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Inspection on 28/01/09 for The Corner House

Also see our care home review for The Corner House for more information

This inspection was carried out on 28th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The home offers choices about how they spend their day and provides individual support for the people living there. The home is comfortable in appearance, well maintained and set in quite part of the town. The Company provides good training opportunities for staff.

What has improved since the last inspection?

This section is not applicable as this is the first inspection for this service.

What the care home could do better:

The home needs to establish it self as a care home for people with a learning disability and admit people to the home that meets the Statement of Purpose. Designated staff need to be appointed in line with recruitment policy and procedures . The registered provider needs to monitor the operations of the home and undertake the regular monthly visits.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Corner House The Corner House 65a Welbeck Street Whitwell Worksop Notts S80 4TW     The quality rating for this care home is:   one star adequate 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: Nancy Bradley     Date: 2 8 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 29 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 29 Information about the care home Name of care home: Address: The Corner House 65a Welbeck Street The Corner House Whitwell Worksop Notts S80 4TW 01909720899 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) : Mrs Ann Gibbins,Dr Edward Marcion Ranjit De Saram care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The maximum number of service users who can be accommodated is 3 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 Date of last inspection Brief description of the care home The Corner House is a residential home in the community of Whitwell. The home provides care for adults who have learning disabilities and are aged from eighteen years. The home provides accommodation for people , who share the whole of the house exceptt for their own bedroom. The home provides twenty four hour care. The residents can access the community and local facilities. Care Homes for Adults (18-65 years) Page 4 of 29 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: one star adequate 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 1 star. This means the people who use this service experience adequate quality outcomes. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. This was an unannounced key inspection and took place over a total of three hours. We spoke with the registered manager. The home currently has only one person living there and on the day we visited was visiting another home within the Elm Care Group. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the registration. This included Care Homes for Adults (18-65 years) Page 5 of 29 the following: The annual quality assurance assessment that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the home. The one person living at the home was case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at support plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. Additionally, time was spent in preparation for the visit, looking at the service history. Records were examined relating to the people living there and the general running of the home. The home has been open since August 2008. We gave out one Have Your Say questionnaires for the person living at the home who confirmed they were very happy at the home and were looked after by the staff. We received four completed questionnaires from staff all were very positive about the working for the Elm Care Group. 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 7 of 29 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 8 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are place to ensure that peoples needs are fully assessed prior to admission. However the lack of comprehensive assessments may compromise service delivery and care. Evidence: During the site visit the care details of the most recent person admitted to the home was examined. The home only has one person living there who was an emergency admission. The home was registered in August 2008 and has not admitted any people on a long-term basis so in the interim period it has provided emergency or respite care. The home has amended its Statement of Purpose to reflect the change of policy. As this was an emergency admission the care needs assessment from the referring authority was not available nor did the home undertake its own assessment. The home is now looking to establish an assessment process for any future emergency and longterm placements. A seventy-two hour review was carried out when the home was given an Occupational Therapy Assessment dated October 2008 stating the person needed personal support to carry out day-to-day household and personal tasks. The Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: home has since given the referring authority notice to terminate the placement, as the person admitted did not meet the registration category. The home was given an assessment from Ash-green hospital dated 2005, which indicated the person did not have a learning disability. The person living at the home stated information was provided about the home and they thought the home sounded nice place to live. Care Homes for Adults (18-65 years) Page 10 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Inconsistencies in the method of care planning system, recording and risk assessments may compromise service delivery. Evidence: During the visit the care plan of the one person who lives at the home was seen. The registered manager had compiled the care plan and evidence was seen of care plan having been reviewed. The home currently uses the style of care planning operated by Whitwell Park Care Home, the registered manager confirmed they are looking to develop their own style of care planning and to include a more person centred approach. The person living at the home was case tracked and had a care plan, which was in accordance with their needs and formulated within a risk assessment. This persos care plan detailed their individual lifestyle preferences and choices; and the interventions prescribed by outside healthcare professionals were appropriate. The care staff had Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: completed daily living and night records on each person. The home is not operating a key-worker system at this time. There was no evidence to indicate that life experiences work had been undertaken with person living at the home. The home has yet to establish a formal reviewing system. We discussed with the manager people having access to the local Advocacy Services. This has yet to be established. Risk assessments were in place covering such issues as, peoples health and safety, physical health, nutrition, mobility, and risks associated with social activities. Care Homes for Adults (18-65 years) Page 12 of 29 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. There were arrangements in place to enable people to maintain and develop appropriate relationships and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. Evidence: The care records of one person from the home seen provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and the wider community. The person spends their day at Whitwell Park residential unit and joins in with the activities offered there. They take the majority of their meals at Whitwell Park and returns to the Corner House before bedtime. The registered manager stated they are building a good relationship with the person at the home, however relationships can be difficult when they is only one person living there. The staff encouraged the Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: person living at the home to take pride in their appearance and their dress sense is respected. The daily routines are flexible with people being able to make their own decisions about how they spend the day. The person living at the home is being encouraged to be as independent as possible to take responsibility for some of the household tasks, such as tidying their room and keeping the communal living area tidy. The person living at the home is unable to work. Their personal goals, choices and preferences have been identified and properly recorded risk assessments. Activities and days out were not always fully risk assessed. Information on records indicated that contact with family and friends were appropriate. Restrictions and contact arrangements were not fully recorded in the persons care plans. People at the home can speak with family, friends by telephone and receive mail. The home is not maintaining a full current record of all meals taken. The person takes their meals at Whitwell Park Care Home and only has breakfast at the Corner House. Care Homes for Adults (18-65 years) Page 14 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in ways, which enables them to be independent. However the inappropriate placement effected and inconsistencies in the health care assessment may leave people vulnerable and at risk. Evidence: During the visit it was clear that the peoples privacy and dignity were respected where supervision during personal care is required. The person stated they really like the company of the staff and being with other people from Whitwell Park. On the day of the visit the person was out with their support worker. Discussions with registered manager indicate that they had insight into the individual needs of the person and they were committed to supporting and assisting them as far has they could. People were generally healthy and records show that staff promptly contacted the appropriate medical services when necessary. Information in the AQAA indicated the home is looking to implement a health plan and include this in the persons overall care Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: plan. Annual health checks will be through Ash Green hospital. The home did request a medication review however when information highlighted the person did not have a primary learning disability they were unable to facilitate the review. The home has registered the person with the local Doctors and medical services. The home has information sheets where all visits made by people at the home to the G.P.s opticians, podiatry, dentists, audiologist, and speech and language therapist, can be recorded. The home operates and monitors peoples medication, as none of them are able to administer their own medication. The arrangements for receipt, storage, administration and disposal of medication were examined and found to be satisfactory at the time of this site visit. The medication is kept at Whitwell Park for security as the home is not fully operational and no one is there in the day. Care Homes for Adults (18-65 years) Page 16 of 29 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. There are suitable arrangements in place to safeguard peoples welfare, which enables their concerns and complaints to be listened to and acted upon. Evidence: The home has a complaints procedure, which is included in the service user guide which all pf the people living at the home have a copy of. The complaints procedure is also displayed throughout the home. The home has yet to develop an easy to read format Records seen indicated that no complaints had been made about the home since the registration in August 2008. The Commission for Social Care Inspection has not received any concerns about this home. The procedure contains the new complaints address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaints process if they wish to do so. Discussions with the care staff and records seen indicate there have been no reported incidents or allegations under the safeguarding of adults procedure since registration. Several of the staff have received training on safeguarding of adults. As discussed with the registered manager the policy did not show the contact details for the local social services office or call Derbyshire. Care Homes for Adults (18-65 years) Page 17 of 29 Care Homes for Adults (18-65 years) Page 18 of 29 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 safe and well-maintained home, which suits their needs and promotes their independence, privacy and lifestyle. Evidence: A full tour of the building was conducted with the registered manager from the home accompanying us. All communal areas were viewed together with staff facilities. Peoples bedrooms were inspected with their agreement and all rooms had been personalised. The home was clean, well maintained, well furnished, equipped and well lit and heated. Bedrooms seen were of a good standard, however they did not have all the required furniture and fittings. The registered manager agreed to address this issue. People stated they were pleased they were with their bedrooms and general living arrangements. There is know outstanding maintenance issues. The home has effective hygiene controls in place. Care Homes for Adults (18-65 years) Page 19 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of suitable recruitment and selection procedures may leave people vulnerable and at risk. People are well supported by an effective staff team who are appropriately trained. Evidence: The staff from Whitwell Park Care Home residential unit provides cover as required. This is usually in the late evenings, sleeping in duty and first thing in a morning. All staff who provide cover have an NVQ level 2 or 3. Staffing is one to one. Several staff have stated an interest in working at The Corner House and the home is looking to implement a recruitment and selection policy. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a probationary period. However the companies application form does not indicate that a full employment history is required. The form is not requesting the days date, month and year. This was discussed with the registered manager. Completed questionnaires confirmed the Company provides suitable training opportunities. All staff have a Personal development Plan. Records examined and Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: discussions with the registered manager confirmed that the home has a formal structure for supervision of staff. Annual appraisals are undertaken. Care Homes for Adults (18-65 years) Page 21 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of a permanent and purposeful team structure demonstrates the home is not always being run in the best interest of the people who live there. Evidence: The registered manager has a number of years experience in the care sector, and has gained a Recognised Managers Award. Discussion with the registered manager confirmed she has a good awareness of her role and responsibilities. Care staff stated the registered manager is supportive and is available as and when required. The registered manager has completed the Annual Quality Assurance Assessment (AQAA) and as discussed more information is required on how they are going to operate and develop At present the registered provider has carried out no regulation 26 visits and no other quality assurance audits having been undertaken. Information in the AQAA indicates this is an area the home is looking to develop. The home has not been able to establish house meetings. The person who lives there has made positive comments about the home, indicating that they liked the staff the home and socialising with people at Whitwell Park. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to us by way of the AQAA. Systems for monitoring and maintaining the hot water temperatures have yet to be established. Care Homes for Adults (18-65 years) Page 23 of 29 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 24 of 29 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 14 The home must establish a formal care reviewing system. This is to ensure the continuity of care and the home can ensure its meeting the persons needs. 03/04/2009 2 1 6 The Commission for Social Care must be informed of any change to the Statement of Purpose. This is to ensure we have the full information on each home also this is a statutory requirement. 03/04/2009 3 2 14 All referrals to the home must have an updated comprehensive care needs assessment. This is to ensure the home has all the required information and can assess if the person is suitable for the service. 03/04/2009 Care Homes for Adults (18-65 years) Page 25 of 29 4 2 14 The home must undertake its own care needs assessment if one is not provided by the referring authority. This is to ensure the home has all the required information and can assess if the person is suitable for the service. 03/04/2009 5 6 15 Peoples care plan needs to 03/04/2009 show how the home is going to care for them. The care plan must include their changing needs aspirations and goals This is to ensure people know how they are going to be cared for and staff have an understanding of the needs of the people they are caring for. 6 19 13 All people living at the home 03/04/2009 must have an annual health check. This is to ensure people good health is maintained . 7 20 13 The home must ensure all medication at the home is kept secure. This is to ensure the safety of the people who live there. 03/04/2009 8 20 16 A fully record of all meals provided and taken must be maintained. This is to ensure people have a healthy diet . 03/04/2009 Care Homes for Adults (18-65 years) Page 26 of 29 9 34 18 All staff appointed must be in line with the Companies recruitment and selection policy. This is to ensure a fair and even approach and people are fully protected. 03/04/2009 10 34 18 All staff must be interviewed 03/04/2009 and a record of the interview maintained. This is to ensure the correct staff are appointed. 11 39 26 The Registered Provider must undertake monthly visits. This is to ensure the management of the home and to ensure the wellbeing of the people who live there. 03/04/2009 12 39 24 The home must undertake a review the quality of care it provides. This to ensure the quality of care and to ensure stakeholders family ,friends an people using the service have their say heard. 03/04/2009 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 2 The home should inform the Commission for Social Care Inspection of when a termination of placement is issued and its outcome. The home should consider developing its own style of care planning and look to a more person centred approach. Page 27 of 29 2 6 Care Homes for Adults (18-65 years) 3 4 5 6 7 7 9 23 34 39 People at the home should have access to the Advocacy Service Risk assessments must be in line with the assessed need and care plan. The homes Safeguarding policy should show the contact details for the local Social Services office or Call Derbyshire The company should amend its application form to indicate to applicants that a full employment history is required. The register provider should provider more information in to the Commission for Social Care Inspection when completing the AQAA. The home should have alone working policy . 8 40 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!