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Inspection on 25/03/09 for 114 Douglas Road

Also see our care home review for 114 Douglas Road for more information

This inspection was carried out on 25th March 2009.

CSCI found this care home to be providing an Good 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 114 Douglas Road 114 Douglas Road Newcastle under Lyme Staffordshire ST5 9BJ     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: Wendy Jones     Date: 2 5 0 3 2 0 0 9 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. 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. 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 © (2009) 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.cqc.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: 114 Douglas Road 114 Douglas Road Newcastle under Lyme Staffordshire ST5 9BJ 01782711041 01785711041 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Staffordshire County Council, Social Care and Health Directorate Name of registered manager (if applicable) Mrs Sandra Ann Forester Type of registration: Number of places registered: 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: 13 The registered person may provide the following category 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: Learning disability (LD) 13 Date of last inspection Brief description of the care home The home in Douglas Road is a purpose built local authority respite care unit catering for up to 13 persons, originally only younger adults with a learning disability, but now the categories have been extended to also cater for both younger and older adults with Dementia, and younger adults with both Mental Health problems, and Physical Disabilities. It offers short stay respite accommodation to both male and female service users, and can accommodate couples in either of its upstairs rooms with double beds, Care Homes for Adults (18-65 years) Page 4 of 29 care home 13 Over 65 0 13 Brief description of the care home or two who wish to share in a room that can have a second single bed installed. Like the double-bedded rooms this is upstairs, so like them would only be available to service users who can manage climbing stairs, as currently there is no passenger lift. The four ground floor bedrooms have been adapted to take wheelchair users. The home is conveniently situated to access a wide variety of community facilities, with the town of Newcastle approximately one mile away. A supermarket is within walking distance. It is located in its own extensive grounds with a safe bounded rear garden containing a patio and a fountain. Communal space on the ground floor comprises two dining rooms with kitchenettes, two sitting rooms, and a separate games and activities room housing a pool table. The fees and cost of this service are included in the service user guide and for the year 2008/2009 are charged at £20.41 per day or £142.90 per week. 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 was a key inspection site visit of this service undertaken on 25 March 2009 that took approximately 05:00 hours. The purpose of this visit was to assess the services performance and to establish if it provides positive outcomes for the people who live there. We checked that any requirements and recommendations of the previous inspection visit of 18 February 2008 have been acted upon; looking at information the service provides for prospective guests, their carers and any professionals; looking at Care Homes for Adults (18-65 years) Page 6 of 29 information that the service provides to people who use the service to ensure that they understand the terms and conditions under which they have agreed to live at the home and the fees they should pay. Other information checked included assessments and care records, health and medication records; activity and records relating to the menus, staff training and recruitment, complaints and compliments, fire safety and health and safety checks. Staff and guests were spoken to during the site visit and a brief tour of the building was undertaken. Before the visit began, the service provided its own assessment of its performance, in the form of an Annual Quality Assurance Assessment (AQAA). Surveys were sent out to guests, relatives, staff and any professional that has involvement in the service. We have received eight service user surveys, four relatives surveys and four staff surveys. The main points are included in this report. Throughout this report people using the service are described as guests, this is the terminology used in the service and one they are familiar with. Since the inspection visit the manager has informed us how she intends to make further improvements to the service. What the care home does well: What has improved since the last inspection? What they could do better: There have been a number of improvements to the service since the last key visit, but the sercice should consider developing these improvements further. Information about the service for guests and their supporters could be produced in Care Homes for Adults (18-65 years) Page 8 of 29 more varied formats. The service should develop further methods of promoting person centered thinking and opportunities guest have to go on outings. A member of staff said in a survey, Possibly more outings during the day when guests choose not to go to day services. Sometimes if staff are off sick it leaves us short, but we usually manage to covers each other. All staff should receive epilepsy training. 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.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 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. People using the service can be confident that they will recieve information about the service and their needs will be assessed so they can be sure they can be met. Evidence: The Service told us in the AQAA that, Trial tea visits and over night stays are planned prior to booking respite breaks, this can take as long as needed. No breaks are booked until the service user is confident that their needs can be met and are happy to have overnight stays. The service has a statement of purpose and service user guide that have been updated to reflect the current position at the service. We saw a copy of both documents and saw that a copy of the guide is located in each of the bedrooms. Each guest and their representatives, receive copies of the guide at the time of referral. The fees for the service are included in the guide. We looked at two sets of care records and saw that assessments have been carried out Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: for guests prior to admission to the service, in co-operation with health and social care professionals, relatives and supporters. Guests told us in the surveys that, I asked if I could stay here for respite care as my friends do and enjoy it. All surveys indicated that guests and their supporters had received enough information about the service before they decided to move in. Relatives said, I received lots of information which helped me when deciding if the place would be suitable. 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. Guests can be confident that plans are up to date and they will usually be included in the reviews of them. Evidence: The service told us in the AQAA that, All care plans reflect the service users needs, are maintained and up to date, risk assessments are reviewed prior to each respite break. We looked at two sets of care records, we saw that they contained assessment details and information about the individuals preferred lifestyle called My plan for everyday. We saw that risk assessments are in place and are reviewed prior to every period of respite care to ensure that they are up to date. We spoke to one guest about care plans and although she didnt know what the records contained she confirmed that she is involved in review meetings. We would Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: recommend that the service make further effort to ensure that guest are fully involved in and agree their plans and where possible have their own copies. We saw that guests meetings are now held twice per week, this change has taken place in response to guests surveys, when some guests commented that they are not included in the then weekly meeting (which was usually held on a Monday) because they only stayed at weekends. We spoke to two guests about the meetings, they confirmed that they take place and that they are asked if they want a bedroom door key, if everything is in good working order in their bedroom, meal choices and about things they want to do during their stay. One member of staff confirmed that the meetings are now structured to ensure that guests view are involved in decision making, a record of the meetings is displayed on the notice board. We saw that the names and photographs of key workers and the guests they support are displayed in the dining room. We spoke to two guests who confirmed that they knew who their key worker is. 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. Guests can be confident that they are able to make choices about their life style and are being supported to develop life skills. Evidence: The service told us in the AQAA that, We ensure that daily routines are continued ie if the service user wishes to continue attending the Day Service, college, employed work or other activities which are normally undertaken when at their own home. The minutes of the guest meetings show an improvement in the planned discussions for people. Guests are now asked if they want a key to their bedroom and if everything in their room is working properly, the planned menus are read out and guests are asked if they are happy with these or if they want any changes to be made. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: We saw that photographs of the main meals available for the day are now located in the dining room, we also saw that there is a choice of main meal offered. We spoke to guests about the food choices, they confirmed that they could have a choice of two meals but can have something else if they want to. One relative said, Packed lunches could be improved, my relative receives 4 rounds of white bread, filled with cheese and has a bag of crisps I would prefer him to have brown bread, with Tuna, egg or ham, no crisps a banana would be better for him. We have been told that the service intends to support guests with independent living skills ie food preparation and cooking if they choose to participate in this. We have also been told that the opportunities for activities have increased since the last key visit. We saw that additional recreational equipment has been purchased and guests have more opportunities to participate in activities in or out of the home. During this visit guests were offered the opportunity to visit the local pub, but decided to stay in to watch a film. One guest had been to the theatre with a member of staff. We have been told that the service has contacted a local bus company and have secured public transport per day to pick up / drop off outside of the unit gates for four trips per day, this means guests have better access to the comunity. 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. Guests can be sure that their health and medication needs are known and the service makes every effort to ensure that they can be met. Evidence: The service told us in the AQAA that, Experienced & trained staff respect service users privacy and dignity at all times. Service users are able to continue their care under their own GP while staying at Douglas Road. We observed that staff were sensitive in their response to guests needs and knowledgeable about health issues. Guest told us that staff usually respond to their needs, but in one survey we have been told that, One day I needed a belt from my room for my trousers, they said there was no time, I had an uncomfortable day. Sometimes the staff forget to give me a fresh towel, but I ask for one. We looked at a sample of two guest care records, we saw that health needs are recorded and that the service ensures that medication records are up to date. Information in the records include health related risk assessments for example in one Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: record bedrails are required, the records show that the risk assessment for these is reviewed prior to any period of respite care. The standard of medication record keeping is generally high, it is possible to undertake a full medication audit, from the point the medication is received in the service until the person goes home. Staff contact guests, their supporters and their GP prior to admission to establish what the current medication and health needs of each guest is. Homely remedies list are also agreed with each guests GP. Medication is stored properly and all staff responsible for the administration of medication have been trained to do so. 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. Guests can be confident that any complaints they make will be managed properly and their concerns will be listened to. Evidence: The service told us in the AQAA that, In last 12 months we have had no complaints. We receive Thank You cards and compliments from carers & service users. We have feedback forms for service users, carers & visitors, we ask that these are completed following each respite break. We looked at the record of complaints the service is asked to maintain, one complaint was received 30/08/08 from a guest about the quality of the pool table felt, this has now been replaced and new pool cues and chalk provided. There are many compliments from relatives of guests recorded. A complaints procedure is on display in the service and is included in the service user guide. Efforts have been made to ensure that that the procedure is in a form that guests can easily read. In the surveys two guests told us they knew who to go to if they are unhappy and know how to make a complaint. All relatives said they knew who to go to, one person stated, I have no need to complaint the service is excellent, my relative loves going to Douglas Road. One relative said they didnt know who to speak to if they are not happy or know how to make a complaint. One guest said, Ive never had cause to make a complaint I would talk to the manager and staff. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: We have spoken to the manager of this service and have been told that the complaints procedure is discused with guest and their relatives/carers at review. Staff surveys indicate that staff know what to do if they receive a complaint. Records show that staff have received training to ensure that they know how to recognise and report suspected abuse and the service has safeguarding procedures in place. There are also Whistleblowing blowing procedures in place. We are aware that there have been referrals made under Safeguarding procedures since the last inspection visit, the service has referred matters as they have arisen for discussion and investigation if it is decided is appropriate. The records we saw during this visit indicate that 8 incidents have occurred. We have not received any complaints about the service. 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. Guests can be confident that the environment is clean, safe and meets their needs. Evidence: The service told us in the AQAA that, We maintain a high standard of cleanliness, decoration. There is a cheerful and friendly atmosphere which is warm and welcoming. We did not undertake a thorough inspection of the environment during this visit. We saw that the service is clean and free from offensive odours and that standards of maintenance and decoration are good. The service provides four single bedrooms on the ground floor, eight on the first floor, two have en-suite bathing facilities. There are two further bathrooms on the first floor, an assisted bathroom and seperate shower room on the ground floor. Toilets are provided in sufficient numbers to meet the needs of guests. The services communal living areas consists of two lounges, two dining rooms with kitchenettes and a games room. There is a main industrial kitchen and laundry. Staff showed that some improvements have been made for the benefit of guests these Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: include, creating smaller areas where individuals can have some quiet time or engage in activities on a one to one basis. In addition the service has changed the use of the second lounge into an alternative TV room with a video recorder for guests to watch films if they wish, or play games on the Wii station. Several bedrooms have been redecorated and we are told after consulting guests on their preferences to colour. The facilities on the ground floor are accessible to people who are wheelchair dependent and there is suitable equipment to ensure that their needs can be met. A loop system is in place for people who are hearing impaired. 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. Guests can be confident that the staff team have the skills and experience to provide good quality care which will meet their individual needs. Evidence: The service told us in the AQAA that, Staff are competent, experienced, trained and commited to meet the service user needs. Training is ongoing to ensure continuing development of staff skills. All but 1 staff have NVQ qualifications at level 2 or 3. We saw that the staffing arrangements during our visit included a manager and three other support workers. We have been told that staff deployment is flexible based upon the known needs of the guests. We saw that staff training matrix and noted that training is up to date or planned, this includes all mandatory training. We saw that some staff have received training about Epilepsy, but not many, this is a concern. We note from the AQAA that 17 staff have a National Vocational Qualification(NVQ) at level 2 or above, this exceeds the minimum recommendation of 50 of the workforce. Senior staff meetings are now held every week to review the care plans of people scheduled to be admitted, risk assessments are also reviewed during these meetings. Staff said in their surveys that, I have the opportunity to attend both mandatory and Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: other training sessions. We are always up to date with our in house training and have access to other training opportunities. Staff also confirmed that, I have regular supervision and support sessions and we also have regular meetings. I have very regular supervision sessions and the opportunity to discuss any concerns with my manager. We looked at a sample of two staff recruitment records and found that they are satisfactorily maintained with evidence of pre employment checks. The service currently has two staff vacancies and are actively recruiting to these positions. 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. Guest can be confident that the service is properly managed and regular reviews of health and safety and the quality of the service are undertaken. Evidence: The service told us in the AQAA that, A permanent unit manager with the required qualifications is in post. All equipment servicing is up to date. Since the last inspection visit the service has a new manager she has applied to us to be approved and registered. During that process she will be asked to provide evidence of qualification and experience. The Statement of purpose states, she has 15 years experience in the management of care and holds a Diploma in the management of care services and NVQ level 4 in management. Staff said in surveys that, We receive a good standard of support from management. We offer good quality care and support to guests. I am proud to work at Douglas Road. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: We looked at individual fire safety risk assessments and have been satisfied that these are up to date, more general assessments are in place for the environment and other areas of risk. The quality of the service is monitored by the manager and a development plan should be produced to ensure that staff, guests and other stakeholders know what the service intends to do to evidence that it is continually improving the service it provides. We saw that the organisation ensures that monthly monitoring visits are carried out, the report of these visits are available in the home. 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 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 1 The service could consider providing information about the service in different formats to make it more meaningful and interesting to guests. The service should continue to pursue further methods for involving guests with person centered planning to ensure that they are owned by the individual. The service should continue to promote guest autonomy and independence. The service should continue to enrich guests lives by continuing to improve the range and choice of leisure and recreational activities. All staff should have the opportunity to receive epilepsy training to ensure they have guests can be sure their needs can be met. 2 6 3 4 11 14 5 32 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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