Inspection on 23/02/09 for Brackenbury Road, 37

This inspection was carried out on 23rd February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brackenbury Road, 37 27/05/08

Brackenbury Road, 37 20/08/07

Brackenbury Road, 37 29/11/05

Brackenbury Road, 37 11/07/05

Brackenbury Road, 37 18/01/05

Brackenbury Road, 37 19/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Brackenbury Road, 37 Brackenbury Road 37 Brackenbury Road Hammersmith London W6 0BG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sheila Lycholit     Date: 2 3 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 28 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 28 Information about the care home Name of care home: Address: Brackenbury Road, 37 37 Brackenbury Road Brackenbury Road Hammersmith London W6 0BG 02085632125 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : info@yarrowhousing.org.uk Yarrow Housing care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The maximum number of service users who can be accommodated is: 5 Thee registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 37 Brackenbury Road is a registered care home providing accommodation, support and care for five men and women with a learning disability. At the time of this inspection there were four women and one man living in the home. Notting Hill Housing Trust owns the property and the care is provided by Yarrow Housing, a not-for-profit organisation. The home is well located, close to facilities in the local community and the shops and transport links of Shepherds Bush and Hammersmith. The home provides accommodation over three floors and is not accessible to people with mobility difficulties. Each person living in the home has a good sized single room with wash hand basin. Shared facilities include a bathroom, separate shower room, lavatories, sitting room, kitchen/dining room and garden. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection took place on Monday 23rd February 2009 from 10am until 2.45pm. The Manager, who had done the sleep-in duty the night before, was on duty with two support staff. Three service users were at home at the start of visit , later going out with staff to activities, including a dance class. The other two service users had gone to their day services - Options and The Gate. Feedback questiionnaires were returned by each of the service users, who had received varying degrees of support from staff to complete them. The Manager had completed an Annual Quality Assurance Assessment (AQAA) in September 2008, which was discussed during the inspection. The Manager made herself available throughout the visit. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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 28 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 28 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. Information about the service is of a high standard, produced in an accessible format, which is regularly updated. Contracts with service users are also in an easy read/accessible format and contain all relevant information. Evidence: The individual files of three service users were looked at, including one person whose needs were being reassessed. Each file contained a copy of the Statement of Purpose and Service Users Guide which had been revised in January this year. Notes of key working sessions showed that staff had discussed the information with service users. The Statement of Purpose and Guide are produced in an accessible format, containing photos, signs and symbols. No new service users have been admitted to 37 Brackenbury Road for a number of years. The needs of one service user who has expressed a wish to move at some time in the future are being reassesssed with the Social Worker and other members of the multi professional Learning Disability Team. A further meeting was planned to take Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: place during the week of the inspection. Up to date contracts and licence agreements were seen on each of the files looked at. Contracts are also in an easy read format and contain all required information, including details of current charges. Care Homes for Adults (18-65 years) Page 11 of 28 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. Progress has been made in developing Person Centred Plans/care plans, including the involvement of service users through the use of multi media. Comprehensive risk assessments are available for each service user, which are regularly updated. Evidence: Three PCPs and care plans were looked at. Records showed that these are regularly reviewed. Where there have been delays in arranging placement reviews, e mails and letters show that the Manager has taken steps to remind Social Workers/Care Managers of the need to set a date. The Manager confirmed that all PCPs are also available on DVD. PCPs and care plans are in an accessible format on file and show the involvement of the service user. The involvement of Yarrows multi media officer has been invaluable in developing the use of more accessible formats both in reviews and to support service users communication more generally. Where the service user has raised issues, for example about the placement, these Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: have been explored both in and following the meeting. Families and advocates, where available, are invited to reviews and notes of meetings show that the majority of families are able to attend. Monthly summaries and notes of key working sessions were seen on file. Generally these records lacked detail and as noted at the previous inspection do not show progress made in relation to decisions or goals agreed at PCP meetings or placement reviews. Service users risk assessments are comprehensive and are regularly updated. Where incidents or accidents have occurred, action has been taken to prevent a recurrence, for example an additional high level bolt and door chain have been fitted since one person went missing for a brief period. Only one of the current service users is able to travel independently and her freedom to leave the building is not restricted. The water to the washbasin in one service users room has been shut off following several incidents of flooding. A risk assessment has been completed. More frequent house meetings have continued to take place, with notes of the meetings made available in an accessible format. The meetings are well attended and a range of issues and concerns discussed. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported to take part in a wide range of individual, group and community based activities. Meals are eaten in the pleasant dining area which is off the kitchen. Staff have continued to support service users in eating healthily, by ensuring that house meals are made from fresh ingredients and by limiting fast food and takeaways. Evidence: Activity plans show that service users are supported to take part in day services, individual and community activities in line with their assessed needs and personal interests. Service users at 37 Brackenbury Road are from a wide age group and have varying needs. Some service users regularly attend local day services, including Yarrow Housings day service, The Gate, which is nearby. Since the last inspection one service user has chosen to attend The Gate five days a week, which the Manager Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: reported she seemed to enjoy, as staff no longer had difficulty in persuading her to get up in the morning. Yarrows multi media officer works with a number of service users both in the office and at the house to develop their IT and communication skills. Staff take steps to support the personal and emotional development of service users, especially those that are younger, by making referrals to the Psychologists in the Learning Disability Team. Good contact is maintained with families, the majority of whom attend reviews, meetings and events at the home. All service users have an annual holiday accompanied by staff, either individually or with one or two other people. Trips last year included Egypt, Italy and the Channel Islands. Photos of recent holidays, outings and events are displayed in the house. Service users cultural and ethnic needs are identified and met through attendance at places of worship, meals at restaurants and cultural events. Staff have continued to encourage healthy eating. The Manager confirmed that the main meal of the day is prepared from fresh ingredients and that biscuits and cakes are rarely purchased. Menus show that fast food and takeaways are not ordered for the house. Service users help prepare meals, as noted on the menu. One service user commented on her feedback form that she would like to do more cooking. The Manager said she was aware of this and was looking at ways for her to cook more often. A range of cookery books are available, reflecting the cuisine of service users differing backgrounds. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive good support to ensure that their health care needs are met. The administration of medication has improved. Evidence: Support guidelines were seen on service users files. These are well written and detail how the person wishes to be supported with personal care. Some guidelines had not been revised for 2 years and need to be updated, particularly as a number of new staff have been appointed to the service. Records, in particular the well kept record of all health care appointments and outcomes, show that service users health care needs are given a high priority. Staff have ensured that service users receive regular dental care, using specialist services where necessary. Service users are supported to attend hospital appointments as well as visits to community health services. Health care plans seen on files were up to date and in an accessible format. The home now uses the Boots monitored dosage system and staff have received medication training from Boots. The Manager has revised Yarrows medication policy and procedure to make the guidance specific to 37 Brackenbury Road. A procedure for Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: handling leave medication has been established. Since the last inspection a thermometer has been purchased for the medication cupboard. The recent visit on behalf of the provider raised some issues concerning the storage of medication, which have been acted upon. It is recommended that Yarrows policy and procedure is revised to include disguised or covert medication and the storage and administration of controlled drugs, although neither is relavent to the current handling of medication at 37 Brackenbury Road. Care Homes for Adults (18-65 years) Page 17 of 28 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. Service users are supported to express complaints and concerns and have access to a sound complaints procedure. Staff receive regular training in safeguarding adults and up to date policies and procedures are available. Evidence: Yarrow Housing has an easy read complaints procedure which is displayed in the home and is included in the Service Users Guide. All service users were made aware of the procedure in key working sessions when it was re-issued in 2008. Notes of house meetings show that time is allocated to complaints and concerns at each meeting. Although noted in the minutes these concerns are not quantified and do not contribute to the homes quality assurance process. The Manager noted on the AQAA in September 2008 that one complaint had been received since the inspection in May. As the records had been archived, they were not checked at this visit. Records kept in the safeguarding file show that all staff have received recent training. No safeguarding referrals have been made in the past 12 months. The recent visit on behalf of the provider noted that one person had made an allegation about being scratched by another service user at 2 recent house meetings. The Manager who had been on leave during this period, was planning to speak with the service user. The recent financial transactions of 2 service users who are not able to manage their money were looked at. The records were well kept, with the accounts regularly Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: reconciled and checked by the Manager. Residents accounts are also checked during visits on behalf of the provider. Receipts are obtained for all purchases. An issue concerning one service users finances was discussed, which the Manager said she had already raised with the Head of Care, and would discuss further at the placement review meeting taking place shortly. Care Homes for Adults (18-65 years) Page 19 of 28 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 house is in a good state of repair and decoration and staff work hard to create a pleasant environment for service users. Evidence: The house is indistinguishable from others in the street and is close to shops, services and public transport. Internally and externally the building is in a good state of repair and decoration. The garden has been cleared and replanted and outdoor furniture is available for use in warmer weather. One service user showed the Inspector her room, which contained a large number of personal possessions, reflecting her interests. New curtains have recently been fitted at the large bay window. There has been no cleaner since the house reopened in March 2008. Support staff have worked hard to ensure a high standard of cleanliness has been maintained. All areas were clean and tidy, including the kitchen and bathrooms, at this unannounced visit. Care Homes for Adults (18-65 years) Page 20 of 28 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 vacancies have been reduced and acting arrangments are no longer in place creating a more stable and cohesive team. Staff have access to a comprehensive training programme. Evidence: Since the last inspection the Deputy Manager has been appointed to the post of Manager. A Deputy Manager from another Yarrow service has transferred to 37 Brackenbury Road. This means that the acting arrangements are no longer necessary. Two staff left the project in 2008. One new member of staff has been appointed and interviews are arranged for the remaining vacancy. Twenty hours have been removed from the staffing establishment to make cost savings and the part-time cleaners post has not been filled. The impact on service users is unclear. The Manager said that additional bank staff can be used for evening activities, such as the Funky Club. Otherwise there is normally one member of staff on duty from 9pm until 8am. Feedback from service users about staff was very positive. Comments included my key worker really understands me. Good interactions between staff and service users were observed during the inspection. Staff are recruited by Yarrows HR team with the involvement of the Manager. A number of Yarrow service users have been trained in recruitment interviewing and Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: take part in interviews. All recruitment checks are undertaken by the HR team and were not checked at this inspection. The Manager confirmed in the recent AQAA that she receives written confirmation of satisfactory CRB checks before staff start at the home. Yarrow has a comprehensive training programme for staff, who also have access to NVQ training. Two support staff have NVQ3 and one is enrolled on NVQ3. Two staff are studying externally - one in Nursing and the other in Social Work. The Deputy Manager is enrolled on NVQ4 and is also studying for a NVQ in computing. Staff receive good support from the Manager through regular staff meetings and supervision. Notes of recent staff meetings were seen, which showed that a range of issues are discussed. It is recommended that all staff sign to confirm that they have read the staff meeting notes. A supervision schedule is displayed on the staff notice board. Care Homes for Adults (18-65 years) Page 22 of 28 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 appointment of a Manager and Deputy Manager has established a stable management team. Attention to health and safety and record keeping has improved. Visits on behalf of the provider are sporadic and reports of visits are not always made available. Evidence: The appointment of the Deputy Manager to the Managers post has create more stability in the staff team. The Manager has a NVQ 4 and has worked at 37 Brackenbury Road for a number of years, getting to know service users and their families well. Yarrow has a number of tenant participation initiatives, including regular satisfaction surveys and a tenants forum. Copies of surveys were seen on service users files, though few if any issues were raised in the surveys, unlike the notes of house meetings where a number of dissatisfactions are raised. Ways of capturing service users views more accurately could be developed, as discussed under standard 22. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: Health and safety is given a high priority. All staff receive health and safety training as part of their core training. The Manager was aware that a number of staff needed to update their training this year. Monthly health and safety checks of the building take place. The fire risk assessment was reviewed in January 2009. Records show that fire drills take place monthly, with weekly checks of the alarm system at different points. The fire detection system is serviced 4 times a year and fire fighting equipment annually. Hot water temperatures are checked monthly and thermostatic valves have been fitted in the kitchen where the water had been above a safe temperature. The recommendations of the Food Safety inspection, which took place in March 2008, have been implemented. Records of testing of small electrical appliances, which are frequently used by service users, are not available, although the Manager confirms that checks took place in 2008. Steps to control the risk of Legionella, discussed at the previous inspection, have not been implemented. Correspondence shows that the Manager has been trying to pursue the matter with Yarrow Housing and with the Housing Association that owns the building. No copies of reports of visits on behalf of the provider were available in 2008 for July, August, September, October and December. The visitors book indicated that visits had taken place in July and December but reports had not been sent to the Manager. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 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 23 13 Staff should report any allegations made by a service user such as being scratched, to a senior member of staff promptly. So that action can be taken to look into the matter and prevent a recurrence. 31/03/2009 2 42 13 Steps must be taken to control the risk of Legionella. To ensure the safety of service users and staff. 31/03/2009 3 43 26 Visits on behalf of the provider must take place at least monthly with copies of the report available in the home. So that the provider has up to date information about the day to day running of the home and of issues affecting service users. 31/03/2009 Care Homes for Adults (18-65 years) Page 26 of 28 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 Key working notes and monthly summaries should refer to the goals, objectives and action plans defined in care plans and PCPs to ensure that support is focused and progress noted. Support guidelines should be reviewed, especially as new staff are starting work at the home. Yarrow Housings medication policy should be revised to include disguised or covert medication and the storage and administration of controlled drugs, although neither currently applies to 37 Brackenbury Road. Ways of recording and quantifying lower level concerns, which do not constitute a formal complaint, should be established. It is recommended that all staff sign the notes of staff meetings to confirm that they have read them. 2 3 18 20 4 22 5 36 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - 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!