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Inspection on 22/09/08 for Hopelea Care Home

Also see our care home review for Hopelea Care Home for more information

This inspection was carried out on 22nd September 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hopelea Care Home 11-13 Annesley Road Hucknall Nottingham NG15 7AD 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: Judith Roan Date: 2 2 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 34 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 34 Information about the care home Name of care home: Address: Hopelea Care Home 11-13 Annesley Road Hucknall Nottingham NG15 7AD 01159538385 01159538385 helensimpson440@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hucknall Hopelea Project Name of registered manager (if applicable) Mrs Helen Simpson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: Residents shall fall within registration category LD (1 named resident shall also be in category PD, and a further resident in LD/E) Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home The Hopelea project represents a partnership between Nottingham Community Housing Association who own the building and the Hopelea Project, a charitable organisation. The Hopelea Project comprises two adapted and internally joined terrace houses very close to the centre of Hucknall with its range of shops and facilities. The Hopelea Project sits discreetly in a residential area. Because of the layout of the building (stairs at all levels) it would not be suitable for people with mobility difficulties. A stair lift is in place. The home does not provide accommodation) to older service users or those whose behaviour may challenge. A statement of purpose is available on request. Care Homes for Adults (18-65 years) Page 5 of 34 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 Care Homes for Adults (18-65 years) Page 6 of 34 How we did our inspection: This is what the inspector did when they were at the care home We randomly selected two people who use the service and tracked the care they receive through review of their records, discussion with them, the care staff and observation of care practices. We also received information other people who use the service, relatives, support staff and a health care professional. The homes registered manager also completed an Annual Quality Assurance Assessment (AQAA) a document required by CSCI. The inspection was unannounced and was undertaken during the afternoon and evening and lasted 5 Hours. Care Homes for Adults (18-65 years) Page 7 of 34 People using the service said that Its a nice house they look after you and we go out I am really happy here I like all the staff they are good to me I like it because my family can come to visit People said that there is good information about the service. Relatives said The home works well and provides a good quality of life for people living at the home. We are kept informed about what is happening. The health care professional said that The staff respond professionally and are caring towards individuals. Care Homes for Adults (18-65 years) Page 8 of 34 They communicate well with families and carers. The Registered Manager stated that the current weekly fee range is between 389.65 to 430.73. What the care home does well Hopelea is a warm and friendly home. Care Homes for Adults (18-65 years) Page 9 of 34 You will be made welcome during your visit. Bedrooms viewed were clean and pleasant. They contained personal items. Support plans are developed with people who use the service. People who use the service are involved with decisions made about them, the home and in developing their support plans People using the service are supported to be as independent as possible. Support workers will assist people in meeting their personal and healthcare needs. Care Homes for Adults (18-65 years) Page 10 of 34 Your privacy will be was respected. Support workers are well trained and have good support. The service is well managed. Records are well maintained and kept secure. Page 11 of 34 Care Homes for Adults (18-65 years) Information is available in easy read documents. People using the service feel safe. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 12 of 34 Recruitment of staff is now meeting required standards. Equipment is maintained on a regular and basis. What the care home could do better The service is meeting national Minimum Standards. Care Homes for Adults (18-65 years) Page 13 of 34 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judith Roan CPC1 Capital Business Park Fulbourn Cambridge CB21 5XE 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. Care Homes for Adults (18-65 years) Page 14 of 34 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 15 of 34 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 16 of 34 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 using the service are fully assessed to ensure that the service can meet their needs. Evidence: There has been one new admission to the service since the last inspection. The Manager confirms within the AQAA that prior to any one moving into the home a pre admission assessment form is completed that states the desires and needs of prospective Service Users are known before a possible move to the home, this enables us to assure their needs can be met before admission. A clear admission criteria and procedure offers potential Service Users the opportunity to visit the home, meet the other Service Users and staff prior to admission. All information during these visits is recorded and held on file for reference. Visit include overnight stays. All potential Service Users have an Extended Community Care Assessment from Social Services prior to admission. This is archived in Service Users file and was evident at the inspection Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: All people living at the service have their needs reassessed as part of the ongoing review process. Additional needs are highlighted and appropriate action is taken to provide the support. Information about the service is provided in an easy read format. There is a clear statement of purpose & service user guide that people using the services have access to. Files contained all the relevant documentation and contracts about the support individuals receive. Care Homes for Adults (18-65 years) Page 18 of 34 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 . Support plans are person centred and demonstrate involvement of people using the service. Evidence: There are positive outcomes for people who live at Hopelea. Support plans are in place for people who use the service and are reviewed on a regular basis to ensure that support workers are updated with changes. The manager confirmed within the AQAA that files are well organised and easy to read and contain information specific to each individual. Our Care Plans are comprehensive and follow the Holistic approach to Care Planning and describe the Service Users needs, strengths and action plans. All Care Plans and Risk Assessments are reviewed regularly at Keyworker Meetings and Annual Reviews. These are documented. All Service Users sign their Review notes and Risk Assessments to confirm they understand and agree with their content. Files seen at the inspection and in discussion with people who use the service confirm this process. Meetings are held on a regular basis to assist people with personal choices. People Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: using the service are supported to attend house meetings to ensure that they are included within the decision making process for future activities and events. These regular meetings promote continuous development. It was observed that there is good communication between support workers with confidentiality being maintained. Files are stored securely within the office. In discussion with the manager they outlined the development that they had achieved since the last inspection with the completion of a One Page Plans for Person Centred Approach and that key Information sheets have all been updated with current information and photographs. In observation of practice and discussion with support workers it was evident they are very knowledgeable about the needs of the people they support. Support workers spoken with confirmed that they had undertaken induction training that included a period of working alongside an experienced worker until they had demonstrated that they were competent and confident in meeting peoples needs. Feedback from families confirmed that they were pleased with how their family members were bring supported and that good progress was being made. Files also contained risks assessments for a range of activities that provide details for support workers and ensure that the appropriate level of support is available to ensure safety and to develop independence within activities that is related to an individuals ability. People using the service are encouraged to be as independent as possible with appropriate support. In this way people using the service are included within activities and not excluded because of any behaviour that may arise. A key worker system is in operation which people using the service value as they build a strong relationship with the person and know that they are listened too. Care Homes for Adults (18-65 years) Page 20 of 34 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 . A wide range of personal, educational and social options are available and promote individual development Evidence: Individuals have a weekly activities programme that is updated to take account of various events and personal choices. New activities are tried out to extend the choices and experiences for each person. Since moving into the service all of the individuals had become fully involved in activities within and outside of the home. During the period of observation it was noted how individuals were supported with everyday activities around the house to enable them to be included and to take on joint responsibility for their environment and their belongings. Careful planning is undertaken for all activities to ensure that people who use the service and support workers are protected and enjoy the experience. Experiences are Care Homes for Adults (18-65 years) Page 21 of 34 Evidence: good and varied. It was noted that several people have day care opportunities and are supported to experience community facilities. The AQAA confirms that people using the service are supported to undertake their own chores such as washing, ironing, hoovering, dusting, shopping and cooking. That they take pride in being able to keep their house clean and cook the evening meal once a week. Individuals can choose their own activity for leisure time, evening clubs, watching television, playing card games with staff, playing DVD games or going out for a meal or a drink or just spending a bit of me time in their own rooms. All activites are recorded in a daily record book kept at the home in addition to Day Books completed by day centre staff. These keep everyone updated on the activities individuals do when at day centres. The books also give home staff the opportunity to discuss daytime activities and take an interest in this part of their lives. Daily routines are chosen by individuals, like going to bed when they choose. Everyone has a key to their own bedroom door and to the front door. People using the service are involved with the weekly shopping at a local supermarket with fresh purchases like fruit and vegetables being bought locally by those who are able to go out without support. The menu is chosen at the weekly house meeting,and individuals take it in turn to cook on one night each week. The meetings have minutes and individuals can place items on the agenda. If someone does not like the chosen meal they are offered a different choice. Meals are served in the family style dining room. The meal was freshly cooked on the day of the inspection and healthy. Individuals are supported to make healthy choices and have a balanced diet, with opportunities to have the occasional not so healthy treat. Support workers have a good understanding of the needs for people who use the service and use the meal times to develop communication skills with each other. Meals were seen to be an important social event at the home. There is negotiation between individuals so that meal times can be arranged around social activities and needs. The standard of food prepared at the home is good. Families commented on how good the communication has been with them and that the manager and the team of support workers kept them informed and involved. All families said that there is a comfortable atmosphere always made to feel welcome at the home and we are invited to join in activities. The manager comments in within the AQAA state that they would welcome more involvement with families and friends. They would also like to Encourage more active leisure pursuits. Care Homes for Adults (18-65 years) Page 22 of 34 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 . People using the service are positively supported to access local or specialist healthcare services, with medication being safely administered. Evidence: People using the service are supported to have regular health checks and there is evidence on files that healthcare appointments are made. The AQAA confirms that people are assisted to attend appointments for all health care needs, such as, G.P. Dentist, Chiropody, Optician, Practice Nurse, Hearing aids and Hospitals. We refer to Social Workers when other professional needs are identified such as Occupational Therapist, Visual Impairment and Physiotherapists. Support plans document individual health care needs, as well as cultural, emotional and sexual needs. Personal support is provided in a discreet manner, with people using the service preferences being a top priority. Individuals spoken with confirmed that support was good and that staff had a caring and sensitive manner. People using the service have risk assessments to be as independent as possible for the self administering of their own medication. The records were found to be in good order and only trained staff administer medication. The chemist that provides a Care Homes for Adults (18-65 years) Page 23 of 34 Evidence: monitored doseage sytem for the home undertakes the training for medication administration and knowledge. The staff files provided evidence to confirm this. Observation of care practice indicates that safety is maintained. Medical profiles for people who use the service are clear to ensure that support workers have up to date information about medical conditions and prescribed medication. All incidents are recorded on file to show how the manager and support workers have reviewed practice to minimise future risks. Hopelea Care Home puts a great deal of emphasis on maximising residents independence and encourage people who use the service to be as independent as possible regarding their health needs. Care Homes for Adults (18-65 years) Page 24 of 34 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 . Practices within the service fully protect people who use the service and ensure that they are listened to. Evidence: The Registered Manager stated in the AQAA that no complaints have been received since the last inspection. A clear and easy accessible complaints procedure is in place, and available in three different formats, signs and symbols, written and on tape. People using the service are therefore able to access the procedure in a format suitable to their needs and abilities. In discussion with people who use the service they confirmed that they felt comfortable in raising a complaint if they were unhappy and would speak with the manager or other staff members. People who use the service are observed to ensure any concerns are noted and brought to the attention of the manager through meetings. Support workers undertake safeguarding training as part of their induction/ foundation training. We checked out their understanding during the inspection, which was good. Families are aware of the complaints procedures and know how to raise concerns they have with the manager. Recruitment procedures ensure that support workers working at Hopelea are security checked with files supporting that enhanced Criminal Record Bureau disclosures have Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: been undertaken. Care Homes for Adults (18-65 years) Page 26 of 34 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home provides a warm family setting with individual space that is well maintained clean and hygienic. Evidence: Hopelea Care Home provides a clean, hygienic, safe and well-maintained environment. The premise of two converted houses has created a comfortable and accessible accommodation for all the people using the service. The atmosphere is calm and relaxing. A garden situated at the rear of the building offers good outdoor space where people can sit a relax in good weather. Bathrooms, bedrooms and communal areas are well maintained and decorated. Bedrooms viewed were personalised, containing personal possessions, photographs, ornaments, and reflected each individuals personality. People spoken with during the inspection stated they are very happy with their bedrooms. The home provides an environment that reflects normal family life. There are adequate rooms to enable everyone to have their own personal space. All people using the service have single rooms with good access to family style bathrooms across all floors. Specialist equipment is available to the meet the needs of people with their mobility. Like grab rails. A stair lift is available but presently none of the people using the service require to use it. Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: Several communal areas are used for joint activities and each bedroom has sufficient room for personal hobbies. People using the service are supported in maintaining their rooms to a high standard of cleanliness and safety. It was evident during the inspection that daily living tasks are completed with people using the service and that no activity is undertaken without their involvement. There is a family size kitchen that is large enough for people who use the service to assist or sit comfortably and be part of meal preparations. The dining area can accommodate all of the people living at the home where meals are eaten as a family. Care Homes for Adults (18-65 years) Page 28 of 34 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 skills and recruitment practices fully ensure that the needs of people who use the service are protected. Evidence: The support worker team have a sound knowledge base about the needs of people that use the service. Through observation during the inspection the team showed that they had a range of skills to support individuals and were proactive in developing everyday living skills. In reviewing the files of support workers it was noted that all contained evidence that recruitment check had been undertaken. The files contained application forms, two references, identity checks and an enhanced criminal record bureau disclosure. The manager confirms in the AQAA that the service has a very low turnover of staff members and most have been here for 4 years or more. All staff are competent and well qualified for their roles as Support Workers or Support Assistants. All staff are friendly and help Service Users to make visitors welcome into their home. We do not use Agency staff at all as we have our own Emergency cover list of experienced staff who will cover any absences due to sickness or annual leave etc. Our staffing levels are adequate and reflect our Service Users current needs and support requiremnents. Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: There are always sufficient support workers on duty to provide support for individuals. Levels of support are increased for outside activities and holidays. Files confirmed that support workers have completed induction and other core training with seven including the manager achieving National Vocational Training at level two in care or above. Training is available for all support workers and staff confirmed that they receive good support from management. The AQAA confirms that all support workers have a record of regular Supervision and Appraisals in their personal files. These were evident on reviewing the files at the inspection. All new support workers complete the Learning Disability Qualification Induction and In House Induction within the probationary period. All Mandatory training is maintained on a regular basis. Care Homes for Adults (18-65 years) Page 30 of 34 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 service is managed in the best interests of people who live at the home. Evidence: The registered manager was available during the inspection and was knowledgeable about the running of the home. They hold the Registered Managers award. A comprehensive quality assurance system is in place that includes feedback from people who use the service, families and regular monitoring by the provider. Questionaires for people who use the service are available in picture and written format. Staff are also asked to comment about improvement and developments. All Health and Safety documentation is filed with evidence that all checks are completed at the required weekly, monthly or annual periods. The registration and insurance certificate are dispalyed. Care Homes for Adults (18-65 years) Page 31 of 34 Are there any outstanding requirements from the last inspection? Yes  No  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 32 of 34 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 Description 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 Description 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 Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 34 of 34 - 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!