Inspection on 10/10/08 for 100 Goldstone Crescent

This inspection was carried out on 10th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

100 Goldstone Crescent 20/11/06

100 Goldstone Crescent 18/01/06

100 Goldstone Crescent 02/08/05

100 Goldstone Crescent 18/01/05

100 Goldstone Crescent 20/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 05/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 100 Goldstone Crescent 100 Goldstone Crescent Hove East Sussex BN3 6BE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nigel Thompson     Date: 1 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 100 Goldstone Crescent 100 Goldstone Crescent Hove East Sussex BN3 6BE 01273553718 01273553718 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Care Management Group Ltd Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home 100 Goldstone Crescent is a care home, which provides personal care and accommodation for up to three residents with mild to moderate learning disabilities. The home is owned and run by Care Management Group (CMG) who are a large national organisation that provides care for people with learning disabilities. The home is located in a quiet residential area in Hove. There is access to local amenities and public transport. There is limited car parking available at the home, however free parking is permitted on the street. All rooms are for single occupancy and are located over two floors with suitable bathing facilities to meet the assessed needs of residents. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Brief description of the care home The layout of the home is not suited to accommodate wheelchair users and residents must be able to independently mobilise to access the first floor. There is a wellmaintained rear garden, which is accessible for residents to use. Prospective residents and their relatives are provided with written information regarding the services and facilities provided at the home prior to admission. The homes most recent inspection report is available on request at the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection took place over four hours in Ocober 2008. It found that all of the key National Minimum Standards were assessed and found to have been met or partially met and the overall quality of care provided was good. Residents spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to monitor current care practices at the home and Care Homes for Adults (18-65 years) Page 6 of 29 check compliance with the requirements from the previous inspection. The focus was on the quality of life and outcomes for people who live at the home. On the day of the inspection there were three residents living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the homes documentation and discussion with two residents, the acting manager, two members of staff and the Regional Director. The home provides personal care and support to residents who are funded by Social Services. The homes fees as of the date of inspection range between 1100 pounds to 1300 pounds per person per week dependent on needs. Additional costs are charged for hairdressing, chiropody, toiletries and holidays. Information received in the Annual Quality Assurance Assessment (AQAA) and responses from a CSCI service users survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The thorough admission policy and procedure ensures that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents know that the home is able to meet their individual care and support needs. Evidence: The Regional Director confirmed that there have been no residents admitted to the home since the previous inspection. However, comprehensive and detailed information regarding the service has been produced and is made available to all prospective residents. The quality and accessibility of this documentation, including the Statement of Purpose and Service User Guide is further enhanced by the effective use of photographs and diagrams. In line with other services within the organisation, the admission policy and procedures have recently been revised. In a welcome development, home managers are now directly involved in the pre admission assessment process. Following a referral to the Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: home the manager will now evidently visit the prospective resident and carry out a full pre admission assessment, including any personal and emotional care and support needs, mobility issues, social and cultural needs and family involvement. In addition to establishing whether the individuals assessed needs can be met within the home, the acting manager also stressed the importance of ensuring compatibility with existing residents. As well as being invited to visit the home to look around and meet with residents and staff, prospective residents have the opportunity to stop overnight or occasionally for a weekend stay before moving in. The acting manager confirmed that new residents undergo a flexible trial period at the home, followed by a thorough placement review, during which time their suitability and compatibility are fully assessed and it is established whether their identified care and support needs are able to be met. Care Homes for Adults (18-65 years) Page 12 of 29 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. Individual care plans enable staff to meet assessed needs in a structured and consistent manner. However, certain plans, including risk assessments do not always reflect residents current or changing support needs. Systems for consultation and participation are effective and residents are treated with respect and encouraged and enabled to make decisions about their day-to-day living. Evidence: Individual care plans that were examined contained personal risk assessments and details of residents physical, psychological and emotional support needs and were found to be accurate, genarally up to date and reasonably well maintained. The person centred plans All about me were found to be comprehensive and informative, containing detailed staff guidelines and sections on: How I like to communicate; Other people who help me; Help I will need with my personal care and Things I do and would like to do. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: The acting manager confirmed that residents and, where appropriate, a relative or representative continue to be directly involved in care plan reviews. However it was noted in certain care plans that were examined, that risk assessments had not beeen updated since February 2008 and were in need of reviewing. Independence and individuality is evidently encouraged and promoted within the home and is reflected in the personalising of residents rooms, the choice of bedclothes and colour schemes and individual preferences for occupational and leisure activities. Residents are encouraged and supported to make decisions regarding many aspects of their daily living, including menu planning, what clothes they wear and how they spend their day. The acting manager and Regional Director both emphasised the importance of staff developing close working relationships with individual residents and being aware of changes in mood or behaviour. Despite the variable and limited verbal communication of some residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of residents being supported by members of staff in a professional, sensitive and respectful manner. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social opportunities. Residents benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: The recreational and leisure interests of residents are identified and recorded in their individual care plan and they continue to be enabled and supported to access activities and facilities, reflecting their individual needs, preferences and abilities. In addition to this, the acting manager confirmed that weekly meetings with residents and staff are held, around the dining room table, to discuss activities and menus. A large information board, situated behind the table, is then updated with photographs Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: to indicate which staff are on duty and detailing residents individual activities for the forthcoming week. Residents are encouraged and supported to maintain family links. Visiting to the home is unrestricted and residents relatives and friends are made welcome at any reasonable time. The menu is varied and balanced and evidently based on residents likes and preferences. An alternative to the main meal is always available and a copy of the menu is displayed. The acting manager confirmed that, in accordance with their wishes, residents are frequently involved in meal time routines, including laying and clearling the table, washing up and drying and preparing packed lunches. Care Homes for Adults (18-65 years) Page 16 of 29 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. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual care and support needs. Residents are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. Evidence: In accordance with their personal care plan, residents are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. As previously documented, during the inspection, residents were observed being supported in a sensitive, professional and respectful manner. The acting manager confirmed that close and effective working relationships between residents and their key worker ensured that any subtle change in an individuals mood or behaviour can be identified and addressed at an early stage. All residents are registered with local GPs and have access to other health care Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: professionals, including physiotherapists, psychologists and occupational therapists, as required. Specialist advice from the Community Learning Disability Team (CLDT) is requested and provided, as necessary, on an individual basis. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. From discussions with the acting manager and members of staff, it is evident that the recently developed Healthcare booklets are proving effective and beneficial. Up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The acting manager confirmed that all staff responsible for administering medication have received appropriate training and are individually assessed and authorised to do so. This was confirmed through discussions with staff and supported by training records examined. The acting manager also confirmed that, following risk assessments, no resident currently has responsibilty for self administering their own medication. Care Homes for Adults (18-65 years) Page 18 of 29 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 open and inclusive atmosphere within the home enables residents, staff and visitors to feel able to express any concerns, confident that they will be listened to and acted upon. Residents are safeguarded from abuse through relevant staff training and robust policies and procedures. Evidence: A clear, comprehensive and accessible complaints procedure has been developed and is included within the Statement of Purpose and Service Users Guide. Residents and members of staff spoken to during the inspection confirmed that, should they have a concern or complaint, they would have no hesitation in speaking to the acting manager and each person was confident that they would be listened to. The Regional Director and acting manger confirmed that staff and residents meetings are held on a regular basis and provide an opportunity for any concerns to be raised and discussed before they become complaints. All complaints are appropriately recorded and include actions taken and outcomes achieved. However, it was noted that there have been no formal complaints received by the home since the last inspection. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: The organisation has produced detailed policies and procedures relating to protection and abuse, including a whistle blowing policy. The majority of staff have evidently undertaken specific training relating to Saferguarding Adults, in accordance with the recently revised multi agency guidelines. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. However it was noted that one senior support worker had not received relevant training since December 2005. When brought to the attention of the Regional Director, during the inspection, he immediately addressed the issue and made arrangements for the necessary training to take place as soon as possible. This is acknowledged as good practice and is indicative of a notable sea change within the organisation and a renewed commitment on behalf of senior management to raising standards, supporting home managers and improving outcomes for service users. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for its stated purpose. Residents benefit from accommodation that is comfortable, generally well maintained and decorated to a satisfactory standard. Evidence: It is evident that there has been little change in the physical environment at 100 Goldstone Crescent since the previous inspection and standards remain generally satisfactory throughout. The premises are accessible, safe and clearly meet their stated purpose. There is an office and sleep in room for staff on the first floor alongside two bedrooms and a bathroom. The fourth bedroom with ensuite facilities is on the ground level. During my guided tour of the premises it was evident that, with two notable exceptions, the generally well maintained decor and adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for residents. Following discussion with the manager and Regional Director, it is recommended that the worn out three piece suite in the lounge be replaced and the tired and outdated Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: bathroom be refurbished. The acting manager confirmed that independence and individuality continue to be promoted within the home and this is evident from the personalising of residents individual rooms, which clearly reflects individual tastes and interests. It was noted that infection control policies and procedures are in place and clearly adhered to. Levels of cleanliness remain satisfactory throughout. Care Homes for Adults (18-65 years) Page 22 of 29 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 are protected and benefit from the homes recruitment policy and procedures and from sufficient trained and competent staff on duty to meet their assessed care and support needs. However current arrangements for the provision of formal staff supervision are inadequate. Evidence: In addition to the comprehensive induction programme undertaken by all newly appointed staff, the acting manager confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was supported through discussions with staff and further evidenced by training records examined. Things have definitely improved and there is plenty of training now, which is good. From discussions with staff it is evident that over the past few months, prior to the appointment of the new acting manager, formal supervision had slipped and individuals were feeling unsupported. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Morale was pretty low but things are much better now and people seem much happier. However, in accordance with company policy, the acting manager confirmed that formal supervision is being reinstated for all care staff on a regular basis. The Regional Director and acting manager are clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of residents. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB)and Protection of Vulnerable Adults (POVA) disclosures. Care Homes for Adults (18-65 years) Page 24 of 29 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. Residents benefit from effective management, comprehensive quality monitoring systems and are protected by thorough health and safety checks and guidelines. Evidence: The current manager of 100 Goldstone Crescent is on long term sick leave and in her absence the Regional Director has transferred the deputy manager from another service within the organisation. It is evident, from discussions with members of staff that the acting manager is very competent and is clearly working hard to address identified shortfalls. She is conscientious, motivated and approachable. Described as very hands on, she evidently also operates an open door policy, with staff feeling confident and able to discuss issues or concerns with her at anytime. The home continues to operate effective quality monitoring systems, including annual satisfaction questionnaires for both residents and their relatives. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Collated responses from the most recent survey indicate a high level of satisfaction with the home and the care and support provided: We all have great peace of mind to know that ....... is happy with his surroundings and friendships. You all deserve a medal for the devotion and care you all give. Thank you! The acting manager confirmed that the health, safety and welfare of residents and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to residents. All accidents, incidents and injuries are recorded and reported, as required. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 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 36 18 It is required that formal and recorded supervision be provided for all staff on a regular basis. Prior to the appointment of the new acting manager, formal supervision had slipped and individuals were feeling unsupported. 28/11/2008 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 6 It is recommended that individual care plans, including risk assessments and staff guidelines be regularly reviewedand updated to accurately reflect residents current and ongoing care and support needs. It is recommended that the worn out three piece suite in the lounge should be replaced and the tired and outdated bathroom is now in need of redecorating and refurbishing. 2 24 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!