include changes identified as necessary by the management of the home, by residents, by the CQC and by commissioners of services. 01/07/2010 3 40 17 All of the homes policies must be reviewed periodically. 01/09/2010 Care Homes for Adults (18-65 years) Page 23 of 25 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 Otherwise they may become out of date, and residents may be disadvantaged. 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 2 6 19 The name of all the residents key workers should appear on their care plans. Weight records should be completed monthly for each resident. If for some reason it is not possible to obtain a residents weight one month, the reason for this should be written on the weight record form. The home should develop an infection control action plan and train staff accordingly. Job descriptions should be dated and ideally signed by the employee the job description is for. The management of the home should themselves ensure that risk assessments have been fully carried out and acted upon. 3 4 5 29 31 42 Care Homes for Adults (18-65 years) Page 24 of 25 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. © 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. Care Homes for Adults (18-65 years) Page 25 of 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!