Inspection on 21/10/08 for Strawberry Field

This inspection was carried out on 21st October 2008.

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

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

Other inspections for this house

Strawberry Field 01/11/06

Strawberry Field 17/01/06

Strawberry Field 27/09/05

Strawberry Field 02/12/04

Strawberry Field 22/06/04

Strawberry Field 02/12/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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: Strawberry Field Mill Common Lane Walcott Norwich Norfolk NR12 0PF The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judith Last Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 36 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home Name of care home: Address: Strawberry Field Mill Common Lane Walcott Norwich Norfolk NR12 0PF 01692650707 01692650330 admin@janithhomes.org www.janithhomes.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Janith Homes Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: Date of last inspection 0 1 1 1 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 36 A bit about the care home Strawberry Fields is a care home providing personal care and accommodation to 3 adults with a learning disability. Janith Homes Limited owns and runs the home and people living there can attend day services at The Rookery, the companys main home. Strawberry Fields stands on the outskirts of the Norfolk seaside village of Walcott. The home has its own transport. This home is located a detached house and all users have their own bedroom. Care Homes for Adults (18-65 years) Page 5 of 36 The home has a large garden with an aviary. Care Homes for Adults (18-65 years) Page 6 of 36 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 36 How we did our inspection: This is what the inspector did when they were at the care home We reviewed all the information we had about the home before we went. This included information that the manager was asked to send us before our visit. We also had written comments from two staff and everyone living at the home. Care Homes for Adults (18-65 years) Page 8 of 36 We visited the main office at the Rookery, where some of the records are held, and then went to Strawberry Field. We spent about three and a half hours doing this and spoke to everyone living at the home, the manager and two staff. We looked around parts of the home that people share, the office and one persons own room at their invitation. Care Homes for Adults (18-65 years) Page 9 of 36 During our visit, the main method of inspection we used was case tracking. This means we look at records to see what they say about peoples needs. We then find out from observation and discussion what happens in the daily lives of people living at the home. This helps us see what outcomes they experience. We use this information and the rules we have, to see how well the service is supporting people in their daily lives. Charges for the service are from 780 to 2000 pounds per week, according to peoples needs. There are additional charges for transport to social activities (but not to health care appointments), and for personal spending. Care Homes for Adults (18-65 years) Page 10 of 36 What the care home does well There have not been many changes in the staff team. This means that people have got to know the staff well, and feel comfortable with them. They feel that staff listen to them and one person told us Im grateful for what they have done. Care Homes for Adults (18-65 years) Page 11 of 36 People are involved in the day to day running of their home. This includes keeping it clean and tidy. People also take part in the shopping and cooking. They also help to keep the garden tidy and to grow vegetables. Care Homes for Adults (18-65 years) Page 12 of 36 People can make suggestions about what they would like to do and staff will help them find out how they might do this. This could be to do with classes they might like to go to or activities they might like to do. They are also involved in planning their holidays. Care Homes for Adults (18-65 years) Page 13 of 36 Staff spoke to people in a calm, quiet and respectful way, showing that they treat people properly and help promote their dignity. What has got better from the last inspection We did not find anything when we last went that the home needed to do by law. Since we visited, the staff team have started working with people on completing health books. These will set out clearly the support that people need with maintaining all areas of their physical and mental health. Care Homes for Adults (18-65 years) Page 14 of 36 Work has continued to decorate the home when this has been needed. There has also been some work to improve the garden and people living at the home have helped with this. Support plans have been reviewed with people and there is a new way of recording peoples activities so the manager can monitor the opportunities people have. What the care home could do better Care Homes for Adults (18-65 years) Page 15 of 36 The manager has identified what needs to improve for himself. This means that we have not made a lot of suggestions about what he could do to make things better. We have suggested that he should look back over one persons financial records to find out where a small mistake might have been made and make sure this is put right. He should also think about looking at the way things are written down about keeping risks to a minimum in the house. Some of the information has not been looked at for a long while. The manager took action while we were there, to make sure that electrical equipment was going to be tested the following day because this was overdue. This is needed to make sure that it is in good condition and remains safe to use. The manager can tell you about his plans for continuing to improve the service. Care Homes for Adults (18-65 years) Page 16 of 36 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judith Last 33 Greycoat Street London SW1P 2QF 02079792000 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 17 of 36 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 18 of 36 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People could have information to make an informed choice about whether the home would be suitable to meet their assessed needs. Evidence: The information about the home has been updated within the last year. This sets out what it can offer. People living at the home could understand some of the information if it was explained. It is also available on the companys website. Plans to provide the information in different formats are under consideration at present. There are no vacancies at the home so at present, no admissions can be made and no prospective service users or their representatives are in need of the information. People have their needs assessed and these are recorded. We know from other establishments under the same manager that there are systems for gathering information about peoples needs so they can be sure the service would be able to meet them. Care Homes for Adults (18-65 years) Page 19 of 36 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 . Residents know their changing needs and goals are reflected in their plans, they are able to make decisions and take reasonable risks in their daily lives. Evidence: Work has been done to make sure that the support plans are up to date and kept under review. There are some pieces of information missing - for example one persons communication profile was incomplete in their individual care plan file. However, the information was contained in their Health book. Each person has a sheet in their folders that records any choices that they have made or suggestions about what they would like to see happen. These show that staff do act on the suggestions that they make. Each person has risk assessments looking at activities and what needs to happen to keep risks to a minimum, for example from cycling or using hand tools for woodwork. They also look at risks associated with behaviour that might be challenging or aggressive and set out likely triggers, ways to avoid it developing and how staff are to Care Homes for Adults (18-65 years) Page 20 of 36 Evidence: manage things if there is a problem. People have signed parts of their individual plans and one person told us that their keyworker does talk to me about what I need. One person has signed an agreement about how their money is managed because they have had difficulties with this. They told us about where it was kept and showed that they had their own key. While we were there a staff member assisted people who wanted money to sort out what they needed and in the case wed discussed with a service user, what happened matched what they had told us and agreed to in their plan. Another person spoke about two of the staff and says they have supported me. Im grateful for what theyve done. Care Homes for Adults (18-65 years) Page 21 of 36 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 have opportunities to participate in a range of leisure and educational activities inside and outside the home. They are supported to have appropriate relationships and their rights and responsibilities are respected. Residents are offered a good diet and enjoy their mealtimes. Evidence: People have access to the companys day services, including an Art Barn and a farm. They say they have lots of things to do although one wrote suggesting that their ability to decide what to do is more limited during the day time than it is when they are in their home. One person says Im very happy with my life now. People told us about the things they do. One person enjoys cooking and currently helps the chef at the main kitchen in the Rookery - a large care home across the road and part of the same company. Care Homes for Adults (18-65 years) Page 22 of 36 Evidence: One person enjoys making garden ornaments like planters and trellis from wood, and told us about doing these as well as showing us some of what they had made. Another told us about the digital photography course they had started. There is also a computer in the home and one person says that use it sometimes but havent done it for a while. Another person told us they are going to a music course tomorrow. People told us they keep their rooms how they like them and sometimes spend time there so I can chill sometimes if I want. Two people told us about the visits they make to their family. The organisation owning the home has a history of supporting people with relationships. We heard the staff on duty talking to people about their day, plans and the mealtime routine. These conversations were quiet, calm and respectful. One person was reassured and calmed by a staff member on duty, having become agitated about something they had lost. People living at the home help with the cleaning and gardening and the aviary. Mealtimes are flexible. People say they like the food. The evening meal when we visited was steak pie and fresh vegetables. One person said they dont like mash and so they had their potatoes whole. Meals are mostly taken at the table in the kitchen/diner, although there is also a dining table in the main lounge which could be used if someone preferred. Care Homes for Adults (18-65 years) Page 23 of 36 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 . Peoples personal and health care needs are met in the way they require and prefer. Evidence: People do not need a lot of support with managing their personal care. If any reminding, prompting or supervision is needed, this is set out in support plans. Support plans also recognise esteem issues and that one person likes to look nice. The support team is predominantly male so people can be offered any assistance or supervision they might need by staff of the same gender - subject to occasional constraints on the duty roster when an experienced female staff member covers shifts. Records show that peoples times for getting up and going to bed vary according to what they have planned for the day. We saw people were able to stay up late if they wished and to lay in at weekends. Health Books have recently been started. These have been devised by the local learning disabilities team and provide for setting out a range of problems. As yet they are not all fully complete. For example, one person had no reference to mental health issues in their health books but a clear reference to issues in their care plan. Care Homes for Adults (18-65 years) Page 24 of 36 Evidence: The main carers in the home have worked there for some time and so have got to know about peoples needs in some depth. The people living there say they like the staff and that the staff treat them well. We looked at medication storage and administration. One person administers their own medicine and confirms that they keep it - I do that myself. The role of staff in giving supplies to them is recorded as staff sign the medication chart and can monitor that the person has run out at the right time so is still taking it properly. There is information about pain relief for one person, showing the maximum dosage they can have. One box of over the counter pain killers has been annotated to remind staff that they need to complete the medication administration record if they give this when someone needs it. There is information about the side effects of medication and where this is likely to have an impact on someone (for example by weight gain) there is additional information in support plans. The drugs storage cabinet would not comply with regulations for storage of controlled drugs should these be prescribed. Care Homes for Adults (18-65 years) Page 25 of 36 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 . People living at the home are able to raise their concerns and can be confident they will be taken seriously. There are measures in place to help ensure people are safeguarded from abuse. Evidence: People who wrote to us all know who to speak to if they have concerns, and the staff who wrote say they know what to do if someone expresses concerns. People we spoke to say they are happy at the home and like the staff. One person singled out two of the most regular staff and said that they have supported me. Im grateful for what theyve done. During our visit we heard a staff member dealing with a situation that could have escalated, responding calmly and reassuringly. We heard a number of interactions taking place between the staff on duty and people living at the home. We observed that people living at the home showed no reluctance to approach either staff member. Staff have training in recognising and responding to abuse. The people living at the home have access to the manager and administrative support in the main house to raise any concerns. They are also able to do so via the regular monthly visits made by one of the directors. These always provide for discussion with people living at the home. The annual survey also provides for people to raise any concerns and the results and follow up from these show that any issues they do raise are followed up. Care Homes for Adults (18-65 years) Page 26 of 36 Evidence: There are regular checks to make sure that peoples finances are managed appropriately, where staff are involved in this. They are also checked at monthly visits and by a deputy manager with responsibility to assess these. The staff member we spoke to was clear about the process and the checks that are made. However, one persons tin was 11 pence short of the stated balance. Care Homes for Adults (18-65 years) Page 27 of 36 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 well maintained, comfortable and clean environment, which suits their needs and encourages their independence. Evidence: There are regular checks on fire safety in the home and the safety of the premises is checked on a regular basis as part of the monthly visits to monitor service quality. This makes sure that any maintenance issues are taken up and addressed promptly. People told us about some of the work they do in the garden. During our visit, people gathered in the kitchen/dining area, or used their own rooms. They also have access to a large lounge with another dining table, computer and television. People told us that they keep their rooms how they would like. One told us I chose the colour and I decided that I wanted to change it round. A staff member had helped the person move things about to try a different room layout. Everyone living at the home is independently mobile, and so there is no need for aids or adaptations for them to access the facilities of their home. Care Homes for Adults (18-65 years) Page 28 of 36 Evidence: Areas of the home that we saw, were clean. The two members of staff who provide most of the cover have both had training in infection control, seen on their personnel files. While we were there, a staff member was discussing with the person who was cooking, good food hygiene practices about washing their hands and not wearing jewellery because it could harbour germs. This shows staff are aware of the importance of minimising the risk of the spread of infection and of food safety, and that they try to share this with people living at the home. Care Homes for Adults (18-65 years) Page 29 of 36 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 are supported by an effective, consistent and competent staff team who understand their needs. Evidence: Staff wrote that they felt there were enough of them to meet peoples needs. Two staff provide most of the cover, and so have got to know people who live at the home very well. People feel that staff support them well and that they like those who work with them. We looked at training records for the two people who cover most of the shifts. These show a range of training. Occasionally, shifts are covered by other staff who also work in the main home across the road. Courses include health action plans, training in the management of medicines, induction (for a new staff member), infection control, nonviolent crisis intervention, first aid, autism and challenging behaviour for example. The senior member of staff has a National Vocational Qualification, level 3, in promoting independence. This helps provide underpinning knowledge to show that staff can support people competently. One other temporary staff member also has a qualification. This means that two out of three people have formal qualifications to help them in their work. Care Homes for Adults (18-65 years) Page 30 of 36 Evidence: Recruitment files show that proper checks are made before people start work, to ensure that they are suitable to work with people who may be vulnerable. At times, the level of supervision for staff shows some slippage so that they do not meet with their manager as often as is set out in standards. However, this has improved since the recruitment of the new manager so we have not made a requirement. Care Homes for Adults (18-65 years) Page 31 of 36 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 . People benefit from a home that is effectively run and where they are consulted. There are measures in place to develop and improve the service further. Evidence: The manager for this home also oversees the main home at the Rookery, and one other small home. He is appropriately qualified and - since the fieldwork visit was carried out, has completed his registration with the Commission. He is supported by an administrative team and general manager, and by deputy managers who have specific areas of responsibility. The manager sent us the information we asked for about the service. This told us what we needed to know and included a good range of evidence to support what the service was doing well. It was also clear that the manager has looked at what can be improved even further and that we will be able to monitor he is making these improvements in future reviews of the service. There are annual surveys to find out what people think of the home and there are regular, less formal meetings for people to make suggestions about what they would like to see happen. They also have regular access to one of the directors, who visits monthly to look at the quality of the service. This shows that the Care Homes for Adults (18-65 years) Page 32 of 36 Evidence: quality of the service is monitored and that people using it can have some say in how it develops. People say staff listen to them. There are risk assessments in relation to the premises. However, many of them have not been reviewed to see if they are still effective and relevant in promoting safety in this particular home, since July 2007. The portable electrical appliances were overdue for testing but the manager took action to address this while we were on the premises. We briefly checked training that would contribute to promoting the safety of people living and working in the home. Staff have access to training in health and safety, fire safety, first aid, dealing with challenging behaviour, and moving and handling where appropriate. First aid training has recently been updated. This shows that staff have underpinning knowledge that would contribute to promoting peoples safety and welfare. Care Homes for Adults (18-65 years) Page 33 of 36 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 34 of 36 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 Financial records should be traced back to see where an error has crept into records. If it is not possible to identify where this has happened the person should be recompensed the small amount of monies for the discrepancy. This is to identify whether there is a genuine mistake and to correct it. 2 42 Risk assessments for the premises should be reviewed and updated, to make sure they relate specifically to this home and how risks at Strawberry Field are to be managed and minimised. This is to promote the safety of residents and staff. Care Homes for Adults (18-65 years) Page 35 of 36 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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