Inspection on 15/02/09 for Rookery Hove

This inspection was carried out on 15th 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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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: Rookery Hove 22-24 Sackville Garden Hove East Sussex BN3 4GH     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: Judy Gossedge     Date: 1 5 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 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.cqc.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: Rookery Hove 22-24 Sackville Garden Hove East Sussex BN3 4GH 01273202520 01273774160 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Priory Education Services Ltd care home 13 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 13 The maximum number of service users to be accommodated is thirteen (13). The registered person may provide the following category/ies of service only : Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD), excluding Mental disorder (MD), or dementia (DE) Date of last inspection Brief description of the care home Rookery Hove is a residential home owned and managed by the organisation Priory Education Services. It is a specialist service for both male and female young adults aged between eighteen and thirty-five years, who have Aspergers Syndrome. Residents are provided with intensive social, personal and educational development programmes usually for a period of between three to five years. Rookery Hove is situated in Hove, within walking distance of Hove town centre and near to the various amenities and attractions available in Brighton. The building comprises of three levels with two lounges, dining room, an IT suite, training kitchen and main kitchen located on the ground floor. There are thirteen single bedrooms situated on the first and second floors. The eight bedrooms on the first floor have enCare Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home suite facilities of a toilet and wash-hand-basin and share three bathrooms with a choice of bath or shower. The four bedrooms on the top floor have en-suite facilities; three with a bath with a shower facility and one has a shower cubicle. There is a small, secluded garden with a patio area at the rear of the home. A copy of the Statement of Purpose and the Service Users Guide will be given to each resident and is available to view at the home. At the time of the inspection fees were documented to be between £1,400.00 and £2,000.00 per week. The fees do not include residents toiletries, clothes, newspapers and magazines, meals out and entertainment. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over six hours on 15 February 2009. The last unannounced key inspection took place on 12 July 2007. Since the last inspection an Annual Service Review (ASR) has been completed. It does not involve a visit to the service, but is a summary of new information given to the CSCI, or collected by the CSCI, since the last key inspection. No concerns were raised. An Annual Quality Assurance Assessment (AQAA) was requested for this service to inform the ASR, and information detailed was updated during the inspection and is quoted in the report. Care Homes for Adults (18-65 years) Page 6 of 27 A tour of the premises took place to look at a selection of communal areas and residents bedrooms and care records were inspected. Eleven residents were resident, three were spoken with individually and a number were spoken with as part of the inspection process. The care that four of the residents received was reviewed. The opportunity was also taken to observe the interaction between staff and residents in the communal areas. No residents or staff surveys were sent out on this occasion. Three support workers, an agency care worker, and the deputy manager were spoken with on the day, and the Registered Manager was subsequently spoken with over the telephone. Three relatives visiting during the inspection were spoken with. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 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. Detailed information about Rookery Hove is available to be viewed prior to any admission to the home and there are detailed pre-admission procedures in place to ensure that residents are appropriately placed in the home. Residents would benefit from the protection of written terms and conditions with the home. Evidence: There is a detailed Statement of Purpose and Service Users Guide available to view. The AQAA details these documents are available to potential residents, their family, social worker, etc at the early stages of a referral. Copies were also available in the entrance of the home. Feedback received from one resident confirmed that they had received this information and that there had been the opportunity to visit the home prior to admission for a period of assessment. A copy of an assessment from the placing authority had been received for both of the new residents documentation viewed. A further three-day residential assessment had been undertaken with staff from the home and following this detailed written Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: assessments were completed and were also viewed. The home does not accept emergency admissions to ensure that any new residents are properly assessed and are compatible with those currently living at the home. The organisation provides new support workers with induction and mandatory training. Records viewed demonstrated there are training opportunities through the organisations Foundation for Growth training programme to access further training and guidance to meet residents care needs. There is a comprehensive staff handbook for staff to reference. The support workers spoken with demonstrated knowledge of the residents care needs for those whose care needs were reviewed. Written terms and conditions were not viewed during the inspection and staff spoken with were not aware of this document. The Manager subsequently stated that the written terms and conditions between the home and the resident are in place, but have not been fully introduced. The AQAA details that this is an area which it is planned to be improved and the Manager confirmed that this would be addressed. So a Requirement has not been made on this occasion. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents individual care plans provide staff with the information they need to ensure that residents individual care needs are met. Residents are enabled to make decisions in all areas of their daily living during their stay. Evidence: Four residents individual plans were viewed, which were detailed, and drawn up with the resident and based on each individual assessment of need. One resident spoken with confirmed they had been party to drawing up their care plan. The care plans detailed individual support to be provided for each resident to enable them to achieve maximum independence and develop their skills. Two had been subject to a review to ensure that the agreed goals are being worked towards and for the other two it was not applicable. Staff spoken with demonstrated that they are aware how they should provide support to assist each resident. Supporting risk assessments were also seen to be in place. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Evidence gathered from documentation, feedback and observation of staff supporting residents highlighted that the home provides a service where residents are encouraged and supported towards independence. The AQAA details that residents are involved in the overall running of the home. Wherever practical residents take part in the recruitment process. Residents meetings are held and residents can make requests for changes to policy or new facilities for the home. The minutes of the last two residents meetings were viewed during the inspection. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged and supported to pursue their educational, vocational and social interests. The meals on the home are good offering both choice and variety and residents have the opportunity to plan and prepare their own meals. Evidence: Each resident has their own life skills programme, which is designed to meet their individual need and support them to reach their full potential for independent living. Evidence gathered from the weekly timetable, care plans, discussions with residents, relatives and staff revealed that residents are being supported to access a range of educational, vocational and social activities. The planning of activities is being arranged across morning, afternoon and evening periods, seven days per week. Residents are being supported to be fully integrated with their local community and make use of available facilities. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: Feedback received evidenced home has a positive approach to enabling residents to maintain contact and relationships with families and friends. Residents reviews include the opportunity for residents relatives/representatives to attend if the resident wishes. The cook draws up a weekly menu, records viewed staff and residents feedback confirmed that the choice of meals are being provided in consultation with residents. Feedback from the residents spoken with was that the food was good. Records were viewed on meals provided to individual residents. The cook was not present during the inspection and on that day support workers were preparing and cooking of the meals. Lunch on the day was jacket potatoes with a variety of fillings, and support workers were preparing a roast dinner for the evening meal. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the provision of flexible and respectful personal and healthcare support and are protected by the systems in place to manage medication. Evidence: Residents at Rookery Hove largely manage their own personal care, with the offering of verbal prompts where required. Risk assessments are in place to ensure the safety of residents. Staff supports residents to ensure their health needs are met. Feedback and the sample of records viewed referred to specialist advice and guidance, which had been sought. Relationships between staff and residents and the care given were observed to be very good, and residents were treated with respect at all times. The AQAA details are policies and procedures in relation to medication in place. The storage and administration of medication were found to be satisfactory. There were some omissions in the recording of administration of medication. This was discussed with the deputy manager who stated he was aware of the omissions and already taking action to rectify this. So a Requirement was not made on this occasion. Staff receive training in the management of medication and undertake a comprehensive Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: competency test. The support workers spoken with confirmed they had received medication training. The AQAA details that all residents now have an plan for death and dying. These were not viewed during the day. 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. Systems are in place to enable residents or their representatives to raise any concerns about the care being provided and to ensure that residents are protected from abuse. Evidence: There is a complaints policy and procedure in place. Six complaints in relation to the service had been received in the last year. The CSCI have not been directly informed of any concerns. Resident and relative feedback was that they were aware of the complaints procedure and knew who to speak to if they were not happy. There are policies and procedures in place in relation to the safeguarding of vulnerable adults and a whistle blowing policy. The organisation provides safeguarding training. All the support workers spoken with confirmed they had an awareness of safeguarding protection procedures and had received an annual update of this training. A copy of the East and West Sussex, Brighton and Hove Multi-Agency Adult Protection Guidelines was available for reference in the home. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment is good and provides residents with an attractive, comfortable and homely place to live. Evidence: A tour of the building was made. Decor in the home is to a good standard, and furnishings are of a reasonable quality and domestic in style. There are thirteen single bedrooms and a sample of the bedrooms was viewed. The eight bedrooms on the first floor have en-suite facilities of a toilet and wash-handbasin and share three bathrooms with a choice of bath or shower. The four bedrooms on the top floor have en-suite facilities; three with a bath with a shower facility and one has a shower cubicle. A sample of bedrooms were viewed and had been personalised. One resident was supported to go out during the inspection to purchase furniture for their bedroom. The AQAA details that the renewal of bedroom furniture is an area that it is planned to be improved. One comment was received was that the quality of the bedroom furnishings varied. This was discussed with the Manager, who stated this is still an area that it is intended will be improved. There are several communal areas on the ground floor for residents, a separate dining Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: room and two lounges one used as a quite room and the other has a television. A further room has been made into an IT suite. Several comments were received that the communal areas are now very busy since the occupancy of the home has increased. The Manager stated that with the increase in occupancy the use of the communal area is being looked at with plans to convert the quiet lounge in to a second lounge with a television, and a therapy room in to a new quiet room increasing the communal space available for residents use. There is a passenger lift between all floors in the home. The home was clean and free from offensive odours. Feedback received was varied and did not always confirm that the home was always kept fresh and clean. This was discussed with the Manager who confirmed there had been a period when domestic support was not available in the home, but that this now had been addressed and domestic support is provided three times a week to clean communal areas. Residents are supported to take responsibility for keep their own bedroom clean and tidy. The Manager stated that the level of support is dependent on individual residents needs. There is a separate laundry room for residents to use. One comment received was that since the homes occupancy has increased the laundry area is now very busy. There are records of regular checks of the hot water supply at outlets accessible to residents, and a sample of the records were viewed. There is an attractive secluded garden at the rear of the home. Routine fire checks of the building, which had been completed were viewed and were adequate. 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. There are robust recruitment procedures and training is provided to staff to enable them to perform their roles effectively. Evidence: The home was calm and relaxed on the day of the inspection, and the staffing in place on the day enabled staff to support two residents to go out shopping during the morning, a group of residents to go ice skating during the afternoon and the remaining residents in the home to be supported in their chosen leisure pursuits. Two waking night members of staff were due to be on duty that night. The staff rotas were viewed and the deputy manager stated that staffing levels were regularly reviewed and would be dependent on individual residents support needs and where they were on their individual programme. Ancillary staff also work in the home with a cook working five days a week and support workers working with residents to prepare meals at the weekend. A domestic member of staff works in the home three days a week to clean the communal areas. Residents are expected to keep their own bedrooms clean with support where required. Support workers spoken with spoke of a team that are very supportive of each other Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: and of good communication. Staff spoken with and three staff files were viewed to evidence of the recruitment process followed for staff, which included the completion of an application form, two written references and a probationary period being in place. The deputy manager evidenced that staff working in the home have undertaken a Criminal Records Bureau (CRB) and a Protection of Vulnerable Adults check. There is a programme in place for staff to work towards NVQ Level 2 or equivalent in care. The Manager stated that eight members of staff hold NVQ Level 2 or 3 in care and five support workers are working towards this qualification. Induction procedures are in place which new staff recruited to the home will be taken through. The Manager stated that this met the requirements of Skills for Care. Support workers spoken with and records viewed confirmed they had received an induction. One support worker was on an induction day and another was about to start their induction. Support workers access the organisations training programme over the Internet. Support workers spoke of completing or were due to complete a range of training and all spoke of good training opportunities for personal development. All staff feedback confirmed that supervision is provided to meet requirements. The Manager subsequently stated that the homes bank staff also receive supervision. The organisation has an annual appraisal system. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall management of the home is good with effective systems to protect residents in place. Evidence: The Registered Manager working at Rookery Hove is an experienced manager and has completed the Registered Managers Award and NVQ Level 4 in Care. He has attended numerous courses relevant to his role and there are opportunities for further training within the organisation and clear lines of line management and accountability. He is supported by a deputy manager who also confirmed attendance of a range of training opportunities. Feedback received indicated that the management approach of the home creates an open, positive and inclusive atmosphere. The AQAA states that there is a quality assurance process in place in the home. That questionnaires will be sent out to residents, family and their representatives and other stakeholders. A suggestion box is in reception so residents are able to leave comments anonymously. Also that monthly visits by a representative of the organisation are Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: undertaken and which are recorded. The records were not viewed on this occasion. The AQAA details that policies and procedures are in place, but that they had not been subject to a regular review. A Recommendation has been made that these are regularly reviewed and at least annually. Detailed training lists have been compiled and a sample of staff training records were viewed. Support workers spoken with and records viewed evidenced where staff had received, were due to or were in the process of completing health and safety training of moving and handling, first aid,infection control, basic food hygiene and fire training. It was not evidenced that an agency member of staff had received this training. The deputy manager agreed to look at this to ensure agency staff had undertaken all the required training. Systems are in place to monitor the completion of training and ensure staff training needs are highlighted. It was evidenced that the maintenance of equipment and services has been carried out. The Manager subsequently confirmed that a fire risk assessment is in place and has been reviewed in June 2009. A detailed check of the environment and fire precautions had been carried out to meet requirements and is recorded. A number of rooms on the ground floor were wedged open at the time of the inspection. A Requirement has been made seek further guidance from the East Sussex Fire and Rescue Service and that this acted upon. Accident records were viewed and were detailed. Details were viewed of current insurance in place for the home. 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 42 13 That guidance is sought from the East Sussex Fire and Rescue Service and acted upon in relation to the wedging open of doors. To protect residents and staff. 31/03/2009 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 40 That policies and procedures are regularly reviewed and at least annually. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 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!