Inspection on 04/03/09 for Cornfield House

This inspection was carried out on 4th March 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

Cornfield House 28/04/08

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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: Cornfield House 3 Cornfield Road Seaford East Sussex BN25 1SW     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: Alexis Reilly     Date: 0 4 0 3 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 27 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 27 Information about the care home Name of care home: Address: Cornfield House 3 Cornfield Road Seaford East Sussex BN25 1SW 01323892973 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) : cornfieldhouse@talktalk.net Jiva Healthcare Ltd care home 19 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 19 The maximum number of service users to be accommodated is nineteen (19). The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Cornfield House is a registered to provide accommodation for up to 19 adults with or recovering from mental health issues. The home caters for people with low dependency needs. The registered manager Mrs Jadwiga Carney has day-to-day responsibility of the home. The premise is a large detached house over three floors. There is 13 single and 3 double bedrooms on the ground, first and second floor. 3 bedrooms have ensuite facilities all others have a wash hand basin. There are 2 bathrooms (not assisted) and a shower room. The home has a large lounge, dining room and a good-sized conservatory. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home To the rear of the home is a large well maintained garden with lawn, established shrubs, fishpond and seating area. The home is situated in a residential area of Seaford. There is on street parking in the front of the home. The home is within walking distance of the town centre, amenities and railway station. The staff compliment consists of a manager, deputy, support staff and maintenance person. Management and staff work a rota that includes two staff on duty during the day sometimes rising to three and one waking member of staff on duty at night. Current fees range from £365.00 to £521.00 per week. Additional charges may be made for hairdressing and chiropody. The current inspection report is available from the home or can be viewed and downloaded from www.csci.org.uk. Care Homes for Adults (18-65 years) Page 5 of 27 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 inspection began at 10.15am and finished at 2.15pm. Time was spent individually with one service user, other residents were seen in the house. The inspector case tracked three residents, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. The care plans and risk assessments of two further service users where also viewed to allow the inspector to make a judgement on the robustness of the care plans and risk assessment documentation. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. Staff recruitment files and staff induction training sheets were also examined. Information was taken from the AQAA which was comprehensively filled in and returned by the due date. Care Homes for Adults (18-65 years) Page 6 of 27 A partial environmental tour was carried out which included all the communal areas, dining area, lounge, conservatory, games room, downstairs office, kitchen, and two service users bedrooms. The inspector spent time with the Registered Manager, and deputy manager and interviewed one care team member. Comments were received from the professionals in the community who have dealings with the home, their views of the service are included in the report. What the care home does well: What has improved since the last inspection? What they could do better: The Registered Manager must ensure that all incidents of notice are reported to the relevant body in a timely manner. The Registered Manager should ensure that the historical information kept in service users care plans is removed and stored securely, and that all risks including historical ones are included in, or made mention to in the Care Homes for Adults (18-65 years) Page 8 of 27 current risk assessments. The Registered Manager must ensure continued work is done to encouraging residents to become involved in activities on offer both within the home and the community such as education, and where appropriate, employment opportunities. Service users agreement to involvement with household chores should be recorded individually. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 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 27 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 service has had no new admissions since the last inspection. Evidence was supporting to suggest that the Registered Manager has in the past always obtained assessment documents such as mental health assessments from the community teams and also CPA documentation. The pre assessment documentation is in the process of being up dated to include equality and diversity, nationality, sexuality and partnerships. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with one of them individually, seeing other service users during the inspection in the home. A further two care plans and risk assessments were viewed making a total of five inspected. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the community mental health team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. The inspector spoke Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: with the Registered Manager the Deputy Manager and one staff member. The home has had no new admissions since the last inspection. However the Registered Manager has started work on including areas such as equality and diversity, nationality, sexuality and partnerships in the assessment documentation. The home works closely with professionals both prior to admission and afterwards. Also available to view was collated information with regard to other service users in the home, and their referring documents. This highlighted that the Registered Manager obtains comprehensive background information and up to date CPA and mental health assessments prior to offering a place in the service. Care Homes for Adults (18-65 years) Page 12 of 27 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 have care plans in place which are person centred and are clear documents to work from. The Registered Manager must ensure that historical issues are included in risk assessments for residents; this is specifically in relation to potential forensic issues. Residents are able to make their own choices and decisions, and are treated as individuals. Contact with advocacy services is promoted. Evidence: As part of the inspection the inspector case tracked three residents in the home, spending time individually with one service user and seeing other service users in company in the home. A further two care plans and risk assessment documents were also viewed, making five in total. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the community mental health team, this helped the inspector to ascertain if the needs identified in the assessment are used by the Registered Manager Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: as the basis for a comprehensive care plan. Other documents examined were copies of notifications, and accidents and appointments. Time was spent with the Registered Manager, the Deputy Manager and a further staff member. The Registered Manager has spent a significant amount of time ensuring that care plans have been updated and risk assessments are in place. Three care plans were examined and risk assessments were in place, however two of these risk assessments did not include historical forensic information, this was discussed with the Registered Manager at the time of the inspection and they ensured that the risk assessments identified were updated prior to the end of the inspection. Staff have a good understanding of residents needs and symptoms to be aware of in relation to the deterioration of their mental health. Two further care plans and risk assessments were seen which highlight comprehensive risk assessments. All risk assessments seen were reviewed. Contact with advocacy services is promoted Care Homes for Adults (18-65 years) Page 14 of 27 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 do benefit from regular and planned activities, although more could be done to promote activities inside and outside the home. Residents benefit from freedoms and flexible routines, and generally enjoy the food. Residents are consulted and listened to. However continued work needs to be done on encouraging residents to become involved in activities on offer both within the home and the community such as educational, and where appropriate, employment opportunities. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with them. The care plan and risk assessments documents for two further residents were also examined. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: reviews from the community mental health team. Other documents examined were copies of notifications, and accidents and appointments, the record of complaints and the complaints procedure. The inspector spent time with the Registered Manager and Deputy Manager and one other staff member, comments from service users and staff are included in the report. A new pool table has been brought for residents, and a new football table has also been purchased. Trips to the theatre are organised three times a year, a few residents have extra hours arranged at the local resource centre, and the Registered Manager and Registered Provider are exploring the issue of purchasing a mini bus to take residents out. A staff member comes in weekly to take residents down to the town shopping and for coffee. Cornfield House encourages service users to continue with outside interests and activities including hobbies. Staff encourage service users to use the local library, cinema, pubs and day centres. In house activities include prize bingo, quizzes, cards and a selection of board games. Cornfield House has a summer garden party and a Christmas party to which service users relatives are invited. There is an expectation service users will tidy their own rooms and carry out household tasks in the home; this is with their agreement and with the help of staff. Residents express their interest and ideas for the menu at the residents meetings, and staff have a good knowledge of residents likes and dislikes. Personal relationships and family relationships are encouraged if these are helpful and appropriate. Menus in the home are varied. Care Homes for Adults (18-65 years) Page 16 of 27 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 benefit from a comprehensive plan of care and input from the community mental health team. The Registered Manager has a good relationship with the general practice and residents health care needs are reviewed and referrals made were appropriate. The procedure for administering medication was found to be in good order. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time individually with one of these, other residents were seen in the home. The inspector examined a further two care plans and risk assessment documentation. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the community mental health team. Other documents examined were copies of notifications, and accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. The inspector examined a sample of MAR sheets and can confirm there is a sample list of staff signatures to reference with the MAR sheets. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: Medication records were found to be in good order, and these sheets had a photograph of each resident on them. The Registered Manager has a productive relationship with the CMHT. No resident self medicates in the service currently. Staff use a monitored dosage system of medication administration in the home and only staff trainined in administring medication do so, staff receive specific training in the use of the system from a pharmacist 3 times a year. All staff are made aware of the range of medicines used in the home as part of their induction and foundation training programme. The service supports individuals with their personal hygiene and each service user is allocated a key-worker within the home. The role of the key worker is to co-ordinate maximum levels of care and support, ensuring that the different agencies and the individuals involved are working with the service user in a consistent, structured and equal way Care Homes for Adults (18-65 years) Page 18 of 27 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 service records complaints and deals with these effectively, the Registered Manager has notified the CSCI and social services of significant incidents in the home. Residents are protected by the homes recruitment procedures. Evidence: As part of the inspection the inspector examined copies of notifications, and accidents and the record of complaints and the complaints procedure. The inspector spent time with the Registered Manager and Deputy Manager and one other staff member. The inspector gained views about the services from the service users and professionals in the community their views are included in the report. The Registered Manager has notified the CSCI of significant incidents which have occurred in the home, and has produced evidence to show these had also been forwarded to the relevant member of the CMHT. In discussion with the Registered Manager it was evident that a current incident had been dealt with appropriately, and additional support had been sought and was being provided from the CMHT until this particular issues is resolved. Care Homes for Adults (18-65 years) Page 19 of 27 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 service has undergone a completed refurbishments ensuring that residents now live in a bright and clean home with an accessible garden. Evidence: As part of the inspection the inspector carried out a partial environmental tour of the home which included the dining area, lounge, conservatory, office, kitchen, and two service user bedrooms. The Registered Provider has ensured that all bedrooms have been refurbished, the entire home has been redecorated, new carpets and a new boiler has been installed and the outside of the house has been painted. Service users bedrooms were well decorated and personalised. The gardens have also improved since the last inspection. The home was clean and well maintained on the day of the inspection. Care Homes for Adults (18-65 years) Page 20 of 27 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 interact well with residents and have a understanding of the needs through, training and a good knowledge of the individual service users in the home. Service users are protected by the homes recruitment policies and procedures. Evidence: As part of the inspection the inspector spent time with the Registered Manager, deputy manager and one other staff member. The inspector examined the recruitment files of staff recruited to the service since the last inspection, these were found to be in good order, also evidenced were the training records, and record of staff supervisions and appraisals. Cornfield House provides 24 hour care for service users with past and present mental health issues with a minimum of 2 staff between 8am and 8pm, 1 awake night staff between 8pm and 8am and 2 senior staff on call at all times. The service uses in house training and evidence was supporting to show that staff had recently been trained in adult protection, moving and handling, food safety and hygiene, and had completed POVA training. Staff were aware of the procedure to follow in the event of a referral under safeguarding adults. Staff now receive regular Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: supervision and annual appraisals and evidence was supporting to confirm this on the day of the inspection. Members of staff were seen on the day of the inspection interacting positively with residents in an encouraging manner. Care Homes for Adults (18-65 years) Page 22 of 27 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 Registered Manager has ensured that care plans are now person centred, and staff receive regular supervision and appraisals, this along with the improvements made to the environment of the home ensure the service user receive a good level of care. Evidence: As part of the inspection the inspector case tracked three residents in the home and spent time with them. The care plans and risk assessment of a further two residents were also seen. As part of the case tracking the inspector examined the new person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the community mental health team. Other documents examined were copies of notifications, and accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. The staff recruitment files of new staff within the service were examined and the list of training completed. The inspector spent time with the Registered Manager and the Deputy Manager and one other staff member. The inspector gained comments from service users and staff and these are Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: included in the report. The Registered Manager has completed NVQ level 4 and has started the Registered Managers Award. The Deputy manager is in the process of completing the NVQ level 4. The Registered Manager has worked hard to address the short falls identified in the last inspection, care plans have been reformatted and are now more person centred, risk assessments are in place and more is done to promote activities in the home then previously. Staff received supervision and appraisals and the home has been completely refurbished. Comments received were it is more structured since the new owner, the Registered Provider has the residents interests at heart and is all for them. The service is considering buying transport which will allow more outings for the service users, and as previously stated more emphasis is being put on activities. However the Registered Manager must ensure that meaningful activities both social, educational, and work related are promoted and that a record of those activities engaged in is recorded for individual service users. The Registered Manager should also ensure that all incident of notice are reported to the relevant bodies in a timely fashion. The information from the AQAA and evidence collected during the inspection confirmed that fire drills are up to date, and the home has the required gas and electrical certification in place. The service has also commenced work on the pre assessment documentation and is in the process of bringing this up to date to include equality and diversity, nationality, sexuality and partnerships. Care Homes for Adults (18-65 years) Page 24 of 27 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 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 The Registered Manager should ensure that the historical information contained in service users care plans is stored separately. The Registered Manager should ensure service users agreement to involvement with household chores is recorded individually. The Registered Manager should ensure continued work is done on encouraging residents to become involved in activities on offer both within the home and the community such as educational, and where appropriate, employment opportunities. The Registered Manager should ensure all incidents of notice are reported to the relevant body in a timely fashion. 2 11 3 12 4 42 Care Homes for Adults (18-65 years) Page 26 of 27 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 27 of 27 - 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!