Inspection on 27/02/09 for The Hollins

This inspection was carried out on 27th February 2009.

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

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

Other inspections for this house

The Hollins 07/03/07

The Hollins 14/02/06

The Hollins 17/10/05

The Hollins 29/03/05

The Hollins 11/10/04

The Hollins 11/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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: The Hollins 260 Congleton Road Butt Lane Kidsgrove Staffordshire ST7 1LW     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: Deborah Sharman     Date: 2 7 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 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 Hollins 260 Congleton Road Butt Lane Kidsgrove Staffordshire ST7 1LW 01782779211 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) : Mr David Joseph Woodcock,Mrs Dorothy Woodcock care home 3 Number of places (if applicable): Under 65 Over 65 1 learning disability Additional conditions: Date of last inspection Brief description of the care home 3 The Hollins is a large detached house set back from a busy main road between Stokeon-Trent and Congleton, near to the town of Kidsgrove. The home is within walking distance of a number of shops and is on a main bus route to the city centre of Stokeon-Trent. The home comprises on the ground floor, three lounges, a large kitchen and dining area, a conservatory, a spare room that was once used as an office, a utility room, toilet and shower area. The first floor consists of five bedrooms; two bedrooms are for the sole use of Mr and Mrs Woodcock and family members. There is a large bathroom/shower/toilet and a separate toilet. Outside there are well maintained enclosed gardens and a large double garage. The property is accessed from a long drive leading from the main road to the rear of the building. The furnishings, fittings and decor had been completed to a high standard throughout. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The home is registered to accommodate up to three people with a Learning Disability. However, there are currently two ladies in residence and it is understood that the proprietors do not wish to take any further residents. The proprietors share the duties of running the home and providing care, with personal care being the responsibility of Mrs Woodcock. We did not request fees and this information should be sought directly from the provider. Care Homes for Adults (18-65 years) Page 5 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: One Inspector carried out this unannounced key inspection on one day over a period of 3.5 hours. As the service is run from a family home we wanted to be sure that people would be in when we arrived to inspect. Therefore we telephoned the registered persons the day before to tell them of our intention to visit the following day. This means that although they had very little time to prepare, we consider this to be an announced inspection. As it was a key inspection the plan was to assess all National Minimum Standards defined by us as key. These are the National Standards which significantly affect the experiences of care for people living at the home. Care Homes for Adults (18-65 years) Page 6 of 29 Information about the performance of the home was sought and collated in a number of ways. Prior to inspection we were provided with written information and data about the home in an Annual Quality Assurance Assessment or AQAA. This is a legal self assessment document where the service must tell us what they do well, what has improved, what they could improve and how they intend to do this. We use this information to plan the inspection and make a judgement about the service provided. During the course of the inspection we used a variety of methods to make a judgement about how people are cared for. Both registered people were available throughout the inspection to answer questions and support the inspection process. Both people who live with the registered persons and receive their support were also available. We spoke to each person separately about the care and support they receive at The Hollins. The people living and receiving care at The Hollins are known as the ladies. We have used this term from time to time when referring to them collectively. We also assessed the care provided to the ladies using care documentation and we sampled a variety of other documentation related to the management of the care home such as maintenance, training, accidents and complaints. We toured the premises. All this information helped to determine a judgement about the quality of care the home provides. What the care home does well: What has improved since the last inspection? What they could do better: The ladies remain happy and well cared for. We did identify and agree some matters requiring attention to ensure on going safety and welfare. The registered person informed us that one person had not received two doses of medication on one day recently following an error by the dispensing chemist. This helped us to understand that medications are not being checked in when received by the home. Checks upon delivery would ensure there is time to manage any discrepancies before the medication is needed and the chemist is closed. Medical advice in the event of any omission or error should also be sought and acted on. We should also be informed of these incidents so that we can monitor any trends and possible changes in service quality. The registered persons are aware of the need to ensure portable appliances are checked by a competent person to minimise risks of injury from faulty electrical products in the home. These tests are overdue and when complete should be carried out annually. Fire safety equipment is being regularly tested by the registered persons but should be included in a regular service maintenance programme to ensure it continues to work effectively and faults can be detected early by a competent person. We have advised Care Homes for Adults (18-65 years) Page 8 of 29 the registered persons to seek advice about this and other fire safety related matters from the Fire Service. The ladies clearly told us that they feel safe at The Hollins. We have advised the registered persons to make enquiries about attending Safeguarding training to ensure they keep themselves up to date with developments and changes in this important area. 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At the last inspection we judged that suitable assessments had been carried out prior to admission so all parties could be confident that the home could meet their needs. There have been no changes since and as there are no changes planned, we therefore consider these standards to remain good. Evidence: At the last inspection in March 2007 practice in this area was judged as good. The two people living there had been suitably assessed before moving in and we commented that they had lived as part of the family for a long time. We also commented two years ago that although there was a vacancy for a third person the registered persons did not wish to admit anyone else. There have been no changes to arrangements with one lady having lived as part of the registered persons family for 14 years and the second lady for six years. The registered persons verified again at this inspection that they do not wish to fill their vacancy, adding that should anyone move out for any reason, they would not be Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: seeking to admit anyone else. On this basis, we did not assess these standards further. Care Homes for Adults (18-65 years) Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive support in the way they need and prefer with their abilities recognised and promoted. Hazards are recognised and steps are taken to ensure people are protected from unnecessary risk. Evidence: Little has changed since the last inspection. Each person has an individual plan of care that had been reviewed and updated in January 2009. The plans describe each persons abilities and ambitions as well as the support they need. Risks have been identified that are pertinent to each person and safe ways of managing these risks are described in the updated care plans. The two ladies who live at The Hollins told us that they have seen their care plan. The registered persons told us they are involved in reviewing both ladies needs in partnership with day care and funding authorities. We could see how independent day centre staff had spent time in 2008 with one lady reviewing her satisfaction with the Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: service she receives at The Hollins by asking a series of questions and recording her responses which were very positive. We spoke to both ladies individually. It was clear from these discussions that they are happy with the care they receive, are able to make choices in their day to day lives and value living as part of the registered persons family. It is evident too that the registered persons value the two ladies who live with them. They know each of them very well indeed and described how much a part of their immediate and extended family they are. We were told that they bring them a lot of sunshine. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live as part of the family and have the opportunity to participate in family and community activities. Their dietary needs are understood and they enjoy their meals. Evidence: At the last inspection we found the ladies enjoyed an excellent lifestyle and little has changed. We could see from records that in April 2008 one person attending day care had told staff there they are happy and enjoyed participating in domestic tasks, going to bingo, going on holiday as well as enjoying meals. The second person, an older lady has a more sedentary lifestyle but is no less satisfied. At this inspection both ladies told us they continue to be happy with their lives. A trip to Bulgaria is planned again for April 2009 and one lady told us that she likes going to the house with the swimming pool. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The other lady prefers to stay at home and this is facilitated. We could see that dietary needs and preferences are known and acted on. Both ladies said they enjoy their meals, enjoy shopping for food and we could see that they had had different things for breakfast to accord with their individual tastes and preferences. Care Homes for Adults (18-65 years) Page 16 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 good 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 the way that they need and want. Changes in health are recognised and advice is sought. Some aspects of medication management could improve to reduce the risk of error and to ensure people always receive their medication as prescribed to promote good health. Evidence: We talked to both ladies and found that they both receive support with personal care in a way that recognises their abilities but supports their needs. One lady prefers a shower and the other a bath and these facilities are available to them. It is positive that following a fall in 2007, the registered persons have installed a ground floor shower and provided a ground floor bedroom for one of the ladies who needs to avoid using the stairs. Health records were available and showed us that the doctor is consulted about any health concerns. One lady is diabetic and has received regular foot care and diabetic eye screening. The registered persons could describe steps they take to promote good health and were pleased that one lady had been healthy in 2008, managing to avoid Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: her usual regular health condition. The registered persons described how they enjoy a positive relationship with a supportive doctor who undertakes to offer them same day appointments if required. We could see that blood sugar levels are taken and recorded weekly for the person who has diabetes. Clinic appointments have been reduced from 3 monthly to six monthly as the condition was considered to be stable and well managed. Records show blood sugar levels to have recently exceeded the target range. We looked at how medication is managed for one lady. An error in dispensing by the pharmacist has highlighted some things that need addressing. We were told that the pharmacist had omitted to put a weeks supply of a drug taken for diabetes in the blister pack. This was not noticed until the drug was needed on the Sunday by which time the pharmacy was closed. Consequently this person missed her twice daily dose that day. We have agreed the need to always check medications upon receipt so remedial action can be taken in time to avoid omissions in administration. Also in the event of missed medication or any other error to seek, record and act upon the advice of a doctor, pharmacist, or the telephone advice service, National Health Service Direct. Also we identified the need to ensure medication records accurately reflect administration given that we could see the missing medications had been signed for as given. The registered person recognised that this matter should have been formally reported to us. Care Homes for Adults (18-65 years) Page 18 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. People living at The Hollins feel safe and are confident that the registered persons listen to them and sort out anything that worries them. Evidence: No complaints or allegations have been made. Both ladies told us that they tell the registered persons if anything is worrying them and they sort it out for them. Both ladies have reported feeling safe where they live and couldnt think of anything that could improve. They have access to their money, which is looked after for them, and systems are in place to account for any expenditure. The registered persons have not received training in adult protection or safeguarding, as it is now known. We have asked them to consider this and to make enquiries about it. Care Homes for Adults (18-65 years) Page 19 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live as part of a family in the family home which is comfortable and well maintained and has been adapted to meet needs. Evidence: The registered premises is the registered persons family home where they live. They share it with the two ladies they support providing them with the benefits of a comfortable, warm, well maintained and furnished home. Steps have been taken to adapt the environment to meet one ladys changing physical needs. She now has a downstairs bedroom. As this was formerly a sitting room, the gas fire has been disconnected to make it safe and an electric bell has been installed at the side of her bed so she can alert others upstairs at night should she need help. The registered persons are advised to seek the advice of the Fire Service about these new sleeping arrangements. Furthermore a downstairs shower room has been built to enable her to receive her personal care safely. Both ladies have access to bathing facilities which meet their preferences. On the day of inspection improvement works were being carried out. One lady was particularly pleased that she was having a new basin and cupboards installed in her bedroom. We were shown both ladies bedrooms which are personalised to reflect their Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: interests. Care Homes for Adults (18-65 years) Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live as part of the family where the registered providers and a family member provide all care. This provides a small family environment with close family relationships and continuity of care. Evidence: Nothing has changed since we last inspected. The registered providers own and live within the registered home and they share their home and their lives with two ladies who they provide care and support to. The registered persons spoke positively about the people they share their home with. When we talked to the ladies who live with them, mutual respect and care was apparent. One person said Dorothy looks after me and the other person said, David has a laugh and a joke with me. One other family member supports the registered persons weekly, or as required. This situation has not changed and we confirmed at the last inspection that appropriate checks had been carried out to ensure this persons suitability to work with vulnerable people. The registered persons confirmed that this arrangement has not changed and no other carers are involved. The registered persons have not done any further training since the last inspection in Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: 2007 to update their knowledge and skills, but will consider doing Safeguarding training. Care Homes for Adults (18-65 years) Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is organised in the interests of the people who receive the care and support of the registered persons. The home is maintained to protect peoples health and safety. Some matters requiring further action and advice have been identified. Evidence: The two ladies are happy living at The Hollins. It was positive that steps had been taken to confirm this independently for one of them in 2008 when a staff member from the day centre discussed aspects of care at the Hollins with her. We were told that reviews are in place to monitor service satisfaction generally. It is a legal requirement for registered services to complete an annual return or AQAA. This tells us what they believe they do well what they need to improve and any changes which may have arisen. The registered persons returned their annual return to us in time by the date requested. We found it to be brief and the registered persons agreed. We have advised that next time, they support their general comments with examples of care over the preceding 12 months to demonstrate what the outcomes for Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: people have been. A range of systems and checks are in place to ensure peoples safety and welfare is protected. We could see that hazardous chemicals are locked away and that the following service maintenance checks are up to date. Electrical wiring report for premises and the new shower, a gas landlord certificate, insurance, a fire risk assessment, environmental risk assessments, fire drills services of fire Extinguishers. We could also see that hot water temperatures are monitored and one lady told us that the registered manager always runs the bath for her and helps her into the bath in case she burns herself. She also described to us what she must do in the event of a fire. We agreed that the registered persons need to ensure fire alarm and emergency lighting systems are regularly serviced in addition to the weekly and monthly self tests carried out. We have also encouraged the registered person to seek the retrospective approval of the fire officer to changes made recently by an electrician to the smoke and fire detection system. Electrical safety tests on portable appliances have not been checked since 2003 and this requires prompt attention now, as we would normally expect this to be done annually. Care Homes for Adults (18-65 years) Page 25 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 26 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 20 13 In the event of any error or omission in medication, medical advice should be sought, recorded and acted upon. The matter should also be reported to CSCI under regulation 37. This will ensure appropriate action can be taken to safeguard and promote the health and welfare of the person. 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 Upon receipt or delivery of dispensed medication, the registered persons should take steps to check that dispensed medication accurately tallies with medications prescribed and ordered. This will ensure that any errors can be identified and corrected quickly to enable people to take their medications as prescribed and to reduce associated risk. Records should be kept of medication received on to the Care Homes for Adults (18-65 years) Page 27 of 29 premises at the time of delivery ie name, dose and strength of drug plus the date and the number or amount received. 2 3 23 42 The registered persons should attend Safeguarding training. The registered persons should seek the advice of the Fire Officer about recent changes made to the smoke detection system. Fire alarm and Emergency lighting systems should be serviced regularly. Advice should be sought from the fire service. Someone qualified should check portable appliances as this is overdue and thereafter they should be re checked annually. 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. 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