Inspection on 05/11/08 for 27 Hamilton Road

This inspection was carried out on 5th November 2008.

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.

Other inspections for this house

27 Hamilton Road 15/11/06

27 Hamilton Road 22/11/05

27 Hamilton Road 07/06/05

27 Hamilton Road 05/01/05

27 Hamilton Road 27/07/04

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

Extracts from inspection reports are licensed from CQC, this page was updated on 30/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 27 Hamilton Road 27 Hamilton Road Reading Berkshire RG1 5RA     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: Yvonne Souden     Date: 0 5 1 1 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 27 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 27 Information about the care home Name of care home: Address: 27 Hamilton Road 27 Hamilton Road Reading Berkshire RG1 5RA 01189351762 01189268214 hamilton@paramounthousing.org.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr David Jewell Type of registration: Number of places registered: HVHS Housing Group care home 13 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 to be accommodated is 13. 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: Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home 27, Hamilton Road is a care home providing personal care and accommodation for thirteen adults with mental disorders, excluding learning disability or dementia, three of whom are over sixty-five. It is a detached house built at the turn of the century, located on the east side of Reading close to Palmer Park. The area provides excellent facilities for all kinds of leisure pursuits and there are many local shopping amenities either within walking distance or on local bus routes. The house comprises three floors and a basement area, providing accommodation in the form of thirteen single Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 13 Brief description of the care home bedrooms. Service users share bathrooms and toilets. Washbasins are provided in each room. The communal area is spacious and there is a large rear garden. Care Homes for Adults (18-65 years) Page 5 of 27 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 last key inspetion took place on 15th November 2006, and no requirments were made. This key inspection was unannounced and took place over 6 hours. The inspection was carried out by Mrs Yvonne Souden. The registered manager of the home was present. A partial tour of the premises took place and a number of files and documents, including three residents files and care plans, staff training and recruitment files, quality assurance information, and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. Questionnaires were sent out regarding the service but none were returned. The Inspector saw most residents who Care Homes for Adults (18-65 years) Page 6 of 27 were in the home on the day of the inspection and three residents were spoken with in more detail. The current fees at this home are 410 pounds per person per week. 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 27 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 9 of 27 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 who use the service have their needs assessed prior to their admission to ensure the home will be able to effectively meet their needs. Evidence: At this inspection three residents files were sampled, including one recently admitted resident. The manager stated within the homes annual quality assurance assessment that a detailed admission procedure, and referral assessment is carried out on all prospective residents, and this was evident from the sample of records viewed. Health and social care assessments detailed the residents personal, health and social care needs and associated risks, and a multi-agency review date had been confirmed. Staff interviewed said that they had been fully informed of a recently admitted residents health and social care needs prior to the residents admission. Care Homes for Adults (18-65 years) Page 10 of 27 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. People who use the service have individual care plans that promote their independence and decision-making, whilst risk assessments promote their safety within the decisions they have made and care needs identified. Evidence: Care plans clearly identify that the residents personal, health and social care needs are identified and reviewed at six monthly intervals within a multi agency care programme approach, and supports the residents to make decisions in their life. Associated risks are identified and have an action plan to minimise risk and promote independence. Staff spoke of reviews, care planning and of daily recordings that report on the individual residents day. Staff said, from observation and recording daily events they are able to identify quickly should the needs of a resident change. Staff spoke of the key worker role and residents spoke of their key worker. Staff said that one of the key worker tasks is to summarise detail from the residents contact sheets and discuss this Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: with the resident. A staff member said residents read their care plan and if they are not happy we try to word it differently or explain why it is their. It was evident that staff were fully aware of the system of care planning used within the home, and ensured residents were fully involved and in agreement with their plan of care. Care plans viewed detailed the signature of the resident in agreement of their care plan. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are enabled to maintain contact with family and friends and are fully involved in the decision-making about the running of the home, and personal choices made within daily living. People who use the service are provided with a menu that is nourishing, varied and meets their individual and cultural needs. Evidence: On the day of the visit one resident was on holiday, four residents had went in to town and another resident was visiting relatives. Discussion with staff and residents identified that the pantry is opened at 12 and closed at 1:30p.m to enable residents to select and prepare lunch independently or with support. Staff said that the pantry is locked at various times of the day as there Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: are residents who would continually prepare and eat food in an unhealthy manner. A resident said, should we want anything from the pantry outside of those hours, we ask a staff member for the key. On three separate occcasions the Inspector observed residents request and be given the key to the pantry. Residents prepared lunch of their choice for example, one resident made beans on toast and another sardines on toast whilst two other residents prepared sandwiches. A small fridge in the kitchen enabled residents access to milk, butter and other items for example yoghurt. Fresh fruit, tea, coffee and cold drinks were readily available. Staff cook and prepare the evening meal from fresh ingredients; training certificates show that staff have received food and handling training. The Inspector observed the preparation of the evening meal and preparation of an alternative for two residents who are vegetarian. Residents said if they do not like what is on the menu they are able to choose an alternative from prepacked meals stored in the freezer. Staff and residents confirmed that the weekly grocery shopping is done online following agreement at the residents meeting of the weekly menu plan. Residents and staff said that when the groceries are delivered both staff and residents check it in and put it away. One resident said, sometimes I buy my own milk and put my name on it, I feel there is always enough to eat. One resident showed the Inspector the kitchen Rota. The rota detailed the name of the residents responsible for helping preparing and clearing away after the evening meal. Residents spoken to said they were happy with this arrangement, confirming that staff cook and serve the main meal whilst the residents help with the preparation for example, preparing drinks and laying and clearing the table. One resident said its a pleasure doing it, Ive been here a long time, so have a routine. Another resident said, we have set tasks, I smoke so take it in turn to clean the ashtrays. Residents are provided with the opportunity to make good use of communal facilities and supported to access employment. One resident said I work two days a week, and enjoy my work, I also enjoy fishing down the Kennett and enjoy walking with my brother, and in walking groups. Residents spoke of their resident cat and said that they pay 50p a week towards cat food and vet bills. It was evident that residents are encouraged to participate in recreational activities of their choice and that thay are supported to sustain relationships and have regular contact and opportunity to visit family and friends. Care plans have an action plan to support the range of activities and hobbies that the residents spoke of and risk assessments have an action plan to minimise associated risks. Care Homes for Adults (18-65 years) Page 14 of 27 Care Homes for Adults (18-65 years) Page 15 of 27 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. People who use the service receive support to meet their health, psychological, personal and social care needs as identified within their agreed plan of care. Evidence: A carer from a domiciliary agency visites the home daily to assist a resident who requires personal care. The manager said that staffs job discriptions have recently been reviewed to enable staff to support residents with personal care, and that it is hoped funding is achieved from the placement agency to enable staff to deliver personal care and for the home to discontinue using domiciliary care staff. It is viewed that continuity of care is best achieved by a permanent staff team working within the home, enabling residents to have personal care delivered as and when required. A resident said, I mainly have a shower, the water is regulated so you dont get scalded. Staff were observed to be respectful and courteous towards the residents. The manager reports that residents have been given greater control over their medication within the last six months, as some residents now administer their own medication with support from staff, and others are asking for the opportunity of Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: managing their own medication. Care support plans and risk assessments have been reviewed to support those residents who self administer. Staff said those residents who self administer are supported to transfer their medication from the blister pack into a doset box. Staff also said this is working well and promotes the residents independence, adding that a spot check is undertaken regularly as part of their risk assessment to ensure residents are administering their medication safely. One resident said, I self medicate, I put all my medication in strips and write on the sheet . Staff have received medication training through the providing pharmacist that covers the system used, and have received further detailed medication training to cover controlled drugs awareness, systems and side-effects; training certificates were seen. Records identify health care appointments attended by residents, and documentation demonstrates that regular multi-agency care plan approach reviews take place. One resident said, I have a mobile phone and I make all my own appointments for example, six monthly dental appointments, eye tests and a blood test every three months. Records showed that two residents had a hospital appointment on the day of the inspection, and it was observed that staff supported those residents to attend. Staff said that the majority of residents would attend health care appointments independently, but they do escort those who are less confident or unable to attend appointments on their own. Records identified that staff have received specialist training that includes mental health, enabling staff to have an understanding of the residents mental health care needs. Minutes of the residents meeting dated 29th October 2008, identified that the option to have a flu jab was discussed with the residents. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaint procedure that is clear and accessible to the people who use the service. People who use the service are protected from abuse and exploitation by a trained staff team who recognise what constitutes abuse. Evidence: The service reviewed their complaint procedure, June 2008. CSCI has received no complaint about the service provided, and the manager reports no complaints have been recieved about the service provided. Residents said, if they had a concern or complaint they would speak to their keyworker or manager, and said they were happy with the service provided. Staff said that they had recently attended safeguarding adult training in October 2008, and that this had been delivered by a trainer at HVHS Housing groups head office. Staff were awaiting certificates to evident training attended. Staff described the training as scenarios and role play. Discussions with staff indicate that they know what constitutes abuse, and that they would inform management if they were to witness a form of abuse or if an allegation of abuse was made by a resident. Staff were unclear of the agencies that they could take concerns or allegations to, outside of the organisation. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: The home has a copy of Berkshires 2006 Safeguarding Adult Policy and Procedure. The manager stated in their annual quality assurance assessments that they have procedures in place for the protection of vulnerable people that includes Disclosures of Abuse and Bad Practice (Whistle blowing), last reviewed March 2006. The registered manager has undertaken to obtain a copy of Berkshires 2008 Safeguarding Adults Policy Procedures. The manager said that he had tried to access the local authority safeguarding adult training without success, and that training was therefore organised within the organisation. The manager confirmed that he would access safeguarding adult training, and would discuss Safeguarding Adult Policies and Procedures with staff that would include the homes Whistle blowing procedure. The manager report that no safeguarding adult referral or investigations have taken place since the last inspection and that no referrals have been made to the Protection of Vulnerable Adults List (POVA). Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from living in a comfortable, homely environment that is clean and hygienic. Evidence: A member of staff showed the inspector around the basement and ground floor of the home, whilst a resident showed the inspector the first floor of the home that included their room, a shower room and bathroom. Residents rooms were observed to be comfortable and clean, and had been personalised. All rooms have a wash-hand basin. A pay telephone and sitting area is located on the first floor, but residents said that it is not often used as most residents have a mobile phone. There is a laundry located on the ground floor and a Rota is in place to enable residents use of the washing machines independently. Staff have attended infection control training and policies and procedures are in place to promote infection control. the manager said that the communual areas and some of the residents bedrooms have been decorated within the last twelve months; furnishings and decor was observed to be of a basic and comfortable standard. Care Homes for Adults (18-65 years) Page 20 of 27 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. People who use the service benefit from being cared for by properly recruited and trained staff in sufficient numbers to effectively meet their needs. Evidence: The people who live in the home are reasonably independent in achieving most personal and domestic tasks with exception of one resident who requires more support from staff. The Rota identifies that there is sufficient staff on shift throughout the day and night to meet the needs of the residents. Most staff have a National Vocational Qualification (NVQ) in care. One care officer commenced NVQ training with their previous employer, but this had come to a standstill due to problems accessing the tutor. The manager confirmed he would now intervene to resolve and enable the staff member to complete their NVQ. Discussions with staff and records viewed identified that staff have received mandatory health and safety training, and have attended specialist courses for example, understanding schizophrenia, depression and bipolar disorder. The Inspector viewed the files of two staff members. Both files identified a personal Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: development review, personal file checklist, statement of main terms of employment and security checks that had been completed prior to their employment, for example, references from previous employers and a CRB check. The manager confirmed that they have recently recruited a person into a vacant care officer post and are awaiting completion of security checks before a start date is confirmed. An agency carer who regularly works within the home and within another home owned by the organisation confirmed that he had receive mandatory health and safety training through the agency that he is employed, and said that he has not received refresher training in three years. The manager confirmed that he would requests from the agency an updated training profile on the agency staff used within the organisation. Care Homes for Adults (18-65 years) Page 22 of 27 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. People who live in the home benefit by having a competent manager and professional staff team who review the service provided on an ongoing basis. The manager ensures risk assessments are regularly updated to promote the safety of the people who use the service. Evidence: The service has had a new manager since the last key inspection as the previous manager retired. The manager became the registered manager on the 21st July 2008, and is a competent, caring and enthusiastic manager who has the qualifications to ensure the safety of the people who use the service and that of the staff team. The manager is passionate about promoting independence and enabling residents to achieve their goal in life, for example supporting and enabling residents to administer their own medication, and continued assessment of the residents personal and health care needs to ensure they continue to be appropriately placed within a care Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: environment that best suits their needs. Staff say they feel supported by the manager and would contact the manager for advice. One staff member said, the manager is supportive and sorts problems out quickly. Records identify that staff have receive mandatory health and safety training. The manager completed an Annual Quality Assurance Assessment (AQAA), which is a legal document required by CSCI. Monthly monitoring and recording of health and safety systems is undertaken by senior staff, and monthly regulation 26 inspections are undertaken by a service manager within the organisation. The manager confirmed that surveys had been sent to the residents within the home and that information collated was used to make improvements; records were seen. Regular staff and residents meetings take place to promote decision-making on how the home is managed. A recent fire inspection of the home recommended installation of new fire extinguishers and updating of the homes fire risk assessment in line with current legislation, which the manager assured was currently in progress. A resident said we have a smoking area, there is fire escapes and I know the procedure. Records identified that staff receive fire safety training. Some of the policies used within the home are from the previous provider, but there is evidence that these are being reviewed and replaced by the existing provider. The manager confirmed that the home does not manage residents money, but said support would be given should there be a risk that the resident does not manage their money safely. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 23 The manager should obtain a copy of Berkshire Safeguarding Adults Policy and Procedures 2008, and discuss the policy and procedure with staff to ensure staff are up to date with safegaurding adult procedures and the homes whistle blowing procedure. Care Homes for Adults (18-65 years) Page 26 of 27 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). 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