Inspection on 26/01/09 for Hunters Lodge

This inspection was carried out on 26th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hunters Lodge 14/11/06

Hunters Lodge 21/11/05

Hunters Lodge 19/05/05

Hunters Lodge 14/10/04

Hunters Lodge 02/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hunters Lodge 26 Berridges Lane Husbands Bosworth Leicestershire LE17 6LE     The quality rating for this care home is:   three star excellent 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: Ruth Wood     Date: 2 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Hunters Lodge 26 Berridges Lane Husbands Bosworth Leicestershire LE17 6LE 01858880538 0185881185 hunters_lodge@lineone.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Christine Anne Gilbert Name of registered manager (if applicable) Ms Claire Gilbert Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: No person falling within category SI to be admitted to the home unless that person also falls within category LD - ie dual disability. The home may not accommodate more than a maximum of 4 persons falling within the categories LD/SI (dual disability). The home to revert to 16 persons when/if one of the married couples leaves. Date of last inspection Brief description of the care home Hunters Lodge care home cares for seventeen adults with learning disabilities, some of who may have an additional sensory impairment. The property was originally a farmhouse and is situated in the village of Husbands Bosworth near to the market towns of Lutterworth and Market Harborough. It is close to shops and other amenities and easily accessible by private and public transport. Accommodation is spread over two floors with communal rooms and some bedrooms being located on the ground Care Homes for Adults (18-65 years) Page 4 of 27 care home 17 Over 65 0 0 17 4 Brief description of the care home floor. There are eleven single bedrooms (seven with en-suite facilities) and three double bedrooms. There is a secluded garden at the back of the home. Current weekly fees are #324. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 three stars. this means that people who use the service experience excellent outcomes. The inspection visit took place on a weekday between 1pm and 6:30 pm. During the visit we looked at all the communal areas of the home and some peoples bedrooms, with their permission. We spoke to people who live in the home about the support they receive from staff, what they do during the day and in their leisure time and their opinions about the food served at Hunters Lodge. We looked at two peoples person centred plans and the support plan and assessment for another person. We also looked at staff recruitment and training records and spoke Care Homes for Adults (18-65 years) Page 6 of 27 to one new staff member about their experience of induction. The registered manager was present throughout the inspection and spoke to us about the arrangements in place for finding out peoples opinions about the service provided in the home. This is part of the process called quality assurance and we looked at some of the responses of relatives and other people involved in the home, such as GPs, to the surveys that the home had given out. Finally we looked at the systems in place to make sure that peoples health and medication needs are met, examining records, looking at staff training and examining the storage facilities in place. In addition to the inspection visit this report draws on information supplied to us by the registered person in the Annual Quality Assurance Assessment and responses to six surveys issued to the people who live in the home, by the Commission. The surveys ask for peoples opinions about the support that they receive. 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 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good assessment practices ensure that the service can meet the needs and aspirations of the people living there. Evidence: The statement of purpose and service user guide are both comprehensive documents, which give detailed information about the service. The Service User Guide makes use of some pictures to enhance the meaning of the written information but would benefit from additional use of illustration, to ensure that it is as accessible as possible to the people who live, or may choose to live at the home. The assessment process is outlined in the Service Users Guide and includes the registered manager visiting the person at their current setting (where at all possible) to gather information about the persons needs, likes and dislikes. People are encouraged to visit the home to have a meal, stay overnight and for a weekend before making the decision to move in. The registered manager emphasised that there is no timescale for this and as much time as is needed is taken adding that, assessment Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: can be a long, slow process. We looked at the documentation in place for one person who had recently come to live at Hunters Lodge. This gave information about their needs and from this a more comprehensive support plan is drawn up. Peoples assessments are kept under regular review. One person is currently being reassessed because of an increase in their needs and we discussed this process with the registered manager. The manager has ensured that all those involved in the persons care are included in the process. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good assessment and person centred planning, ensures people receive the necessary support to take responsible risks and to make informed decisions about their lives. Evidence: We looked at three peoples support plans which outline how their individual needs should be met. Two of these are in the form of person centred plans and people are actively involved in putting these together and deciding how the information should be presented. One person went through their plan with us and confirmed the accuracy of the information. The other persons plan also reflected their needs and interests and the kind of support they needed from staff. People are given a choice as to whether they want a person centred plan and both they and staff receive training in putting them together. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Plans contain information on how people like to communicate and these are particularly detailed for those people whose communication, for whatever reason, may be difficult to understand. The service uses a range of methods and resources to facilitate communication and to help people to make informed choices about what they do in their daily lives. We looked at a book of photographs of objects which is used and staff also use real objects to give people a direct choice between one thing and another. The six people who responded to the Commissions survey said that they always or usually make decisions about what they want to do. Some people were supported to complete the survey by staff at their day service to ensure that the homes staff did not influence their responses. People are also informed about advocacy services such as those run by People First and Age Concern. One person said that people were encouraged to try things, I tried horse riding, but didnt like it. They did add that they were glad they had tried it. Risk assessments form part of peoples support plans and relate directly to peoples individual needs. An assessment for one person was in place to help them use public transport independently, which in turn enabled them to access more leisure and vocational opportunities. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have excellent opportunities to engage in vocational, leisure and community activities, are given good support in maintaining links with family and friends and enjoy good, nutritious food. Evidence: People take part in a wide range of activities during the day, depending on their personal abilities and interests. One person spoke about their various paid and voluntary jobs, which include working in a theatre cafe, at Age Concern and at Wilkinsons, I enjoy working in the cafe best. Another person spoke about the college courses they attend. The majority of people attend some kind of formal activity during the day, be this paid or voluntary work, college courses, formal specialised day care or a combination of these activities. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: There is a wide age range of people living at Hunters Lodge and the manager has taken on board feedback from people who do not like going out too much, particularly during the winter months, and would like some less active activities in the home or in the local community. A games night is being arranged at the local pub and one staff member is looking to develop the range of activities available to people who would prefer to stay in. Many people living at the home do enjoy a very active social life and people spoke to us about their holiday in Spain last year, trips to London and outings to see Disney on Ice and the Abba tribute act, Bjorn Again. Some people showed us photographs of their holidays and trips. There is a weekly active club to support people to go swimming, bowling and horse riding. Some people living in the home belong to the local gym and one person rang the home during the inspection to say when they would be home, as they had gone to the gym after work. One person spoke to us about attending the local church every Sunday and said how much they enjoyed this. People are encouraged to take part in the day to day running of the home and help with cooking and cleaning if possible; three people who wanted to do their own laundry are supported to do this. People are very positive about the quality of the food served, particularly the packed lunches, I like the pack ups. Peoples likes and dislikes for food are written in their person centred plans. The main meal is served during the evening and there is a choice of main course and pudding. People can choose to eat in the dining room, their own room or in the lounge in front of the television. Some staff members have received training in nutrition and menu records demonstrate that a varied and wellbalanced diet is served. The service supports people very well to maintain contact with family and friends, believing in the importance of maintaining these ties. Some families wished to come and stay overnight at the home and this has now been accommodated. One person spoke about their ongoing contact with different members of their family and the support they had been given to maintain and extend these links. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent provision is in place to meet peoples personal and health care needs. Evidence: Peoples needs and preferences in personal care are outlined in detail in their person centred plans. Specialist equipment is in place for those people who have developed additional needs in relation to moving and handling. Some people have gym membership and a physical activity programme in place as part of managing their particular health condition. Each person has a health action plan and staff have received training on how to keep these up-to-date. Peoples plans contain information about regular appointments with dentists, opticians and chiropodists, as well as regular health screening such as smear tests. All people living in the home receive an annual health check and review of their medication from their GP. Peoples records show that investigations take place into peoples specific health concerns, and this was confirmed through discussion with the manager and one of the people living at the home. The manager has developed a very effective way of ensuring that the service receives full feedback about tests or Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: investigations, by designing a feedback form which the GP completes. This ensures that any issues arising from such investigations are promptly followed up. A family medical history form has been introduced as part of the services assessment process, to identify any family health problems which may impact on the health needs of people living in the home. Grab sheets are also in place outlining key health information should the person have to attend either a planned or emergency medical appointment. There is a list of all staff authorised to administer medication. Staff have completed a course run by Boots (the homes dispensing pharmacist) as well as a level two course in medication administration by distance learning. Medication Administration Records examined were fully and accurately completed and a homely remedies policy is in place, which is reviewed annually by the GP. No controlled drugs are currently being administered but the service has the required storage facilities in place. One person administers their own medication and has secure storage facilities in their own room to ensure this is kept safe. A comprehensive risk assessment has been completed to ensure the person fully understands the process; this includes a questionnaire for the person, with photographs being used to aid their communication and understanding. Although some protocols were in place specifying under what circumstances as required medication should be administered, we discussed the advantages of extending this information and ensuring it was in place in the Medication Administration Record and in person centred plans. This recommendation has now been implemented. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns are listened to and systems are in place to protect them Evidence: Monthly meetings are held and people are encouraged to raise any concerns at these, or with the manager or their key worker. People were observed to have a genuine, open and friendly relationship with staff and there was a great deal of communication between them. People have access to an advocacy service from the day centre and information about independent advocates is also available. The homes formal complaints procedure is outlined in the Service Users Guide. All staff members have received training in safeguarding vulnerable adults, delivered by the Local Authority. Criminal Records Bureau checks are completed on staff members and their names are checked against the Protection of Vulnerable Adults Register; this helps to ensure that only suitable people work at Hunters Lodge. We noted that one person had started their induction period before confirmation of their not appearing on the Protection of Vulnerable Adults Register. The person had been engaged in training, sometimes outside of the home, during this period and when in the home had not directly supported people or been left unsupervised. We looked at systems for supporting people to manage their finances. All transactions are recorded and receipts are kept. Each person has their own bank account and the Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: registered manager is the only person who supports those people who need help to access this. Bank statements and receipts of money withdrawn are kept, to ensure a clear audit trail. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and comfortable environment which meets their needs well. Evidence: All six people who responded to the Commissions survey said that the home was always clean and fresh and during the inspection visit communal and personal areas appeared clean and tidy. Staff have received training in infection control. Several peoples rooms have been redecorated as has the main dining area and one of the lounges. People have been involved in choosing the colour schemes and furniture. One persons room reflected their support of a local football team and another persons their love of a particular animal. All rooms seen were highly personalised. One double bedroom has been converted into two single rooms at the request of the people who shared the room. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good support from competent and well trained staff Evidence: A comprehensive induction programme is in place for new staff members, which includes access to an Introduction to Learning Disability course for new staff who may not have worked in this setting. New staff also visit the day services that people use, to establish links with the other people who are involved in supporting the people who live at the home. A recently appointed staff member said that they felt that their induction had been very useful and was still ongoing. Staff have access to a wide range of training, including the opportunity to undertake National Vocational Qualifications at level 2, 3 and 4. Recent training has included an Introduction to the Mental Capacity Act and training in Safeguarding Vulnerable Adults. Staff receive regular one-to-one supervision with the registered manager and a record is kept of these meetings. The people who live in the home who responded to the Commissions survey felt that staff treated them well adding, Staff do keep an eye on me. I like some staff better than others but on the whole they all do a good job. Another person commented that Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: the staff make me laugh. Positive interaction between the people who live in the home and staff members was observed throughout the inspection visit. Three peoples recruitment records were examined; these contained completed application forms with a full employement history, written references and evidence that Criminal Records Bureau checks and checks against the Protection of Vulnerable Adults Register (POVA) had been made. It was noted that the most recently appointed staff member had started their induction before confirmation of their status on the POVA register had been received. The person had been engaged in training, sometimes outside of the home, during this period and when in the home had not directly supported people or been left unsupervised. The registered manager was informed that even with such safeguards in place, no person should start work at the home until their names had been checked against the vulnerable adults register and they must be supervised at all times until their Criminal Records Bureau check was processed. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good management and effective quality assurance ensure that Hunters Lodge is run in the best interests of the people living there Evidence: The registered manager has completed the Registered Managers Award and keeps up to date with training related to the needs of the people living in the home. She provides a clear sense of leadership and ensures that strategies are in place for the people living and working in the home, to voice their opinions and contribute to how the service is run. Staff and resident meetings take place on a monthly basis; both are structured with a clear agenda which participants can add to. Staff meetings also usually include a training element. There is a very well developed quality assurance system in place, which takes account of the views of people living in the home, their relatives, other interested stakeholders (such as GPs and commissioning social workers) and staff members. Various changes have been implemented as a result of the most recent review in July 2008 including Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: changes to the physical environment (such as extra seating in the outdoor courtyard) and the provision of less active activities for some people living in the home. The Annual Quality Assurance Assessment, returned to the Commission was completed comprehensively and demonstrates a pro-active approach to maintaining and improving the quality of the service. Policies and procedures (such as the medication policy) show evidence of review, as new information becomes available about changes in good practice. The registered manager holds a formal qualification in health and safety and all staff are currently reviewing their own training in this area. All staff have also received training in food hygiene. Records demonstrate that fire systems and equipment are regularly serviced and tested. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 19 The registered person must 06/02/2009 ensure that no person begins working for the service, until confirmation of their status on the Protection of Vulnerable Adults Register has been received. This is to help ensure that only suitable people, who do not pose a risk, work with the people living at the service. 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 1 The service user guide would benefit from additional illustrations to make sure it is accessible to all the people who live, or may want to live at Hunters Lodge Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!