Inspection on 10/11/08 for Bishops Lodge

This inspection was carried out on 10th November 2008.

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

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

Other inspections for this house

Bishops Lodge 10/11/06

Bishops Lodge 17/11/05

Bishops Lodge 25/04/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bishops Lodge 19 Fearon Road Hastings East Sussex TN34 2DL     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: Caroline Johnson     Date: 1 0 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: Bishops Lodge 19 Fearon Road Hastings East Sussex TN34 2DL 01424719011 01424421684 admin@newdirections.gb.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Amanda Elizabeth Jane Gates Type of registration: Number of places registered: New Directions (Hastings) Ltd care home 6 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: 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: Learning disability - LD Date of last inspection Brief description of the care home The home is situated in a detached Victorian house on the outskirts of Hastings. It is situated close to local shops, a local park and bus routes. Ore railway station is about a mile away. The home is registered to provide accommodation for six younger adults with a learning disability, predominantly those with Prader-Willi syndrome. At the rear of the home there is a garden, which slopes up away from the house, and decking has provided areas to sit. There is a building at the rear, which is used to provide an inhouse day care centre. Accommodation is on two floors. There is adequate communal space and each service user has a single bedroom. Five of the bedrooms have en-suite Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home facilities and the sixth has the use of a bathroom nearby. There are parking spaces to the front of the home. Fees for the servcie can be found in the summary section of this report. Additional charges are made for hairdressing, toiletries, magazines and papers. Inspection reports are made available at the home and reference to the availability of reports is also included in the homes statement of purpose. 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: For the purpose of this report the people living at Bishops Lodge will be referred to as residents. As part of the inspection process a site visit was carried out on 10 November 2008 and it lasted from 10:00am until 5:25pm. The registered manager facilitated the inspection. Over the course of the inspection there was an opportunity to meet with and to spend time in the dining room with all of the residents. In addition time was spent with two members of staff in private. All communal areas were seen along with two of the bedrooms. Two care plans were examined in detail. In addition records seen included; staff rotas, training, medication, menus, health and safety, quality assurance and leisure activities. Care Homes for Adults (18-65 years) Page 6 of 29 The last key inspection on this service was completed on 10 November 2006. The fees for the service range from 1,451 to 1,507 pounds 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 29 Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with clear information to assist them in making an informed choice about accommodation. Evidence: There is a detailed statement of purpose in place setting out how the home is to operate and providing clear information about whom they can accommodate. Views of the residents, staff and relatives are included in the statement. The terms and conditions of residence are attached to a detailed service user guide. The room allocated and specific room fees charged per individual are not yet included in individual documents. There has been one resident discharged and one admission since the last inspection. The resident admitted initially moved to one of the other sister homes within the group as an emergency admission. However, once more thorough assessment of needs had been carried out it was felt that Bishops Lodge was a better placement. The placement authority provided a detailed assessment and care plan and the home have put in Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: place an interim three month care plan rather than the normal six month plan. The resident concerned has signed their service user guide but has yet to sign the terms and conditions of residence. The resident advised that they were happy in the home; they liked their room and enjoy being busy with lots of activities such as swimming and day services. 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. Care plans clearly demonstrate the abilities and needs of the residents. The action to be taken to assist residents in meeting their identified goals should be recorded in more detail and this would improve care plans further. Evidence: The home uses a PCP (person centred planning) approach for care planning and staff have had training on this approach. Two care plans were examined in detail and both included a wealth of information about the residents, including their likes and dislikes and details of their hopes and aspirations. In addition there are a number of risk assessments in place, which include detailed information on the level of the perceived risks and the action to be taken to minimise accidents/incidents occurring. Each of the residents have a number of goals identified that they have chosen to work towards. In relation to the two residents case tracked it was noted that they had goals but record keeping was not clear in relation to the steps to be taken to achieve these Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: goals. For example one residents goal is to cut down to the bare minimum with cigarettes. However, for how this will be achieved it stated now smoking again. There is no reference to how many cigarettes the resident actually smokes and how they are to be encouraged to cut down. This has been identified at the last inspection of the home. Another goal identified is for the resident to obtain work. For how this will be achieved, it states that he browses the newspaper and to encourage him to phone for an application form. On further discussion with the manager it was evident that more detailed work had been carried out with the resident in identifying the type of work and how it was to be achieved, but record keeping does not match up with the work done. Despite the record keeping in relation to goal achievements it was noted that the home has had good success in encouraging residents to achieve their goals. Recent successes include securing work placements for some residents, one resident achieving their cycle proficiency and very good progress in residents reaching their target weights. Residents meetings are held regularly and show that a range of discussions were held regarding health and safety issues, menus and day services issues. A recent entry states that holidays have all been booked and residents were advised to save. Records could not be found showing that there had been a discussion regarding the destinations and the choices made. The manager advised that some of these decisions would have been made at individual PCP meetings and that all residents were involved with the discussion regarding holidays. 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. Residents have access to a wide range of interesting and stimulating activities. Evidence: Each of the residents has an individual programme of activities in place. There is a full time activity co-ordinator in post and a range of day services are run either in the day centre to the rear of the property, at a day centre based at one of the sister homes or in the community. Activities in the community include swimming, basketball, trampoline, horse riding, gym, music gym and pottery. Activities in the day centres include literacy and numeracy and a wide range of art and crafts. One resident loves photography and will be doing a college course on the subject in the near future. Another resident recently chose to start formal swimming lessons and started a course of lessons the week prior to the inspection. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: One resident has a work placement two days a week, another works at a charity shop two afternoons each week, another at another charity shop one day per week and one day at a local school. Residents also enjoy visiting other homes within the group for coffee evenings. There are annual holidays, trips to France, trips to other towns, literacy and numeracy classes, evening and/or days out with girl/boyfriends, pubs and clubs. Theme nights are arranged in the home with food from around the world and during summer months residents enjoy barbeques. It was reported that one resident was supported to pass their cycling proficiency test allowing them to achieve their goal of accessing the community on their bicycle. Staff advised that residents would be given access to the internet in the New Year. One resident has chosen to go to Church on a weekly basis and staff will provide support for this activity. It was noted that there was a list of pubs on display on the notice board in the hallway. Staff advised that the residents compiled this list. The residents have decided to follow the list and visit each pub in turn once a week and to go together as a group. There is a four-week menu in place and in addition a record is kept of the actual meals served. A cooked breakfast is served once a week. There is a choice of main meal served one being a vegetarian option. One of the residents is a non-meat eater. It was noted that the vegetarian main meal option includes jacket potato and fillings two to three times a week. In addition there is some reliance on quorn products. If a resident were to follow the vegetarian option strictly, then there would be a need to review the menu provided. However, as the one vegetarian also eats fish this provides more variety in their diet. This needs to be kept under review. On the day of inspection there was pasta and vegetables for lunch. The meal was well presented and portion sizes were ample. 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. Residents are protected by the systems in place to manage their healthcare needs. Evidence: Each of the residents has been offered the opportunity to have a health action plan completed. Some of the residents have chosen to have one and some not to have one. Residents individual weights are monitored regularly. Records show each individuals target weight and their actual weight. Most of the residents are close to their target weights. One of the residents that had been treated for diabetes, no longer needs any treatment. Where necessary the home seeks specialist advice and support to meet individual needs. It was reported that they have requested a speech and language assessment for one resident and for another resident anger management support for some mental health issues. In addition residents are supported to attend a wide range of health appointments such as dental, chiropody and opticians. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: The arrangements in place for the storage, handling and administration of medication were in order. Records were detailed. A list is maintained of the staff signatures for those staff that have been trained to administer medication. There was a returns book in place showing all medication returned to the local pharmacy along with signatures from staff and the local pharmacy. Monthly audits are carried out to ensure that a clear audit trail of medication in and out of the home is maintained. Information is also provided about all medication prescribed on an as required basis, what it is prescribed for and when it should be administered. The home has drawn up an assessment tool to assess those residents who wish to self-administer their own medication. In relation to one of the residents case tracked, it was noted that there was a risk assessment in place to enable them to administer some of their prescribed medication. However, information provided elsewhere in their care plan led to confusion regarding who had responsibility for administering which medication. The manager agreed that this should be updated to make it clearer for staff. It was noted that the home has addressed the good practice recommendation made at the last inspection of the home in relation to the signing of medication. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures in place ensure that anyone wishing to make a complaint can do so. Evidence: A complaints/suggestions box is located in the hallway so that anyone wishing to make a complaint, compliment or suggestion for change can do so. In addition there is a detailed complaint procedure and a more simplified version of the procedure. The procedure is on display in the home and a copy is also included in the service user guide. Records showed that since the last inspection of the home two of the residents had raised issues that they were concerned about. In both cases the home had explored the issues, dealt with the problems and spoken to the residents concerned. The home has a copy of the multi-agency guidelines on the protection of vulnerable adults in the office and a flow chart explaining the procedure is also on display. A staff member spoken with was clear about what they would do if an allegation were made to them. A second carer had yet to have training on the subject as they are still relatively new in the home. However, they were aware of the flow chart. The arrangements in place for the management of residents finances were discussed and records were seen in relation to one of the residents case tracked. All records seen were in order. This resident also has a risk assessment in place in relation to the management of their money. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and decorated to a good standard. Evidence: Communal areas include a very large lounge/dining room. In addition there is a conservatory, which is classed as a smoking room. There is a large lobby area with seating provided and some of the residents choose to watch television in this area. Staff advised that the lounge/dining room has been ear marked for redecoration and the residents have chosen the colour scheme already. There is a new TV in the lounge and a computer. A new computer will be purchased for the day services in the New Year. New carpet has been laid in the lounge and the stairs and landing. The woodwork is now to be painted. Residents have access to the kitchen area as and when they choose. The larder is kept locked in line with residents needs but residents have free access to drinks at any time. The manager advised that they residents have designed their own rules regarding food. Fruit is kept stored in the larder along with drinking chocolate which the residents choose to have in the evenings. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Only two of the bedrooms were seen during the inspection. The residents were pleased to show their rooms and advised that they enjoyed spending time there. Both rooms had been personalised and reflected the tastes and interests of the residents. In one room, one of the walls was being repainted on the day of inspection. There is a detailed maintenance schedule in place for 2008 which included a wide range of tasks most of which have already been attended to. The manager advised that there were plans to replace the sealants on all the showers in the coming months. All areas of the home that were seen during the inspection were clean. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are provided with regular opportunities to update their knowledge and skills to meet the needs of the residents. Evidence: The rota provided shows that there are two care staff on duty each day. In addition the manager and the activity co-ordinator work nine to five Monday to Friday. Three evenings a week there is an additional worker to support activities and one day a week an additional 10 to 4pm shift. Recruitment records were seen in relation to two staff that had been appointed since the last inspection of the home. Appropriate checks had been carried out and both staff members had been issued with terms and conditions of employment. Records seen in relation to one of these staff members showed that they had completed an inhouse induction and had gone on to complete the Common Induction Standards and all mandatory training. The majority of the staff team have completed NVQ at level two or above. In addition the majority of the staff team have completed their mandatory training. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Records showed that all but two staff were up to date with supervision. Dates had been booked for the two staff and the reason for the delay was explained. 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 home is run well in the interest of the residents accommodated. Evidence: The Registered Manager has completed NVQ Levels 3 & 4 in Care, the Registered Managers Award, and the A1 Assessors Award and is currently working towards an NVQ 2 in computer skills. Staff meetings are held regularly and minutes of the last meeting showed that a resident joined part of the meeting as a representative for the residents. A regular feature of the meeting is that two policies and procedures are highlighted for staff to read through before the next meeting and they are then discussed in detail at the next meeting as a way of ensuring that all staff are kept up to date. Staff spoken with stated that they were well supported. One staff member stated that the manager was approachable and they felt comfortable asking questions or even just seeking reassurance. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Staff advised that there is a good handover between shifts. A staff member who starts their shift later in the day advised that the senior gives her a handover when she comes on shift and highlights any changes that have happened. They also read the communication book. There is an annual development plan, which is revised in January each year. There is a now a computer in the office making it easier for the manager to keep up to date with administration and managerial tasks. In relation to quality assurance the home sends satisfaction questionnaires to residents and their relatives, to staff and to any visiting professionals. Surveys for 2007 were seen and all were very positive. It was noted that this years surveys have just gone out to residents and they are due to go to staff and relatives shortly. Staff spoken with stated that the home has a good relationship with the relatives of the residents. The home receives an unannounced visit each month from a member of the senior management team who then report to the director on the running of the home. Reports carried out in September 2008 were comprehensive showing that a wide range of areas has been monitored. The manager advised that a fire risk assessment was completed the week prior to the inspection and the home are now waiting on the report of the visit. Regular fire drills are carried out and records showed that good procedures are followed. In addition the home keeps detailed records showing that equipment is tested and serviced and that water temperatures are recorded. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 5 5 The registered manager must ensure that the room and fee charged be stated on each individuals terms and conditions of residence. The terms of residence must be clearly stated. 15/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 The home should continue to work on identifying the steps to be taken by staff in assisting residents to achieve their identified goals. The home should find a way of demonstrating more clearly the choices and decisions made by the residents. The home should review the risk assessment in place in relation to one resident who self-administers their medication. 2 3 7 20 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!