Inspection on 28/11/08 for 3 Ashley Avenue

This inspection was carried out on 28th November 2008.

CSCI found this care home to be providing an Excellent 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

3 Ashley Avenue 19/01/07

3 Ashley Avenue 13/02/06

3 Ashley Avenue 04/08/05

3 Ashley Avenue 26/01/05

3 Ashley Avenue 29/06/04

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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: 3 Ashley Avenue 3 Ashley Avenue Folkestone Kent CT19 4PX     The quality rating for this care home is:   three star excellent 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: Lois Tozer     Date: 2 8 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 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.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: 3 Ashley Avenue 3 Ashley Avenue Folkestone Kent CT19 4PX 01303270153 Telephone number: Fax number: Email address: Provider web address: sarah_proactive@hotmail.co.uk Name of registered provider(s): Type of registration: Number of places registered: Blythson Ltd 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 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 category: Learning disability - LD Date of last inspection Brief description of the care home 3 Ashley Avenue is one of four Proactive Development care homes in the Folkestone area. It provides personal care and support for a maximum of three residents who have learning difficulties. The home is a three story semi-detached house situated in a quiet street near to the shops at Cheriton. It is well maintained and well furnished. The communal accommodation is very spacious, homely and comfortable. The residents each have their own room. The home has a small front garden and a larger back garden, which has free access. There is on street parking in the vicinity. The manager has recently come to post and is in the process of applying for registration. An organisation, Blythson Ltd, own the home. The organisation is more widely known as Proactive Development. The fees for this home range between 1,500:00 and 1,860:00 pounds per week and are based on the assessed needs of the individual. Previous Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Brief description of the care home reports and up to date information in the statement of purpose can be obtained directly from 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: three star excellent 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: We visited the home on 28th November 2008. Because this is a small, community home, we felt it important to telephone 1 hour before to make sure someone would be in. We arrived at 2:45pm and finished at 5:15pm. The manager in post, Sarah Suggett is not yet registered with CSCI, but intends to have her completed application pack in by early January 2009. We spoke to one service user. Another service user has not yet moved in properly, and was not around to speak to us. We were pleased to hear that living in the home is fun and that, as a resident, the individual is very happy with their choice of home. We spoke with the manager and staff. The manager helped to gather all information Care Homes for Adults (18-65 years) Page 6 of 29 that was requested. This was her first experience of a CSCI visit while being in the manager role. We were pleased that all documents could be easily located and produced instantly. Staff told us that they really enjoyed working at this home. They felt it was one of the best organizations they had worked for. As well as collecting information in the home on the day, and from all the documents sent to CSCI as part of the regulatory requirements, we also looked at the homes Annual Quality Assurance Assessment (AQAA). This had been completed in February 2008 by a person who was overseeing the home. At the time, the home was empty, so we confirmed that health and safety tests and certificates stated in the AQAA were still up to date, which they were. During the course of the visit, we had a look around the home. What the care home does well: What has improved since the last inspection? Although the home has maintained a level of excellent direct service delivery, there has been difficulties over the last 12 months. These have been around the protection of service users finances and making sure that new staff have had the right police checks and references before commencing work with service users. The organization has been open and honest in their dealings with CSCI, Social Services and the Police. They have demonstrated complete compliance and provided information as it has been needed. From this, they have changed the way they monitor the management of services. We were pleased to see that the visits to the service by the organization are now thorough. Individual service users finances are better audited and this takes place more often. The owners are also taking a greater lead in making sure that home managers have the right checks in place before allowing staff to work in the home. Care Homes for Adults (18-65 years) Page 8 of 29 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 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are interested in living in this home will have a thorough assessment to make sure that this is the right home for them. Staff will have the right skills to help people living in the home have their needs met. Evidence: We discussed the before admission assessment process with the manager and found that she clearly understood the importance of getting as much accurate information as possible. The service user assessment in place had brought together work and support plans from, for example, previous school placement, psychologist, speech and language therapists as well as medical health professionals. We saw that individual development, wishes and feelings had been noted and supported, and where there were behaviors that were difficult to support, plans had been put in place. These plans had been agreed by all the people within the support network for the service user. Because so much detailed information was known about the person before they came to live at the home, staff were supported with the right Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: specialist training. Staff who already had special knowledge were recruited from within the organization. A prospective resident is currently spending time at the home each weekday as part of their transition process. This helps both they and the existing service user to establish a house sharing relationship before committing to moving in. 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. People can be confident that staff and managers will support them to make their own decisions and take well assessed risks. They can be sure that choices will be offered in a meaningful way. Evidence: The person living at the home said, as well as indicating, that they were very happy here. They are fully involved in their care planning and this was evident in the very well documented and useful care support plan. The manager told us that speech and language support packs were no longer used, and verbal communication was actively encouraged. The manager should consider that long established communication aids may still be useful when the individual is independently communicating in the wider world, especially with others who are not tuned into particular speech patterns. A daily activities planner is being created in pictorial form, but this is not yet in place. The aim of this is to help individual plan out their day and make decisions. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: We noted that the care plan contained all aspects of the individuals care needs and was written in a way that encouraged staff to see the potential that the person had. We saw that this plan had been reviewed regularly, as the person was developing skills at a rapid rate. There were clear risk assessments in place, all of which had clear action stated to enable freedom and decision making while minimizing risk. In some areas of life, some restriction had been included, such as locking away personal items during the night. This had been done in a considered way and with the full knowledge of the individual and their support network. This carefully applied restriction had improved individual life quality by reducing anxiety. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be sure that the lifestyle they choose will be supported by staff who are keen to help personal development. There is an emphasis on making choices and decisions, which focuses on healthy lifestyles. Evidence: We found that the manager and team had looked closely at the individuals lifestyle and medical support needs before helping them develop an activity plan. They had then scheduled all out of house activities to the part of the day when the individual would get most benefit from them. The communication between staff and service user was easy going and informal. The manager told us that the formal communication aids were no longer used regularly. This needs careful consideration before discarding this learnt skill, as it has potential Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: lifelong value when communicating with people who are not tuned into individual vocal ranges. A daily activities planner is being created in pictorial form, but this is not yet in place. The aim of this is to help individual plan out their day and make decisions. The home is situated close to Cheriton High Street, and staff support individuals to use many of the local amenities. During this visit, an individual went off to purchase take away food with staff support. The local barber is used, and good relationships have been established. The home support the individual to keep in contact with friends and relatives, and they are as involved with helping plan out lifestyle decisions as the individual wishes them to be. There is a daily routine planner for chores and house duties. The individuals are involved in the day to day running of the home, and do vacuuming and dusting tasks, as well as food shopping and other necessary chores. This is a flexible routine, and is often changed around social opportunities or health care support needs as they arise. Staff told us that there is an excellent food budget, and that the quality of food is good. A service user agreed that food was nice, and that they had the chance to try out new foods and also have a weekly take away of their choice. Eating support plans have been successful in introducing new types of food and has encouraged healthier eating. 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 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 this home will be certain that all their health care and personal support needs will have thorough assessments. They will be certain that staff support will be based on knowledge about their condition and them as an individual. Evidence: The home have conducted a very detailed and thorough health assessment and have made a clear support plan based on the assessment. Specialist support has been used and recommendations from these sources followed. There is clear evidence that day to day personal and health support needs are met. It was good to see that even through there were complex health support issues described, these did not get in the way of the individual having an ordinary lifestyle. Where incidents have occurred, the manager and team have spent time analyzing these and establishing if a particular behavior is an early warning sign for health care support issues. The team now know the person more thoroughly, and can offer a more educated and appropriate response to some behaviors. This is excellent work, as it has holistically looked at the person and sought to establish the root cause of behavior, not Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: assumed it is within a persons control. Special arrangement for medication administration were in place. Staff have had direct training from the district nurse so they can support the person each day. Medication is stored centrally. Although this was clean and tidy, it was not stored in a suitable facility. We discussed that medication storage must only be for medication, and the potential for individual storage, rather than a large central source. We asked the manager to look at the Royal Pharmaceutical Society guidance for medicine storage in care homes. The manager said that she would do so, and have suitable storage in place by 30/1/09. As an excellent service, we know that this requirement will be met, so have not placed this in the requirements section at the rear. 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. People can be sure that staff will listen to them and take the right action if things go wrong. The home could provide an easy to use complaints system so there is a formal route for service users. Evidence: The complaints procedure is known to staff and is included in the statement of purpose and service user guide. The home does not have a complaints procedure on obvious display for residents, this is kept in the office. We discussed how a person would make a complaint. The manager told us that their behaviour would change if there was a problem, and that this would be picked up and analysed. While this is absoloutly essential, we discussed the benefit of having something symbolic for the person to use. Alongside portable communication aids, the manager has told us that there is a pictorial activity planner being developed. This may be the place for an easy to use and understand complaints or unhappiness indicator. There has been one safeguaring vunerable adults (SVA) alert in the last 12 months. This was in relation to the alleged theft of money. The situation was made safe immediatly and social services have closed the alert raised, the matter is now being supported by the police. Staff have had SVA training, and the two staff we spoke to were clear in how they would proceed if there were a problem. They told us that the manager, deputy or another manager is always available on call. They felt supported Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: by the organisation and said that they would not have any issue speaking to the managers or directors about concerns. Staff have regular one to one supervisions with the manager. The manager said that she would ask staff in future if there were any issues of concern as part of the formal process. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The house is homely, well maintained and comfortable with few restrictions. Fixtures and fittings are maintained to an excellent standard. Evidence: The house really is a homely place and is clean and hygienic in appearance. There is very little to indicate that this is a registered care home both inside and out. The home is furnished with good quality fixtures and fittings throughout. All carpets are either new or have been kept in good condition. The home has been decorated in a neutral look, allowing people, as they move in, to make personal touches. We saw one persons bedroom and this was in keeping with their style and personality. There are few restrictions in the home, the kitchen is freely accessible. There are good staff numbers to make sure that the right support to do activities in the house, such as making a drink, or going to the shop can happen without unreasonable delay. There is a small rear garden that is freely accessed off the dining room. The utility room area remains locked, but when it is in use, we are told that support is given to service users to use the washing machine. The front door is necessarily locked to prevent incoming intruders and unsupported access onto a very busy road several meters away. All bathrooms and toilets are freely accessible and are in good condition. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: We spoke to a resident, and they said they liked the house, giving a very big smile. Staff told us that the maintenance department are available to sort out any problems quickly and that a vehicle is available for their use. There is alot of communal space, meaning that people can do one to one support work without being in other residents space. 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 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 will be sure that staff can meet their needs. This is because the organization will have assessed the prospective service user and put in place staff training around them as an individual. Staff all have careful checks before they commence work. Evidence: There is a small staff team working at the home. A clear shift pattern is in place, so that service users know who will be supporting them and so they can discuss plans for the future. In the past 12 months, the organisation has not been as careful as it needs to be in vetting staff. They have been open with CSCI about their mistakes, and have taken steps to put this right and make sure it does not occur in the future. All staff have now had the right checks by the police (criminal records beaureau - CRB), have had references taken and have been given a full and thorough induction, leading onto enrolment onto a NVQ programe. The AQAA (annual quality assurance assessement) told us that at least half of the staff have an NVQ level 2 or better qualification. The staff we spoke to gave positive feedback about the type and quality of training they receive. They said that they are supported to have training that means they know they give the right support in a safe Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: way to people. We were pleased to learn that the manager is using her ongoing training in behavioural managment to coach staff in positive behaviorual support techniques. We saw that staff enteries on reports and records were considered and looked at the wider picture that affected individual service users. Staff are therefore equipt with the skills and expertise to meet the current service users needs. 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. The manager needs to complete the CSCI registration process, but is running the home in the best interests of the service users. It is a well organised and well delivered service that helps them develop skills and keeps people safe. Evidence: The manager has been in post since late summer 2008 and this is her first position as manager. She has had a good range of experience within the organization, supporting people in their own homes. She has an NVQ 3 qualification in social care, and will commence NVQ 4 early 2009. Currently, she is training on a specialist course in Applied Behavioral Analysis. This knowledge is being put to good use within the home, as we have seen in examples such as behavioral analysis. She is supporting the team to support service users in an individualized way based on person centered support. We observed a harmonious relationship between staff, service users and manager, where easy going banter was delivered at the level right for all to join in with. The manager will be applying for CSCI registration and hopes to have her application pack completed by early January 2009 latest. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Quality assurance was a difficult area to assess, as the home has only been fully operational after a spell of refurbishment, since August 2008. It is clear that the day to day reviewing is making a positive difference for people using the service. We saw this in the way care plans were reviewed when needs change, and that it was the individuals needs that dictated the review schedule, not a date in a calender. This said, formal reviews are scheduled in, but was really makes a difference to the lived experience of the persons at the home is the rapid response to their development. The organization, as a Limited Company, conduct monthly audits. We saw the latest audit and found that the provider had been thorough and discussed life in the home with the full range of people involved. We were pleased to note that the provider had made action points and was keeping the cycle of evaluation at a different level alive. The manager said that the providers are approachable and offer support with development in the service. To make this an excellent outcome area, developments around multiservice user involvement will need to be delivered. The AQAA was not completed by the current manager, so we confirmed that regular checks for fire alarms and boiler maintenance were in place. The manager showed us evidence that checks are taking place, and the visits by the provider also showed that these were monitored monthly too. All staff have the health and safety training that they require to work in this home, such as food hygiene, care of the back, health and safety and first aid. 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 20 So that individuals can have a level of ownership around their medication, assessment needs to take place. This will enable the home to build up a support plan so the individuals can have maximum autonomy around their medication while still receiving the support they require. So that service users have a clear, consistent way of voicing if they are very unhappy, an easy use pictorial system should be developed and implemented. 2 22 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 © (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. 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!