Inspection on 17/11/08 for Carlton Gate

This inspection was carried out on 17th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlton Gate 26/11/09

Carlton Gate 19/11/07

Carlton Gate 04/01/07

Carlton Gate 27/06/06

Carlton Gate 24/02/06

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 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Carlton Gate 10 Florey Lodge Admiral Walk, Harrow Road London W9 3TF     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: Ffion Simmons     Date: 1 7 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Carlton Gate Admiral Walk, Harrow Road 10 Florey Lodge London W9 3TF 02072892352 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Westminster Society 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 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 Carlton Gate is a registered care home providing personal care and accommodation for two men and four women with a learning disability. Westminster City Council leases the property from the health authority and care is provided by the Westminster Society, a voluntary organisation. The home is well located to enable residents to use facilities in the local community and is close to shops and transport links. The home is split into two flats, Florey Lodge and Barnard Lodge, each for three people. All accommodation is on the ground floor and the home is fully accessible to people using wheelchairs. Each person living in the home has a single room. Each flat has an assisted bathroom and accessible shower room. The flat in Florey Lodge contains the staff office. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 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: 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 key inspection took place over one day on the 17th November 2008 and lasted a total of 8 hours. During the inspection, we spoke with residents and staff and observed care practices. We tracked the care of two residents and in doing so we checked their personal records. We also checked a range of other records and documentation including health and safety documentation, training records, quality assurance records, incident and accident records. Questionnaires were sent to residents, professionals and staff to comment on the service. We have used the information within these questionnaires as part of this Care Homes for Adults (18-65 years) Page 6 of 29 report. The Registered Manager took time to complete and return the Annual Quality Assurance Assessment (AQAA) which has also been used as evidence to inform 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.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 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. The home understands the importance of having sufficient information when choosing a care home and has developed clear information to help them understand what specialist services the home can provide. A full needs assessment is conducted in a professional and sensitive way and involves the individual and their family or representative, where appropriate. Evidence: The home has an accessible service user guide in place. The Registered Manager told us that the guide has been updated slightly in consultation with the residents and now includes some new photographs and clearer explanations of some areas of service provision. We noted within the AQAA that the home would like to produce a video brochure for the house, which would involve current and new residents. The AQAA, which was completed by the Registered Manager confirmed that since the last key inspection, the two vacancies at the home have been filled. The Registered Manager explained within the AQAA that the rooms had been held vacant following the Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: death of two of the residents to enable residents and staff to have time to come to terms with the losses. During the inspection, we case tracked one of the residents who has recently moved into the home. A detailed assessment of needs appeared on their file, which had been undertaken by a senior person within the Westminster Society. All prospective residents and family have the opportunity to visit and stay over. Residents who provided feedback on the service commented that they had been asked if they wanted to move into the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs and personal goals are outlined within their individualised support plans. Individuals are encouraged to make their own decisions and choices. Risk assessments are in place to enable residents to be supported to take responsible risks. Evidence: During the inspection, we tracked the care of two residents and in doing so, we checked their personal files and talked to the residents and staff. One of the support plans checked makes very good use of pictures, making the information within the document accessible to the resident. The residents life story was illustrated in pictures, and the Manager confirmed within the AQAA that residents are fully involved in completing the plans. Some of the information within the support plan needed updating, and it is a requirement that staff ensure that the information within the support plans is kept up-to-date. The support plan of the second resident was also checked. Staff are still working to Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: complete this support plan. The information on file was person centred and detailed, but the current format is not accessible to the resident. It is recommended that the information within the plan is made accessible to the residents. Individuals are encouraged to make their own decisions and choices. Both files checked during the inspection, included detailed risk assessments, which covered a range of potential risks. The assessments covered and identified potential risks associated with for example, bathing, manual handling, fire and malnutrition. These assessments were up-to-date. Where residents have been identified of being at risk to themselves and others and where they display challenging behaviour, risk assessments and positive behaviour plans were in place for managing these behaviours. Residents also benefit from the input of a Challenging Needs nurse, who works with staff to develop the positive behaviour plans, and to provide support and training. Incidents of challenging behaviour are fully recorded and reported to residents Care Management teams. 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 good 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 be involved in meaningful activities, which meet their individual needs, interests and preferences. The service is committed to principles of inclusion. Evidence: Residents are supported to access the local community. Through checking daily records and monthly reviews, we found that they regularly access local shops and cafes with staff support. Residents are also supported to take part in activities of choice within the home, including art and bingo. Residents interests and preferences are outlined within their support plans and residents are asked about their interests and preferences during house meetings and key worker meetings. Residents needs with regards to cultural and religious needs are also outlined within their support plans, and residents are supported to attend religious services outside of the home Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: where requested. Residents are supported to maintain links with their families and friends, and for one of the residents case tracked, maintaining links with the family had been incorporated into their weekly plan. Residents who provided feedback on the service commented that they can always make decisions about what to do during the day, evening and at the week-end. Residents are encouraged to maintain independence as far as possible and are encouraged for example to be involved in attending to their washing and shopping. During the inspection, we observed staff offering choices to residents of what they would like to eat and observed a resident being involved in food preparation. The Manager told us within the AQAA that residents predominately eat what they want to and when they want and are supported to buy food if they want something that isnt in the house. 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 good 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 access care from the multi-disciplinary team as necessary. Residents are protected by the homes medication policies and practices. Evidence: We case tracked the care of two residents during this inspection and found that both residents had a detailed support plan on their files outlining their needs and preferences with regards to health and personal care. The Manager confirmed that staff respect gender care preferences wherever possible. There was evidence on the files checked that residents are supported to attend regular healthcare appointments including podiatry and dental appointments. Health Action plans were on file for both residents case tracked, with follow-up appointments arranged to review the health action plans. Records also showed that residents weight is regularly monitored. Residents living at the home benefit, where necessary from the input of members of the multi-disciplinary team including Psychologist and Challenging Needs Nurse, who also provide training and support to staff. Policies and procedures are in place to ensure the safe storage, administration and Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: recording of medication. Medication was seen to be securely stored within a locked cabinet in the home. No controlled drugs are currently in use in the home. The medication administration records checked during the inspection were well completed with no gaps noted. This is an improvement from the last inspection, when a requirement was made to ensure that staff sign the medication administration records when they give medication to residents and not later in the shift. The manager ensures that regular audits are undertaken to ensure that medication is administered safely and that the records are accurate and up-to-date. 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 a clear complaints policy in place, which is accessible to residents living in the home. Staff understand the procedures for protecting residents from abuse and report any concerns to the local safeguarding team. Evidence: The home has an accessible complaints policy, which is made available to each resident living in the home. The Registered Manager told us within the AQAA that the home has received 15 complaints within the last twelve months. Residents who provided feedback on the service, commented that they know how to make a complaint. Staff are also aware of the importance of logging residents complaints. Complaints are logged on a computerised system, which can be accessed by senior managers at the Westminster Societys Head office. The complaint records were well completed and demonstrates that staff take complaints seriously. Residents are given opportunities to raise any concerns during house meetings and during key work meetings. The Manager confirmed within the AQAA that there has been one safeguarding adult investigation within the last twelve months. The issue was reported to the local safeguarding team and to the CSCI at the time. Staff have received training in safeguarding adults from abuse and the service has policies available for staff to follow in the event that they suspect or witness abuse. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: During the inspection we checked the financial records of three residents. The records were well completed and there were receipts kept for transaction undertaken. The balances of residents monies kept in the home are checked three times per day at each shift handover to ensure that the records are fully completed and that the balances are correct. 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 home is suitable for the needs of the current residents and provides a homely, clean and accessible environment in which to live in. Evidence: The home is well located, close to local shops and accessible to public transport. The home accommodates six residents, and is split into two flats. Each resident has their own bedroom and the manager confirmed within the AQAA that each person is supported to choose furniture that is both comfortable and meets fire standards. The home is accessible to residents who use a wheelchair. There has been ongoing problems with damp in the homes shower rooms. The home is continuing to address these problems and hope to resolve these as soon as possible. Laundry facilities have been moved from the kitchen areas into internal corridors in the home. This is a better location for the laundry facilities so that the risk of cross infection is minimised. The home was observed to be clean during the inspection. The manager confirmed that there is a comprehensive cleaning schedule for cleaning all areas of the service. Residents are encouraged to participate in cleaning their accommodation as much as they are able to. The home has a policy for controlling the Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: spread of infection. Residents who commented on the service told us that the home is always fresh and clean. 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. Staff work well together and receive appropriate training to enable them to understand the needs of the residents living at the home. The staffing levels should be reviewed to ensure residents receive the support they need. Evidence: When we arrived at the home there were three support workers on duty. Two support workers were allocated to support residents at Florey Lodge and one support worker was allocated to support residents at Barnard Lodge. The Manager later came on shift at 13:00. During the inspection, we checked the staff rotas and found that these were clear and demonstrated who was on duty and the length of the shift. Staffing levels at the home have increased to provide additional support between the hours of 08:00 and 12:00. This means that there are four people on duty during the morning shift. Current residents living at the home have high care needs, with one resident requiring one to one support for most of the day. Staff were observed to be very busy throughout the day and evening shift. There have also been a number of incidents where residents have been displaying behaviour which challenges the service. It is recommended that current staffing levels are reviewed to take into consideration this challenging behaviour and the increase in residents needs and to ensure that there are sufficient staff on duty to support residents both at home and out in the Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: community. We observed staff interacting with residents during the inspection, and found that these interactions were positive and respectful. Residents were offered choice and were sensitively supported. Residents commented that staff always treat them well and always listen and act on what they say. Staff commented positively on the support given to them and commented that the team worked well together. The team currently experience a low turnover of staff, with only one member of staff leaving employment within the last twelve months. This provides residents with good continuity of care. The recruitment of new staff and the completion of the necessary pre-employment checks are carried out by the Westminster Societys Human Resources department. The Manager confirmed within the AQAA that all new staff have a Criminal Records Bureau check completed. The Manager also told us that residents are involved in the interviewing and appraisal of new staff. Checking the AQAA provided the evidence that 53 of the staff team have obtained the National Vocational Qualification in care at level 2. A further 12 of the staff team are working towards this qualification. Staff commented that Westminster Society provide them with good training opportunities. The Manager keeps a training matrix of training undertaken by staff. This was checked and we saw that staff were up-to-date in their training in safe working practises and have been receiving training which is relevant to help staff understand and meet the needs of the residents they support. The Manager confirmed that all staff undergo the Learning Disability Award Framework induction training. 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 managed by a qualified, experienced and competent person, who has a good understanding of the residents needs and the aims and objectives of the service. Evidence: The home has a Registered Manager in post, who has a clear understanding of the needs of the residents living at the home and works hard to maintain standards. He is a very experienced manager and holds a Social Work qualification and is currently completing the NVQ level 4 qualification. The manager also attends periodic training to update skills and knowledge. Since the last inspection, the home has successfully appointed a new Assistant Team Manager who has been able to support the manager in some of the management tasks. The Manager told us within the AQAA that the service is supported by an efficient finance team and senior management who enable the manager to effectively plan and manage the budget for the house. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: During the inspection, we observed the manager discussing the agenda for the next residents meeting with one of the residents, who was very keen to participate. Minutes of the last meeting and the agenda for the next meeting was viewed during the inspection. The minutes were in pictorial format making the information accessible to the residents who live at the home. There is a strong focus on seeking the views of residents and facilitating choice. We checked other quality assurance documentation also and found that residents were supported to participate in a survey to ascertain their thoughts on their housing preferences. The manager told us that staff are due to attend training in order for them to to repeat this survey this year. During the inspection, we checked the reports undertaken on behalf of the registered provider and found that these were not being undertaken on a monthly basis as per the regulations. Steps must be taken to make sure that these visits take place on a monthly basis. The reports from these visits must be forwarded to the home without delay so that any required action identified as part of the visit can be taken quickly. During the inspection, the manager told us that senior managers at the Westminster Society have very recently undertaken the annual audit of the service. At the time of the inspection, the home was waiting on their report. We checked the health and safety documentation during the inspection and also within the AQAA. We also viewed communal areas of the home to check for any health and safety risks. There have been a low level of accidents in the home, but a high level of incidents where residents have displayed challenging behaviour. Full records are maintained of these incidents, which are reported to the relevant Care Management teams and Challenging Needs Nurse for ongoing discussions and review of the support plans in place. We did not identify any urgent health and safety issues during this visit. We checked the staff training matrix and found that staff are up-to-date in their core training. 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 Residents support plans must be kept under review and updated where there are changes to residents needs. This is so that the plan of care supports the residents current needs. 12/01/2009 2 39 26 Action must be taken to make sure that visits on behalf of the Registered Provider is undertaken on a monthly basis. The reports from these visits must be forwarded promptly to the home. This is so that any necessary action identified during the visits can be taken without delay. 05/01/2009 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 Care Homes for Adults (18-65 years) Page 27 of 29 1 2 6 33 Consideration should be given to making the information within the support plans accessible to the residents. Current staffing levels should be reviewed to take into consideration the increase in residents needs and to ensure that there are sufficient staff on duty to support residents both at home and out in the community. 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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!