Inspection on 18/02/09 for Hollyacre Bungalow

This inspection was carried out on 18th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hollyacre Bungalow 29/01/09

Hollyacre Bungalow 30/01/07

Hollyacre Bungalow 23/01/06

Hollyacre Bungalow 25/07/05

Hollyacre Bungalow 07/12/04

Hollyacre Bungalow 27/04/04

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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: Hollyacre Bungalow Front Street Sacriston Durham DH7 6AF     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: Kathy Bell     Date: 1 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Hollyacre Bungalow Front Street Sacriston Durham DH7 6AF 01913712020 P/F Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Moorlands Holdings (N.E.) Ltd Name of registered manager (if applicable) Miss Sharon Walker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Hollyacre Bungalow is a care home registered to provide care and accommodation for 10 younger adults with learning disabilities. The home does not provide nursing care, but can look after up to 5 residents who have a physical disability as well as a learning disability. The home is located in the village of Sacriston, 3 miles north of Durham City. It is operated by a private company, Moorland Holdings NE Ltd. The accommodation is on 2 floors in a large bungalow converted for use as a care home. There is some outside amenity and parking space, and the home has pleasant views across the local countryside. The home charges from 421.50-735 Pounds a week. This information was provided to us in February 2009. 10 Over 65 0 care home 10 Care Homes for Adults (18-65 years) Page 4 of 29 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: This inspection took place during part of two days in February 2009. It was the key inspection planned for this year and we did not tell the home when we were going to visit. During a visit we met with people who lived in the home and staff, looked at records and around the building. Before the inspection we had received surveys completed by people who live in the home, helped by staff, and from a care manager and a GP. The manager had not received the self-assessment questionnaire (the AQAA) so we could not use information from this. 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 Care Homes for Adults (18-65 years) Page 6 of 29 considered that people who use the service are not being put at risk of harm. In future, if the requirement is repeated, it is likely that enforcement action will be taken. 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 has generally made sure, before admitting someone, that they had enough information about them to know if they could meet their needs. But if a specialist needs to check the facilities will be suitable, this must be done before the person is admitted. Evidence: Records showed that the home had obtained assessments by care managers before people moved into the home. They also carried out their own assessment. In one case, an occupational therapist needed to check whether the home had suitable equipment and facilities for a new person and this did not happen until a few days after he had moved in. But in this case, the home did already have the equipment that was needed. Care Homes for Adults (18-65 years) Page 10 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. Each person has a care plan to explain the help they need. Although these did not always include enough detail about what staff had to do, staff showed that they had a good knowledge of each persons needs. Staff help people to make choices in their daily lives. They have looked at the risks everyday activities may present to people and written down how to keep them safe. But they have not included a specific risk assessment for helping people get in the bath. Evidence: Each person has a care plan which explains the areas staff need to help them in, for example if they need help with their personal care. The care plans also give a picture of each person, their abilities and their likes and dislikes. The home has recently started using a new way of recording these care plans. The new care plans did not always include enough detail. For example,a care plan would say someone needed help with dressing. But staff need to know how much the person can do for themselves so they are give enough help but do not take away someones independence. We Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: found examples of when they had not been kept up-to-date. Advice from a dietician had changed but the change had not been recorded in the persons care plan. But when we talked to staff we found that they had a very good, detailed picture in their heads of what they needed to do for each person and what that person liked and disliked. They also explained how the ways they pass on information about any changes work well. Because most of the staff have worked there for some time and know the people who live in the home very well, the lack of some detail in the care plans does not seem to have affected the care people receive. But the manager must make sure that all the information available in the home is in the care plans and kept up-to-date, in case at any time someone other than the usual stuff has to provide the care. This also makes sure that people have the same understanding of each persons needs and can work consistently. Many of the people who live in this home have difficulty in speaking. Staff explained how they listen to peoples behaviour to understand their wishes, and are familiar with individuals facial expressions which tell them whether they like something or not. An example is, if somebody has fallen asleep in their chair in the evening, this may mean they would like to go to bed. Staff take them to their room and make them comfortable in bed, perhaps putting on music for them. But if it is very early, staff do keep checking in case they wake up again and would prefer to be back in the lounge. Staff also explained how they try and give people enough information about possible new activities to help them decide. They get pictures and other information to help with this. The care plans did include information about peoples likes and dislikes. This was the information which staff had built up over time, when people had shown what they liked or disliked. Staff had recorded when they had considered if taking part in an activity could cause a risk to someone. These record showed they had thought about the benefits to someone of doing an activity, like cooking, and the safeguards which needed to be put in place to make it as safe as possible. But they had not written down a risk assessment which showed exactly how they needed to help somebody with having a bath.These moving and handling risk assessments are required by law, so that staff know what equipment to use and how to use it, to protect them and people who live in the home, from injury. Care Homes for Adults (18-65 years) Page 12 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. Staff help people take part in a range of leisure activities. They can maintain social relationships. The home provides a satisfactory diet and meets individual dietary needs. Evidence: About half of the people who live in the home go out to day placements arranged by their care managers. Daily records showed that people are helped to take part in a range of activities outside the home. The home has a special van so it is easier to take people out. They go swimming, to the Alan Shearer Centre where some benefit from the sensory room, to a leisure centre and for trips out. The staff explained that they can take some people out during the week and leave one member of staff at home with anyone who did not want to go out. At weekends they said that generally one day every other weekend four staff were on duty. This meant that two people could take Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: half the group out while the other half goes out the next time. They described how particularly in summer, they would go out for the whole day for an outing and have a meal out. In the home people can watch TV or DVDs, have beauty or baking sessions or take part in arts and crafts activities. People who live in the home can have personal relationships and staff help one person maintain social relationships by taking her to a club every week. Some people who live in the home have difficulties with eating or their diet. Staff weigh people regularly so they can tell if they are losing or gaining weight. We saw the records of when the home had asked advice from specialists like the dietician or the speech and language therapy team. They were keeping the records these specialists had told them to keep. Staff showed they were aware of the special diet or extra supervision people needed. The menu showed a satisfactory diet and staff respect individual preferences, like a vegetarian diet. Care Homes for Adults (18-65 years) Page 14 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. The home meets the personal and health care needs of people with complex needs. Medication is handled safely. Evidence: Care plans and records showed the home provides care for a number of people with complex needs. We saw how staff seek advice from specialists like physiotherapists, occupational therapists and other people who advise on aids and adaptations. Staff had detailed guidelines on how to position somebody who needed support in bed . During the inspection and in surveys staff confirmed that the ways they passed on information about people and were kept up-to-date generally worked well. When we asked in surveys, do the care staff have the right skills and experience to support individuals social and health care needs?, one care manager said always and the other said usually. One care manager said that the home does well at managing very challenging behaviour, liaising with other professionals when their input is required and has an excellent relationship with the local GP practice. The GP said that the home, looks after their patients as if they were their own family. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Medication is stored safely and staff keep records of when medication comes into the home, when it is given out and if it has to be disposed of. They keep the required records of any Controlled Drugs, in a book designed for this, which helps them do it correctly. All the staff have had training in handling medicines safely and last year some did refresher training. Care Homes for Adults (18-65 years) Page 16 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. There is a system to respond to any complaints but the home should do more to make people aware of it. People are protected from harm as far as possible. Evidence: The home has a written procedure about how to complain. This would be better if it was written in simple English, although it does include the information it needs to. There is not a version with pictures, which some people might find easier to understand but the manager said this would not be helpful to the people currently in the home. The complaints procedure has not been given to relatives. No formal complaints have been recorded. In the surveys, the four people who responded said they knew who to talk to if they were not happy about something but only two said they knew how to complain. The home has a procedure to tell staff what to do if they suspect someone may have been abused. This was incorrect in one place and did not include the current contact details for the local authority, so people would know who to contact. But the manager showed she knew what to do and the staff all went on training in safeguarding last year. Staff keep proper records of the money they look after for people who live in the home including receipts. In December 2007, Durham County Council looked at these records and said it was a satisfactory, clear system. The home carries out checks before someone is employed so they can be as sure as possible that they are suitable to work in a care home. Care Homes for Adults (18-65 years) Page 17 of 29 Care Homes for Adults (18-65 years) Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a domestic style of accommodation, with enough space and adaptations to meet peoples needs, except that a shower is required. Access to the home should be improved for safety and to give a better impression. Evidence: All the bedrooms are single and all but two are on the ground floor. (Although the home is called the bungalow, there are two bedrooms, a bathroom and a staff sleep in room on the first floor) They are bright and decorated in a domestic style, with peoples individual possessions in them. There is a bathroom with an adapted bath where a hoist can be used. There is also a bathroom with a corner bath which is unsuitable for most people who live in the home. An occupational therapist has assessed that one person living in the home cannot use the bath safely and has recommended that the home install a shower. This would also be of use to other people who live in the home. The manager said that the owner is looking into this: action should be taken as a matter of urgency. There is a lounge with plenty of room for people with special chairs and wheelchairs. One area of the corridor inside the home is noticeably uneven but staff reported this has never caused problems. Outside, there is a small garden area but this looks rather neglected with overgrown Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: grass. The road leading to the bungalow is in a poor state of repair but the area in front of the home, where people walk from the bus into the home is much better. Care Homes for Adults (18-65 years) Page 20 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. Enough trained and qualified staff are on duty to meet peoples needs. But the manager must make sure night staffing arrangements are adequate to meet peoples needs safely. People are checked before they start work to make sure they are suitable to work in a care home. Evidence: Eight of the nine care staff have already achieved the National Vocational Qualification in care at level 2. This is the recognised qualification for care workers and the National Minimum Standards recommend that at least half the staff in a care home should have this qualification. Hollyacre bungalow has done much better than this and two of the staff already have this qualification at level 3. Staff seemed to have relaxed, friendly relationships with people who live in the home. The rota showed and staff confirmed that there are generally three staff on duty during the day and evenings. Sometimes the manager said she works extra hours to keep the numbers up to this but she has not always shown this on the rota. Given that half of the people go to day placements during the week and the manager confirmed that it is possible for two staff to go out and one person to stay in the home safely with a few people, the staffing arrangements seem satisfactory. In the surveys, all five staff said that there were always enough staff. At weekends, on some days there are four Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: people on duty which makes activities outside the home possible. At night there is one person awake on duty and one sleeping in. The manager said that one person needs to be turned through the night, to avoid pressure sores. She must ask an occupational therapist to assess whether this can be done safely by one person, to ensure that one person on duty is enough. A domestic worker is also employed for 16 hours a week which means that staff can devote their time to care, although they do prepare meals as well. In the staff surveys, all five staff said they were given training which was relevant, help them understand individual needs and kept them up-to-date. Staff have received training in essential areas such as first aid, food hygiene, moving and handling, the safe handling of medicines and safeguarding adults. We looked at the records of the most recent person who started work in the home. These showed that Criminal Records Bureau/Protection of Vulnerable Adults checks had been obtained to make sure there was nothing in the persons background which meant they should not work in a care home. The home had only been able to obtain one reference (they should always obtained two) but the manager could explain why this had happened. Care Homes for Adults (18-65 years) Page 22 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 well managed and a safe place to live and work. The owner has developed the systems to check on the quality of care but should improve the way he finds out what people think of the home. This information should form a development plan which will help the service continue to improve. Evidence: The manager is experienced and has worked in the home since 1997. She has already achieved the management qualification recommended for care home managers but should still work towards the NVQ 4 in care. The owner of the home has made some recent improvements in the way he checks it is running well. The company administrator checks financial records every month. The property manager is starting to visit monthly to check the premises, inside and out, fire precautions and records, and cleanliness. The owner has been carrying out the monthly visits to the home which the law requires him to do. The manager has tried to find out what people who use the home, and those involved with them, think about the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: service. She sent out surveys early last year and received four back from relatives. These all praised the care, although some said the access to the building and the outside of it needed attention. The manager has recently asked care managers and occupational therapists to fill in surveys. The comments which have been received have not been developed into an improvement plan. An improvement plan would help the owner identify what action should be taken and review success in improving the quality of the care. There are arrangements for checking the safety of the services in the home, the gas and electricity and the hot water. Last year the Fire Officer visited and as well as noticing various faults, told the home to carry out a fire risk assessment which is required by law. This assessment was done thoroughly and identified a number of improvements needed. These have now been done. We looked at the records of fire safety checks and these showed that they were being carried out regularly and staff were noticing when things were wrong and taking action. All staff are taking part in fire drills. Care Homes for Adults (18-65 years) Page 24 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 25 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 2 14 The manager must make sure that all areas of need have been assessed before someone is admitted. This is so that she can be sure the home will be able to meet the needs of the new person. 08/05/2009 2 6 15 Care plans must include all 08/05/2009 the detail staff need to know to meet peoples needs and wishes. They must include risk assessments for any situations where people need moving and handling. This is so that staff will always know exactly how to care for each person. Moving and handling risk assessments are essential for the safety of staff and people who live in the home and to comply with the law. 3 23 13 The safeguarding adults 08/04/2009 procedure must be amended so that it is clear and Page 26 of 29 Care Homes for Adults (18-65 years) matches the local authoritys safeguarding procedures. It must include details of who to contact in the local authority. This is so that anyone who needs to, is absolutely clear who to contact and when. 4 27 23 A shower must be provided. This is so everyone who lives in the home can be washed safely. 5 33 18 The home must ask an occupational therapist to assess whether one person can safely turn a person in bed at night. This is so the manager can be sure there are enough staff on duty at night. 08/04/2009 08/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 22 The home should do more to make sure people know how to complain, including looking at how the complaints information is presented , and providing any relatives who are involved with the care of people who live in the home, with information about how to complain Access to the home should be improved to increase safety and the impression the home creates. The garden area should be tidied. The manager should achieve NVQ 4 in care as this is the recommended qualification for care home managers. The home should develop systems for finding out the views of people who live in the home and professionals who commission and work with the service, as well as relatives. 2 24 3 4 37 39 Care Homes for Adults (18-65 years) Page 27 of 29 An annual development plan should identify areas for improvement and action to be taken. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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