Inspection on 27/02/09 for Amber House

This inspection was carried out on 27th February 2009.

CSCI found this care home to be providing an Adequate 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

Amber House 29/02/08

Amber House 07/08/06

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 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Amber House 25/27 Norreys Road Didcot Oxon OX11 0AT     The quality rating for this care home is:   one star adequate 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: Ruth Lough     Date: 2 7 0 2 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: Amber House 25/27 Norreys Road Didcot Oxon OX11 0AT 01235512509 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): alliedcareltd@aol.com Ashamber Homes Ltd Name of registered manager (if applicable) Tichatonga Nyenya Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 6 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 Amber House comprises of two, three bedroom semi-detached properties, able to provide support to six people, which is on the outskirts of the Oxfordshire town of Didcot. Amber House provides 24-hour support to individuals who have been discharged from hospital and who require care, support and accommodation for mental health issues. Referrals to the service are received from many sources. Care Homes for Adults (18-65 years) Page 4 of 29 care home 6 Over 65 0 6 Brief description of the care home The goal of the service is to enable individuals to regain and enhance skills to return to independent living in the community. Adjoining conservatories link the properties. Internal access can be made through the adjoining door. The current scale of fees for this service is £850 to £1700 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection process generated from the adequate findings identified at the last assessment of the quality of the service by the commission in March 2008. This inspection process included reviewing information provided by the service before a one-day visit to the home. During the day the records for care planning, recruitment, and administration of the service were assessed. The people who use the service and the staff who provide the support were consulted about their opinion of what is provided, through surveys. Of the six people who are in receipt of support that we contacted, we received five Care Homes for Adults (18-65 years) Page 6 of 29 responses at the time of writing this report. Three staff were also contacted through surveys. A professional who has been involved with visiting the service on a regular basis also completed a survey and two professionals were present during the day. From this visit it was found that some recommendations that were made to develop the service during the last inspection process have been carried out. There were a few areas that will need to continue to improve as to provide a better quality of life for the people they support and two requirements were made to reflect this. A number of good practice recommendations were given at the time of the inspection and can be found in the body of this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 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 9 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. A thorough assessment of need process is carried out prior to an individuals admission to the home, with significant information obtained from other health professionals and risk assessments carried out. Evidence: Amber House has been providing long term support for a small number of residents with mental health needs who require assistance to regain and enhance their skills for independent living in the community. From what we were informed there have been no new residents admitted to the home over the last twelve months. As the previous inspection process identified that the assessment of individuals needs was suitable and supported prospective users of the service to be involved in the process, this area was not assessed fully on this occasion. The three people living in the home who completed the surveys sent to them from the commission, confirmed that they thought they had been given sufficient information Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: about the service before they moved in. Care Homes for Adults (18-65 years) Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning documents are not kept up to date or show that they are reviewed regularly to reflect the changes in individuals care needs and all risks identified and assessed. Evidence: From information given by staff and the residents we spoke to, changes in care and support are provided as an identified need occurs. All three respondents to the surveys thought they were in receipt of the help they needed. One health professional supported this during the visit to the home and another gave the same response in a survey. The care planning records for two people using the service were reviewed as to see if the identified improvements needed that were outlined at the last inspection have been implemented and the individuals receive the support they require. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: The records show that the service uses a Care Programme Approach, which means that they work with a single care plan that all the mental health practitioners involved with the individuals concerned contribute, develop and review. For one the records reviewed the information was found again not to be up to date. The other was up to date in most parts and gave a holistic view of the persons required care and support. In regard to the individual whos records did not reflect his actual needs the most significant area of concern was the considerable changes in personal physical and mental health that had occurred over the last few months. Included in the records were assessments and reviews carried out by the individuals health care professionals providing their specific support. These gave a good picture of the person concerned and identified the intended actions to continue with supporting the individual. However, the detail of this was not necessarily noted well in the homes own care planning for staff to follow. Concerns were previously identified at the last inspection with security practices in the home for personal information. This was because the facilities for these were not kept locked. From information given and an observation of the practices in place during the day, this is still and issue. The senior member of staff on duty, acknowledged that action had not been fully taken to secure the information, but assured that it would be completed during the day of inspection as maintenance staff were present in the home and could rectify the concerns. Individuals are supported to make informed decision making about their lives within a risk assessment process. This was confirmed by one of the residents who we spoke to during the day and in the surveys returned to the commission. Risk assessments are included in the care planning, again the dates of review had not been noted for some of these, others had not been reassessed effectively as the issues were possibly no longer relevant to the individual. Care Homes for Adults (18-65 years) Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to pursue the some occupation, and activities for personal development and to maintain their independence. They are also enabled to continue and develop new relationships and they have the opportunity to be part of the wider community. Evidence: The information in the care records for supporting the individuals with any education or occupation were reviewed as to identify if any changes have occurred and that residents feel less bored as previously identified at the last inspection process. From what we observed and through conversation with visiting health professionals, staff and residents, some areas of activities has improved during the recent months. This is mainly due to one new member of staff who has a specific interest in sports and Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: has encouraged some of the more active people living in the home to participate in using community facilities for this. This may not interest all of the residents living in the home but has generated a little more personal activities for some and sparked the interests of others. From discussion with staff and observing the facilities, very few residents are participating in the running of the home. One resident stated that some were reluctant to be involved with housekeeping duties, as others were not tidy or particular about the standard of cleanliness. Therefore it was mainly left to staff to take charge of this. They do have regular house meetings and discuss the plans and events going on in the home. Although, there remains little activities going on in the home other than which individuals decide to do, themselves. Residents are supported to take part in some community activities within a risk assessment process and within their planned agreed limitations with the health professionals leading their care. They do use the local shops and facilities with the support of staff and have the use of a house car to achieve this plus local public transport. Meal times and menu planning continues to be around individuals choices, wishes and needs. Each person appears to have an independent meal plan and only a small number of the residents each together on a periodical basis. There were no previous concerns about diet and nutrition provided to the residents during the last inspection process, although the changed health needs of one individual now indicates that greater observation of their nutrition should now be in place. From information given there is only one or two of the residents that participate with preparing their meals, others are dependent on the care staff carrying this out. Care Homes for Adults (18-65 years) Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The gaps in some of the care planning and assessment of possible risks to individual do not support that personal care and health needs are being met. Evidence: The information given in the Annual Quality Assurance Assessment, self-assessment and from that by staff during the day, identified that the personal care needs of one individual has changed significantly over the last few months. As previously stated, the care planning records did not truly indicate the degree of deterioration or needs of the person concerned. However, some of the information from the reviews carried out by the visiting health professionals did show that staff have been adapting to supporting this persons changed needs. What should be in place is the supporting evidence that staff are monitoring specific dependency needs, changes in physical health and the actions taken by staff to meet these. This is in particular reference to the nutritional needs, such as weight, diet and elimination and the mobility of the person concerned. Putting these in place would assist staff to seek the relevant health care professional help and aid them with any Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: decision making that the home will be able to meet the current and future needs of the person concerned. The element of the deterioration in mental health is noted and recorded within the shared records. For others in the home, personal care and support is not required but they are encouraged to care for themselves within their care planning. They are also encouraged to take the lead in seeking any healthcare consultations and treatment should it be required. The home has medication policies and procedures in place for medication administration and staff are provided with the necessary training at the commencement of their employment. All staff are given training for this as they are often working alone and take sole responsibility for this. The policy and procedure for medication includes instruction and risk assessment tools for self-medication should an individual be deemed able to do this themselves. Only one resident currently does this and has been provided with the necessary facilities for storage in their own room. In the care records for this person an assessment that the risks to themselves or others for self-medication had been carried out but not reviewed regularly. The storage facilities for the medications in the home have been reviewed and now are secured safely in recognised cabinet made for the purpose. The records for personal choices for ageing and death were reviewed to see what they have put in place for individuals wishes. Although this topic may not be particularly relevant to the majority of the people living in the home as to their current state of physical and mental health, it is a subject according to their records, staff may not of particularly explored. This could be an area to further develop as they may be the only advocate which an individual may have in the future. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has the necessary complaints policy, and procedure in place and people using the service and others can be confident their concerns will be listened to and acted upon. Service users are protected from possible harm or abuse. Evidence: The processes for making any concerns and complaints to the service were reviewed. There was a positive majority response in the surveys about knowing how to make a complaint. One expressed that they didnt know how to make a complaint, but did confirm that they knew who to speak to if they were unhappy. From observation of the staff and residents present in the home during the day there appeared to be good communication between them. They do hold regular meetings to provide another opportunity for residents and staff to discuss any concerns that arise, and also do discuss these in individuals reviews of care with their key workers. One resident put in the survey, If I have a problem I get help right away. The home use a book to record any comments or concerns made and the appointed manager was advised to look at the current practices in regard to data protection and confidentiality. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: The home has been in receipt of two complaints during the last twelve months, both appear to have been managed appropriately and acted upon within the necessary timescales. The commission has not been in receipt of any concerns, complaints, or information about the service but has been made aware of one safeguarding referral to the local authority during this period. Information provided in the Annual Quality Assurance Assessment indicated that from this one safeguarding referral, a member of staff was referred to the Protection of Vulnerable Adults list. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are provided with a homely comfortable environment to live in. Evidence: The home is not purpose built and is two semi-detached, three bedroom homes, linked together by a conservatory at the rear. It is domestic in nature and meets the current needs of the majority of the people living there. However, as previously identified, one resident has deteriorating physical and mental health and requires a moderate intervention of physical support for moving and handling. The home does not have the facilities or equipment for assisted living that this resident needs now, or possibly in the future. From observation the home has had a partial rolling programme of repair and refurbishment. However, parts of the home could be seen to be in a poor decorative state and have not been kept to a high standard of cleanliness. This was mainly in the area of the hallways, bathrooms, and toilets. The redecoration, refurbishment, and cleaning practices were discussed during the day with the senior staff on duty, who confirmed that action was planned to improve the Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: facilities. One bedroom was reviewed, with permission of the occupant, and it appeared to be kept clean, tidy and had been personalised to the individuals own choice. Residents have the use of a variety of communal spaces to use, including a two conservatory areas and a garden to the rear. These appear to be clean, tidy and comfortable places to use. Comments from residents about the cleanliness of the home included: The staff clean every morning and do a good job in keeping it clean. The staff like to keep it clean, but it is difficult. Depends which staff are on. Care Homes for Adults (18-65 years) Page 21 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. There are sufficient numbers of skilled and experienced staff employed and who have been provided with the necessary training to carry out their roles. Evidence: The residents we spoke to and those who contributed in the surveys were complimentary about the staff. They confirmed that they felt that the staff treated them well and listened and responded appropriately when asked for assistance. One resident wrote, All the staff that work here are very friendly and easy to get on with. Another put, I get on well with all the staff here now. No complaints. The rota indicated that two care staff are on duty during the day and evening times, and one at night. The service does have a dedicated staff team employed in the home but also has the added flexibility of staff available who work across the other two services belonging to the organisation that are based in the locality. This gives the people who use the service a broader experience of carers supporting them and if there are activities external to the home they are able to access them. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: The service does not use any agency staff and any deficits in staffing levels through sickness and annual leave are accommodated by the organisations bank team of staff used across the three homes. The majority of the staff are male, only one female member of staff is on the current team employed in the home. This appears to work well and suit the current residents. Information in the Annual Quality Assurance Assessment stated that five of the six employed in the home had attained an NVQ 2 or above in care. The appointed manager is a registered general nurse. The recruitment and employment records for two staff (SM and NR)were reviewed as to see if the process is robust and protects the people living in the home. The records seen supported that the necessary checks are carried out and that copies of the relevant training and qualification certificates are kept. Staff comments in the three surveys returned to the commission confirmed that they thought the recruitment process was carried out appropriately and that sufficient information and training within their induction period. Staff were also very positive about the training they were provided with and the support they were given to attain qualifications appropriate to their roles. Information was available to support that there is a good programme of health and safety training given to staff. The appointed manager confirmed that he was exploring training appropriate to his role and to develop his knowledge for caring for people with mental health needs. Care Homes for Adults (18-65 years) Page 23 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 home is run effectively and safely and in their best interest of the people who live there. Those who use the service or come in contact with it are consulted about the quality of what is provided. Evidence: One professional wrote about the service, I feel that this is a good service appropriate to my clients needs. As previously identified the home has a newly appointed manager in place, October 2008, who at the time of the inspection had not submitted and application to the commission for the registered manager of the home. The previous registered manager had left the post in April 2008. He is supported by the other registered manager in the area and a senior team of management in the locality from the provider organisation. The home has some processes in place for quality assurance including formal and informal consultation with the people who use and come in contact with the service. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: This is usually through regular six monthly surveys and monthly provider visits in accordance to regulation 26(Care Standards Act 2000) being carried out. More informally, residents expressed that they were confident that the staff listened and responded to any opinion they may have about the service that is being provided. There is information and guidance for safe working practices available for staff in the home and they have had the necessary training to carry out their roles. From information given there is a programme of safety checks in place for heating, water, electrical and fire to protect the people living and working in the home. Care Homes for Adults (18-65 years) Page 25 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 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 That the registered person ensures that the service users plan is reviewed and reflects how the individuals needs are to be met. You should ensure that the needs of the individual are regularly reviewed and changes to the planned care of how to meet those needs is recorded in sufficient detail. 31/03/2009 2 20 13 The responsible person should make arrangements for the recording, handling, and safekeeping of medications held in the home. You should ensure that any risks to individuals or others in the home for those who self- medicate are assessed and reviewed regularly. 31/03/2009 Recommendations Care Homes for Adults (18-65 years) Page 27 of 29 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 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. 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!