Inspection on 14/01/09 for Spring Mount 8

This inspection was carried out on 14th January 2009.

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

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

Other inspections for this house

Spring Mount 8 17/01/07

Spring Mount 8 20/03/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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: Spring Mount 8 8 Spring Mount Harrogate North Yorkshire HG1 2HX     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: Irene Ward     Date: 1 4 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Spring Mount 8 8 Spring Mount Harrogate North Yorkshire HG1 2HX 01618721234 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Henshaws Society for Blind People Name of registered manager (if applicable) Miss Julie Edwards 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: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only Code 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, Code LD maximum number of places 6 Sensory Impairment, Code SI, maximum number of places 6 Date of last inspection Brief description of the care home 8,Spring Mount is operated by Henshaws Society for Blind People and is registered to provide personal care for 6 younger adults aged 65 years and under who have learning disabilities with an additional visual impairment. The house is well situated just off the Ripon Road and within walking distance of Harrogate town centre. It is a large three storey terraced house with a small garden to the front and rear patio with a seating Care Homes for Adults (18-65 years) Page 4 of 28 care home 6 Over 65 0 0 6 6 Brief description of the care home area. All bedrooms are designed for single occupancy. The weekly fees on 14th January 2009 range from 688 pounds to 750 pounds and do not include costs for leisure activities, hairdressers, personal clothing and toiletries and chiropody. Service users/relatives and other interested parties are able to have access to inspection reports by requesting them from the home. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 3 star excellent. This means that people who use the service experience excellent quality outcomes. The Commission for Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed.The inspection process has now become a cycle of activity rather than a series of one-off events.Information is gathered from a variety of sources, one being a site visit.More information about the inspection process can be found on our website www.csci.org.uk.This is what was used to write this report. A review of the information held on the homes file since its registration. One visit to the home by one inspector which was unannounced that lasted for four Care Homes for Adults (18-65 years) Page 6 of 28 hours. One visit to the organisation Human Resources office which is based on Henshaws College Campus. Information asked for before the inspection, this is called an Annual Quality Assurance Assessment. Four comment cards have been returned from people who live at the home. Looking at two peoples care files in detail.Some time was spent with the people who live at 8 Spring Mount. Time was also spent talking to two member of staff. The site visit took place on the 14th January 2009. However some people living at the home went out to various activities,although there was the opportunity to speak with them before they did so. The registered manager was available to assist throughout the visit and available for feedback at the end of the day. 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 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are properly assessed prior to admission,this makes sure that 8 Spring Mount is the right place for them to live. Evidence: There has been one new admission into the home since the last inspection.The manager confirmed that the person was given the opportunity to visit the home as they wanted.The manager said this was slowly built to an overnight stop the person then came for weekend stay, they came for meals to the home,they then went out on some trips with the other people living at the home,they were also encouraged and supported to cook a meal at the home,this was gradually built up over a period of time before the person confirmed they wanted to move into the home and so that people could get to know each other. Records of three people including the new persons records showed that the home carries out detailed pre-admission assessments when referrals are made to the home. They visit people and get information from relatives and other professionals to help Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: them decide if they will be able to meet peoples needs before a place is offered.This is particularly useful for those people who have complex needs and/or difficulties with communication.The pre-admission assessments carried out by the home were very comprehensive and detailed the specific individual needs of people and how these are to be met.Local Authority assessments were also on peoples individual files.Each person living at the home had an individual statement of terms and conditions or licence agreement, which had been agreed between them and the home.People made comments on the surveys they returned such as: We were involved right from the start. We visited it,we were asked about the colours in our rooms and things like that. We were asked where we wanted to live and who we wanted to share with. Given a Service User Guide,came to meet the staff and service users in the house,had days out with everyone.Stayed overnight serveral times and was given information on the home such eg.leisure activities,daytime programmes etc. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care provided is of a high standard and encourages people to make their own decisions about how they wanted to live their lives. Evidence: People living at the home looked well cared for and staff were seen supporting people during the day and it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. Each person has a individual service plan(ISP)detailing their individual needs and the actions that staff needs to follow to meet these.The plans focuses on the person and contained information about every aspect of the persons life,they focus on achievement and improving opportunities for individuals including areas for developing new skills. The individual service plans were very detailed and covered peoples routines and how people preferred their care to be provided. All areas of daily life such as peoples daily routines,activities were covered in the plans.The document provided the reader with very good information,was easy to understand and gave a sense of the person.The Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: plans are reviewed regularly and were agreed and signed by the people living at the home. Also present were a range of risk assessments with the purpose of supporting people to live as independently as possible with safeguards in place,these had been reviewed regularly. Three people living at the home told us they received the care and support they need, people also confirmed and said that they are always able to do what they want.Examples of comments made were Yes its still good living here. The staff are good here.I like the support from staff. The examples people gave was that they are supported to make decisions as to what courses they wanted to attend at college. People who are able to work have jobs,where they have established community links.Through discussions with the manager at the time of the visit and the contents of care plans or individual service plans it was clear that people are able to make choices wherever possible. People who use the service are continually consulted on a regular basis about how the home runs and have the opportunities to voice their views.One person said that they participated as part of the interview panel when the organisation was recently recruiting new staff. Another person said they had an independent advocate to talk to. Surveys returned from people living at the home were positive and comments made were, I like my daytime programme and go out when I want to go out.Choose my own courses. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are always able to make choices about their lifestyle and are supported by staff to carry these out. Evidence: Care plans or Individual service plans detailed the various daily activities people attended.People who live at 8 Spring Mount have the opportunity to attend college and various courses.People who are able to have regular employment as one person said that they were working in a shop one morning a week and then they were attending college in the afternoon to do a numeracy and literacy course. Another person said they were going to Harrogate College for the day as they were doing a pottery course in the morning and creative craft the afternoon.Some people attend Henshaws Arts and Crafts center. People also have days at home to participate in personal shopping, laundry and Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: household tasks.People continue to have opportunities to pursue other interests outside of the home such as going to the library,Henshaws gym,going swimming at the Harrogate Hydro,workshops at St Lukes such as pottery,music,media studies and relaxation.People go to The Junction and Phab Club which two people said they usually go most Sunday evennings, where they meet up with friends and sit and socialise, and where they have regular discos.People go horseriding,have piano lessons,go into town to do their own personal shopping,go to the pub,have meals out,belong to a drama group and a discussion group. One person said they continue to enjoy listening to music. But also enjoyed playing and singing in a band.They also said they were enjoying their course at Harrogate College as they were doing a course in music from around the world this year.Surveys returned from people living at the home confirmed they are able to make decisions about what they do each day. Menu sheets are kept by the home. Menus are varied and people choose what they want to eat.As part of peoples living skills they are supported and encouraged to shop,prepare and cook some of their own meals. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare is provided appropriately and sensitively according to individual needs. Evidence: Each person living at the home is registered with a General Practitioner.People receive support from staff in attending dental and other health care service appointments. Peoples health needs were recorded in their individual support plans with additional step-by-step instruction as to how they wished to be supported. Harrogate District Hospital is used for Accident and Emergency service and most out patients appointments.People have access to other health care professionals such as dentist,chiropodist and diebetic nurse. The home operates a monitored dosage system.There is a policy in place for the storage and administration of medication for all staff working in the home to follow. The Medication Administration Records show that everyone receives their medication as prescribed.Records were up to date and well maintained.Medication seen in the Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: home was securely stored in a locked cabinet.No controlled drugs are currently held.All staff that administers medication in the home have been provided with medication training. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to an effective complaints procedure and are protected from harm. Evidence: A comprehensive complaints procedure is followed and is made available to people and any other interested parties.The complaints procedure is also produced in various formats such as Braille,large print or tape. The complaints procedure is summerised within the service user guide. No complaints have been received by the Commision For Social Care Inspection.The home has received one complaint since the last inspection which was investigated appropriately by the organisation with a satisfactory outcome. People when asked were clear as to whom they would speak to if they had any concerns or worries. All said they would speak to either the manager or the staff.Surveys returned from people living at the home, when asked who they would speak with if they were not happy made comments such as, Keyworker,manager,Frank, people like that. Another person said,Keyworker,manager, Wendy or Frank and another said,My keyworker,a member of staff,my mum and dad, an instructor,rehab officer,Wendy and Frank,Care Standards or Social Worker. People were all clear as to how to make a complaint. There are regular meetings in the home,where people can make their views Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: known.One person has access to the independent advocacy service,as a visit was being carried out by an advocate on the day we visited. There is a policy and procedure with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse and staff demonstrated a good awareness of this.Staff receive training in adult protection and safeguarding issues during induction training and further training when required.There have been no allegations regarding safeguarding made to the home or to the Commission for Social Care Inspection. Appropriate recruitment procedures are followed, with references and Criminal Records Bureau CRB checks made to reduce the risk of unsuitable people working in the home. Peoples finances were not checked at this site visit.Historical evidence from previous reports gives evidence that their financial interests are safeguarded. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and safe home that is decorated and furnished to a good standard. Evidence: The home is a three storey Victorian terraced house and provides spacious accommodation for people.This includes a lounge,dining room, kitchen and one bedroom on the ground floor.There are bedrooms, bathrooms and shower rooms on the first and second floors. One persons bedroom was seen,which had been personalised with posters and their various possessions such as a small electric organ,CD player and items they had collected and made. Rooms have been decorated and furnished appropriate for their age.There is a small garden to the front of the property and to the rear there is a patio area.The patio area has been improved as there is now a seating area for people to sit out in the garden,which had previously been an area to park a car.This improves the outside to the home and makes it more pleasant for people living at the home. There is on street parking to the front of the home. All areas including the lounge,dining room,kitchen and bathrooms were all clean,free from any odours and maintained to a high standard.Paper towel dispensers have been installed in all of the bathrooms and kitchen. This makes sure that good infection control measures are in place and followed. Surveys returned from people Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: living at the home stated that the home is always kept fresh and clean.One person commented,I tidy my own room. There is a cleaner twice a week. A range of maintenance checks is completed on a regular basis to make sure that the house is safe and secure. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staffing levels, proper recruitment procedures and good staff training meant that peoples needs were met and their interests were safeguarded. Evidence: Staffing levels were sufficient for meeting the needs of people. The duty rota showed that there are usually one or two members of staff on duty both in a morning and afternoon. Although there can be only one staff on duty in a morning which is generally the person who has done the sleep-in duty.Until a second staff member arrives or is needed.This includes the registered managers hours.The manager said that there were three staff on duty most week-ends and that staffing hours were increased and were dependent on what actvities people who live at the home were doing.This makes sure that peoples social activities are not compromised. At night there is one staff sleeping in on the premises.The organisation operates an on-call system in case there is an emergency. The staff records of three staff were looked at.These showed that all the necessary pre-employment checks had been carried out prior to the new workers starting in post. All records showed completed application forms,two written references,CRB (Criminal Record Bureau) checks had been obtained. The home provides all the mandatory training that is required. A range of other Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: training has been completed by staff such as food hygiene,fire safety,health and safety (IOSHH),safeguarding,moving and handling,basic first aid,first aid at work,mini bus driving,care of medicines,sighted guide,equality and diversity,stress management,risk assessments,in house fire training,in house drug administration,independent living skills, fire marshall, dealing with difficult people and situations,are just some of the training staff have attended. One staff holds a National Vocational Qualification (NVQ) Level 2 and three staff have completed NVQ Level 3. Records of supervision were seen at the site visit to the home. Staff meetings are held regularly and minutes of meetings were also seen at the site visit. People who live at the home who were spoken to on the day spoke positively about staff. People living at the home made comments such as,The staff are good here.I like the support from staff. Surveys returned from people living at the home stated that staff always treated people well. Comments received such as, Since the staff are nice I want to keep my keyworker.Im happy in this house. The organisation has employed a new training manager and a health and safety officer.This makes sure that training is more organised and that staff complete the neccessary training. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well managed home in which their needs and wishes are put first. Evidence: The registered manager has worked at the home for sometime. She has a lot of experience in the care sector.The registered manager holds the National Vocational Qualification (NVQ) Level 4 in Care and the Registered Managers Award. The home has a good and effective management team in place. The ethos of the home is open and positive. People who use the service and staff all commented highly about the home. Regular house and staff meetings are held and minutes are taken. Comprehensive Quality Assurance systems are in place and the home is audited regularly by the organisation. A managers monthly visit is carried out and a report is written.This is carried out by one of the managers from another of the community houses. The schemes manager carries out regular three monthly visits to the home Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: and reports are completed and copies are available for inspection. All accidents are recorded as required and an accident book is maintained in line with the requirements of Data Protection. Peoples finances were not checked at this site visit. Historical evidence from previous reports gives evidence that their financial interests are safeguarded. Information provided from the (AQAA) Annual Quality Assurance Assessment and the examination of selected health and safety documents show that regular checks to electricity and gas and fire safety equipment are regularly undertaken. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 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. 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