Inspection on 03/03/09 for Durham Street and Endymion Street

This inspection was carried out on 3rd March 2009.

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

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

Other inspections for this house

Durham Street and Endymion Street 13/03/08

Durham Street and Endymion Street 27/03/07

Durham Street and Endymion Street 24/10/06

Durham Street and Endymion Street 03/10/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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: Durham Street and Endymion Street 49 51 & 53 Durham Street Hull East Yorkshire HU8 8RF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: George Skinn     Date: 0 3 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 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.cqc.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: Durham Street and Endymion Street 49 51 & 53 Durham Street Hull East Yorkshire HU8 8RF 01482620214 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) : cince@avocettrust.co.uk Avocet Trust care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 7 The service at 49-53 Durham Street is managed by Avocet Trust who rent the premises from Sanctuary Housing Association. It is one of a small number of similar services that Avocet provides. Avocet Trust is a registered charity. 49-53 Durham Street is registered to provide care and accommodation for up to 5 adults with a learning disability. The home in the Holderness Road area, to the east of the city centre. 49-53 Durham Street consists of three separate living units. No. 49 is a ground floor flat for one person, with a bedroom, living room, kitchen, bathroom and rear garden. Nos. 51 and 53 have similar facilities with an additional single bedroom each and are for two adults. No. 51 is at ground floor level. No. 53 is above it, accessed by an internal staircase with own front door. The properties adjoin each other and share a large communal garden at the front. There is parking available on the street. 48 Endymion Street is a terraced property for two people that is owned and managed by Avocet trust. The house consists of a small hall, lounge, dining room, kitchen and utility room, and two bedrooms with en-suite facilities. There are a variety of shops, pubs and health facilities nearby. Public transport to Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home various parts of the city is accessible and in addition, people have access to cars arranged through their mobility benefits. Additional charges are made for the following: newspapers/magazines, hairdressing, chiropody, transport for social activities and sweets. Information on the service is made available to current people via the Statement of Purpose, Service User Guide and inspection report. 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment AQAA. Comment cards returned from people who live at the home and staff. A visit to the home carried out by one inspector. Care Homes for Adults (18-65 years) Page 6 of 28 A site visit was carried out which lasted 4 four hours. We spoke with the people who live at the home and staff. We looked at records relating to the people who live at the home, staff and the management activities of the home. During the visit care practices were observed where appropriate and time was also spent watching the general activity within the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 13th March 2008. Senior staff were available to assist throughout the day. Current weekly charges range from 1223.64 GBP to 1703.53GBP. What the care home does well: What has improved since the last inspection? What they could do better: At the present time there are three staff sleeping in on a night time and no waking staff; although they are in the building. Following conversations with staff it was apparent that one of the people who live at the home does get up during the night and wander, and if the staff member who is sleeping in does not hear him he could be vulnerable and even leave the building undetected. It is therefore recommended that the company reconsider the night time staffing arrangements and maybe have a waking night staff to ensure the safety of all the people who live at the home. Currently night staff are sleeping on a camp bed in one of the peoples lounges this does inhibit that persons freedom choice to use the lounge while the staff are using it Care Homes for Adults (18-65 years) Page 8 of 28 for sleeping in purposes; the company to review this and more appropriate arrangements provided. This has been identified at previous inspections as a requirement but has made been a recommendation in this inspection due to the fact that while this inhibits the persons freedom choice it does not put the person at any significant risk of harm. Sometimes the people who live at the home take medication which is not in the established system which the home use, for example if GP calls and prescribes antibiotics. When this happens there should be two (2) staff signatures on the records used. This will ensure that the right information has been copied down and the person is not but at risk. The home is currently without a manager and a deputy manager from another service is over seeing it. This is fine for the time being and until a new manager is in post but the company should recruit and register a new manager as soon as is practicable. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 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 10 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. People have their needs assessed before they move into the home. Evidence: We looked at two (2) files which belonged to the people who live at the home. We saw that these all contained an assessment of the persons needs done by both the home and the placing authority. We saw that there was a copy of the Local Authority Care plan that had been developed from the Local Authority Community Care Assessment and we saw an Individual Programme Plan (IPP) that had been developed by the home. 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. People are supported through a care planning and risk assessment process to live the lives that they choose. Evidence: We looked at two (2) files which belonged to the people who live at the home. We saw that the files included a plan of care and an IPP. We saw that information was held about the person that included a pen picture, their personal history, a weekly activity plan, an assessment of need and support plans. We saw that the support plans covered a variety of areas that included self help skills, leisure, relationships, community living and choices. We saw copies of annual care reviews held with the Local Authority. At the last inspection it was noted that not all of the files had been reviewed regularly, this has been addressed and we saw that all the files we looked at had been reviewed at least monthly (6) six monthly or sooner if the needs of the person changed. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: We saw that peoples files included details of the choices that they like to make in their everyday lives; this included how they like to take their bath and the leisure activities they enjoy. We saw that peoples daily diary notes indicated that they could choose when to go out and when to spend time in their room alone. We saw that people were given choices including what to eat and drink. When we spoke to staff they told us that people are asked about activities and staff work at the individuals own pace allowing them time to make decisions. The staff told us that they make sure people are aware of the choices they can make. We saw that peoples files contained copies of risk assessments that identified the risks to the individual and others in their daily lives for example the risk of falling when getting onto a bus. At the last inspection it was noted that the risk assessments covered a lot of areas of daily living but did not always have the dates when they were started or dates showing when they had been reviewed; or if they were still suitable to the individuals needs. This has now been addressed and we saw that the risk assessments had been update. We spoke with the member of staff who was responsible for this, she said she had a regular routine and was aware of when risk assessment needed up dating. She also told us that she up dates the risk assessments if the persons needs change. 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. People are supported to undertake activities that are on the whole their choice and are supported to maintain relationships and have their dietary needs met. Evidence: We saw that peoples files included a weekly activity sheet showing a variety of activities within their own home or the community were planned. We saw that peoples diary notes indicated that they had been out and about to local shops and cafes. While we were at the home we saw that one person was going out to the shops and to the GPs to sort out some medication issues. He told us that he goes regularly to the local charity shops and buys CDs, he told us that he budgets for these and saves up his money if there is anything he wants. He told us he enjoyed this but did not like going to the cinema, as this was boring. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: We saw that peoples files included information about important people who are part of the persons life. Staff told us they had good knowledge of the important relationships in peoples lives including both relatives and friends. One persons diary notes recorded information about how they are supported to maintain contact with a friend and visit them. We saw that people are able to choose where they wanted to be within the home, be it alone or with other people. Every one who visited the home knocked on the door and waited to be asked to come in by the people who live at the home. We saw that staff and the people who live in the home interact positively with each other any conversations were calm and relaxed. We saw that staff were very patient with the people who live at the home even though some conversation were repetitive. At no time did we hear anyone belittling anyone or being disrespectful. We saw that there is a (4) four week healthy eating menu in place within the home. One person who lives at the home told us that he enjoys the food and always gets plenty of choice, he told us that he likes fruit but was not keen on salad but he ate it because it was good for him. He told us he liked going out for lunch best. The staff told us that some people were on special diets due to swallowing problems and they liaise closely with dieticians about this, we saw this had been recorded in peoples files. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to meet their personal care health and medication needs. One person could be put at risk due to the night staffing arrangements. Evidence: We saw that people have individual Health files, these contain details of any health needs of the person, how these are to be met, what is good practice and what is poor practice when dealing with the person. We saw that the files contain letters and documents from other health and social care professionals and details of any appointments including the outcomes. At the last inspection it was noted that the health plans had not been consistently completed and they lacked essential information about dates of reviews. We saw that this had been addressed and the files we saw contained detailed information and dates when these had been reviewed, again the member of staff responsible told us she had a routine and was aware of when the files needed updating. She told us that she updated the health plans if there were any changes to the persons needs. We saw that the home had involved as much as possible and when relevant any other health care Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: professionals in the health plans. We saw that people are supported with aids to living there is a ramp in place to enable safe access to the property and one person has a wheelchair and walking aids. We saw that medication continues to be stored in a locked cupboard and up to date records are kept of all medication administration and disposed of. We saw that a list of staff signatures is kept to easily identify the person responsible for the administration of medication at any given time. Avocet, as a company, ensure that all staff who administer medication have attended accredited training. A competency checklist is also in place to make sure that following training staff remain competent in the administration and handling of medicines. Stock sheets continue to be kept this ensures there are adequate quantities of medicines in the home. Sometimes medication is provided which is not in the monitored dosage system used by the home, which has been set up and supplied by the pharmacist, for example antibiotics. When this happens the staff have to write the information from the container on to the sheet they use. Two (2) staff signatures should be on the sheet to ensure the correct information has been copied; this will make sure no one is put at risk of receiving the wrong dosage of the mediation. Staff told us that the home are changing supplying pharmacists in the near future. Staff did comment of the vulnerability of one of the people who live at the home during the night and how inadequate the safety arrangements were. The person has a tendency to get up during the night and could leave the building. The fact that there are staff sleeping in and not waking could mean that he is not heard and staff would not respond to keep him safe. It is therefore recommended that his needs are looked at and safer arrangement are put in place to keep him safe at night. 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. People are supported by policies and procedures to be protected from harm and to raise concerns. Evidence: We saw there continues to be a complaints policy held within the home. No compliants have been received by the CSCI since the last inspection and the home have not been the subject of any investigations undertaken by the Local Authority Safeguarding Adults team. The AQAA returned by the home indicated that no complaints had been received by the home since the last inspection. We saw that staff continue to have access to a copy of the Local Authority policy The Protection of Vulnerable Adults (POVA). Avocet ensure that all staff have received training about safeguarding adults and this is refreshed when needed. Staff told us they understood about protecting people and they have a good knowledge of POVA and the actions that they would take should they suspect an incident of harm had occurred. People continue to be supported by the staff to manage their personal finances. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Records and receipt of purchases continue to be kept. 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. People live in a clean warm and comfortable home, people freedom of movement is severely restricted due to the sleeping arrangements. Evidence: People have moved back to Durham street but unfortunately there are signs of damp damage, this is being attributed to secondary damage due to the flood damage sustained last year. It is likely that the people will have to move out again in the near future so repair work can be undertaken. Notwithstanding this the home was warm and welcoming when we visited. At a previous visit it was noted that staff that provided sleep-in support for the people living the home did this by sleeping on a camp bed in the lounge. The staff told us that it was agreed that a new bed would be purchased for sleep-in staff to use this has not been done. The current situation remains unsatisfactory as staff sleeping in the persons lounge seriously inhibits the persons freedom of choice to use the lounge. Staff should be provided with adequate sleep-in arrangements that do not intrude on the communal areas of people living in the home. Endymion Street is an older property that has been refurbished and updated. It Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: provides clean and comfortable accommodation to the people who live there, and people have personalised their rooms. The staff told us that they are continuing to help people to furnish their home with smaller items to make it their own. We saw that records continue to be in place for the checking of fire equipment and alarms, these were up to date. The home continues to be assessed and reviewed by the company health and safety trainer; risk assessments are updated and put in place when required. Care Homes for Adults (18-65 years) Page 21 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. People living in the home are supported by a staff team that are trained and supervised in their roles. People are protected by the companies recruitment policy. Evidence: Staff recruitment files are not available at the home as they are held centrally within the organisation; these have been looked at on previous inspections and no issues or concerns were found. Staff told us that when they had been recruited they only started working if they had a satisfactory Criminal records Bureau (CRB) check and all references had been taken. Sometimes staff have to start work before the CRB check is complete this is called working with a 1st POVA check; Avocet ensure these people are closely supervised at all times and records are used to demonstrate this. No one is working at the home currently under a 1st POVA. The company now employ a central coordinator for all of the staff training and they have ensured that all induction training now meets the guidelines and requirements of all of the recognised training bodies. At the last inspection it was noted that the staff were not receiving the required amount of supervision per year; this has now been Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: addressed and we saw that staff have received supervision at least once every 2 months, sometimes sooner if needed. Care Homes for Adults (18-65 years) Page 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well run home but the lack of a full time manager does compromise the quality of the service. Evidence: The home currently has no registered manager, a deputy manager from another service is overseeing the home. This management arrangement is satisfactory for the time being, as an interim measure, but will not be sufficient in the long term and is not a satisfactory substitute for a full time manager on site. The home have now fully implemented the company quality assurance system. This now includes consultation with other health care professionals who have an interest in the care of the people who live at the home like doctors and nurses. At the last inspection it was noted that visit which must be undertaken by senior managers to the home by virtue of regulation 26 were not being carried out on a regular basis. The company have recently introduced a new format for these visit and Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: this now fully identifies areas for improvement and sets time scales for completion. While we were at the home staff meetings were being arranged and staff told us that these occur on a regular basis . The home continues to have a Health and Safety file that includes a copy of the Health and Safety policy and risk assessment. There are additional risk assessments relating to the use of the Barbecue, the risk of falls, hot water fire and cleaning materials. An Electrical wiring and gas safety certificates are available at the home to show that these areas are safe and do not pose a risk to the people living and working in the home. Care Homes for Adults (18-65 years) Page 25 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 26 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 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 18 The home should look at the needs of the people who live at the home and change or improve the staffing cover on a night. Two (2) staff signatures should always be recorded when transcribing medication from an original container onto the MAR sheets. The company should make it a priority to employ a full time manager. This will ensure consistency in the managing of the home. 2 20 3 37 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 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!