Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: The Willows Halvarras Park, Halvarras Road Playing Place Truro Cornwall TR3 6HE 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: Michael Dennis
Date: 2 6 1 1 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. 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 Willows Halvarras Park, Halvarras Road Playing Place Truro Cornwall TR3 6HE 01872865588 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): mail@dcact.org Spectrum (Devon and Cornwall Autistic Community Trust) Name of registered manager (if applicable) Mrs Jolene Kim Kitts Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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 either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home The Willows is a home providing personal care and accommodation for up to three adults with a learning disability. The registered provider is Spectrum, an organisation that provides specialist care in small units for people with autism. The aim is to provide them with specialist support in a domestic style environment. There is a manager in charge of the home on a day-to-day basis. A team of care staff assists them. Senior managers from within the organisation are available to provide specialist support and assistance where necessary. The home is located in the village of Playing Place, close Care Homes for Adults (18-65 years)
Page 4 of 29 care home 3 Over 65 0 3 Brief description of the care home to the city of Truro. There is reasonable access to public transport and the home has its own vehicles to assist service users to access the local community. The home is a single storey building, set in its own grounds and is set off the main road. There are three single bedrooms for use by the service users. The home has a combined lounge and dining room, a kitchen, separate laundry room and two bathrooms. There is a lockable office, which also functions as a sleeping in room for staff at night. The home has a large garden and some off- Street parking space. There have been some adaptations, with the provision of grab rails to assist people with specific physical disabilities to access the building. Fees range from #908.17 to #2104.50 per week, according to information provided by the manager at the time of the inspection. There are additional charges for hairdressing, private chiropody, personal newspapers, dry cleaning, alcoholic beverages, off-site entertainment, confectionary and stationary. The costs of these are variable. Information about the home is contained in the home?s statement of p 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: This was an unannounced key inspection, which took place on 26 November 2008. It lasted for approximately five hours. Information about the home received by the Commission since the previous inspection was taken into account when planning the inspection. The purpose of the inspection was to ensure that the needs of people who use the service are appropriately met in the home, with particular regard for ensuring good outcomes for them. People who use the service were met and observation of their daily life and care provided occurred. There was an inspection of the homes premises and of written documents concerning the care and protection of the people who use the service and the ongoing management of the home. Discussions with staff and observations in Care Homes for Adults (18-65 years)
Page 6 of 29 relation to their care practices occurred as well as discussions with the homes registered manager. The principle method used was case tracking. This involves examining the care notes and documents for a select number of people who use the service and following this through with interviews with them and/or their relatives and staff working with them. This provides a useful, in-depth insight as to how their needs are being met in the home. At this inspection, three people who use the service were case tracked. The Commission received the Annual Quality Assurance Assessment, which is a questionnaire that the registered manager completed. The AQAA describes the services and facilities that The Willows provide and identifies what areas they do well in and where they want to make further improvements. What the care home does well: What has improved since the last inspection? The improvements that have been made to the service since the last inspection are that people who use the service are now provided with clear information about the costs of their placements, including more detailed and accurate information on how their personal contributions are calculated. The manager has brought with her knowledge and experience from working within another Spectrum home. She has therefore introduced to staff new documents to work with for example care plan review documents and activity rotas that will benefit the care that people who use the service receive. People who use the service are assisted to access the healthcare services they need, when they need them, with particular reference to dental care. Care Homes for Adults (18-65 years) Page 8 of 29 There were a number of statutory requirements issued at the last inspection and it is pleasing to note that these have been complied with. The homes manager has now been registered with the CSCI. The Statement of Purpose and Service user guide now more accurately reflects the services provided. Care planning documentation was seen to be regularly reviewed and more pertinent to the needs of the people who use the service. Activity programs are more varied with evidence to support the interests of people. Food choices have improved and it is apparent that service users have the opportunity to influence the menu. Medication practices have improved and it is now possible to conduct an audit of medication from the ordering process through administration to the return of unwanted drugs. Storage facilities now comply. Staff training has improved with staff taking NVQ courses as well as other short course relevant to the work they do. Improvements are noted to the environment. 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 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.The Statement of purpose has been reviewed and updated so that it accurately reflects the service that The Willows provides for people who use the service and their representatives.People who use the service are assessed prior to their admission so that they can be confident it will meet their health, personal and social care needs. Evidence: There have been no changes to the service user group since the previous inspection. From observations and talking with people who use the service it was evident that they are settled in the home, and that they get on well with each other and with the staff. The homes manager has updating the Statement Of Purpose and Service Users Guide to reflect accurately the services, facilities and staffing arrangements of the home. People who use the service and their representatives can then have accurate information on what The Willows provides. From documentation inspected it was evident that admissions are made following a full
Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: assessment and in consultation with the service user, their family or advocate, and relevant professionals. All of the people using the service had up to date contracts. When reviewing documents please ensure the CSCI address at Bristol is used for contact purposes. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.Individual care plans have been updated to address the persons health, personal and social care needs, including needs relating to their individual and diverse backgrounds. They are able to take safely managed risks and make important decisions about their lives so that they develop their skills and independence. Individual risk assessments are comprehensive and fully reflect any necessary restrictions to protect them or other people. Evidence: People who use the service, their family, advocate and relevant professionals are involved in the development of individual care plans and their subsequent reviews. The reviews record their views so that they are aware of the purpose of their placements in the home and are able to contribute to the ongoing care planning process. The care plan has specific headings to address the individuals health, personal and
Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: social care needs, including their diverse needs. These now more accurately reflect the individuals care needs and direct, inform and guide staff as to what actions are needed to provide care to the person. It was noted that all care plans are regularly reviewed. The manager has introduced the updated format of Personal Care plans which provide service users with specific goals to work towards, and inform and direct staff in how to support the person to achieve this goal to encourage them to fully maximise their skills for independent living. People who use the service participate in making decisions about important aspects of their daily lives, according to their individual abilities and this was observed during the inspection. Staff were observed supporting people who required it, to make decisions about what to do during the day. People who use the service can choose the level of privacy they wish to enjoy in their private accommodation. Spectrum has undertaken an internal review of all its restrictive practises towards people who use the service to ensure that any restrictions placed on them are necessary and in their best interests. People who use the service are able to take managed risks, backed up with written risk assessments and risk management plans, particularly with regard to their engagement in higher risk activities. These risk assessments are formally reviewed at six monthly intervals. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.People who use the service are able to take part in a range of activities in and out of the home so that they develop their skills and confidence. They are supported to maintain valued social and family relationships so that they are not isolated or institutionalised. The menus and range of activities are clearly documented. Evidence: A revised activity rota has been implemented so that people who use the service have information, in pictorial formats about the different activities available to them and they can plan and choose what they will do each week with staff. Each person has an individualised activity program which is evidenced the activity log backed up by photographs of the events taken place.
Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: People who use the service have contact with their families, including regular visits to/from relatives. Needs in relation to their developing personal relationships are considered as part of the ongoing assessment and care planning process, including specific risks. Greater choice is now available to people regarding the food provided. Everyone is given the opportunity to choose their meals and this process is aided by a series of pictures showing the various dishes. 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.Peoples personal and healthcare needs are well met so that they are able to live full and active lives in and out of the home. Medication systems have been improved and no errors in administration were found. Evidence: People who use the service appeared to be attractively and fashionably dressed and were well groomed so that they can comfortably take part in community life. The home has suitable bathroom facilities so that they can attend to their personal care in private. For people who use the service their healthcare needs are considered as part of the care planning process and regularly reviewed. Documentation showed that access to external healthcare providers, including specialists, occurs when needed. Medication is now stored in an appropriate lockable cabinet secured to the wall in the office. Records of the receipt, disposal and administration of medication are available
Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: and accurately maintained Evidence was presented to confirm that staff handling medication have received appropriate training. The homes medication policy and procedure has been updated to reflect current practice. 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. This judgement has been made using available evidence including a visit to this service.People who use the service are listened to and respected so that their views, concerns and complaints are taken seriously and acted upon. There are formal and informal systems in place to ensure that they are able to feel safe in the home. Evidence: People who use the service were encouraged to speak to the inspector if they wished in private or with staff present so that they could make their views known or raise any concerns. No concerns were raised and the home or the Commission has received no complaints. People who use the service are provided with written copies of the homes formal complaints procedure and have formal and informal opportunities to raise any concerns with staff before they become serious complaints. The home has written procedures to guide staff on what to do if they suspect a person is at risk of abuse. There are records to show that staff are recruited on the basis that they are suitable to work with vulnerable adults in a care setting and appropriate checks are made. Residents are not isolated in the home, but take part in a range of activities in the local community and have relationships with people from outside of the home that they can communicate serious concerns to. Spectrum has a whistle blowing policy. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: The manager attended the Multi Disciplinary Adult Protection course. The home does have a copy of the Cornwall Multi agency adult protection procedure. Other staff are also attending appropriate training. Service users monies are audited at Spectrum Headquarters on a regular basis. We inspected the procedure currently in place regarding the management of peoples money and found this to be satisfactory. Care Homes for Adults (18-65 years) Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. Improvements to the homes decor and furnishings have been made to allow a more comfortable and safe home for Service users to live in. More needs to be achieved before an improved rating can be awarded in this area. Evidence: People who use the service appeared to be happy in the home. It is well located so that there is good access to the local town. It is an ordinary, domestic building so that they live in a non-institutionalised environment in which they can develop their skills and become more independent. A tour of the premises identified that improvements have been made since the last inspection. For example: some redecoration of communal spaces and bedrooms has occurred. One bedroom is rather sparse in terms of furniture but this suits the needs of the person who occupies the room. The other bedrooms are personalised and again meet the requirements of the occupants. Communal areas have been refurbished to include new dining and lounge furniture. The home presented as being reasonably clean and tidy. A previous water tank leak
Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: has been repaired. The laundry room still remains adjacent to the kitchen and is not ideally sited. Refrigerators remain sited in the laundry area which is unsatisfactory as soiled laundry enters these premises and therefore infection control risks are high. New fire doors have been installed throughout. It is recognised that improvements have been made but additional work still needs to be considered, specifically to kitchen, laundry and bathroom areas. Care Homes for Adults (18-65 years) Page 22 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. Quality in this outcome area is goodThis judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient numbers at all times so that service users can have confidence that people working with them are competent to do so. Staff are recruited fairly, safely and effectively on the basis that they are suitable to work with vulnerable adults in a care setting. They have access to ongoing training. Evidence: The minimum number of staff on shift at any time is two. However the staff rotas demonstrated that three care staff are on duty from 8am to 10pm, which allows people who use the service the opportunity to partake in their individual activities. One sleeping in staff member is on duty with on call for support if needed. Staff spoken with felt the daytime staffing levels were sufficient. The manager risk assesses the need for additional staff according to the needs of residents. According to the manager and records held in the home, less than the recommended 50 of care staff are qualified to NVQ level 2, however all but one person, all are currently undertaking NVQ qualifications with two staff almost completing the course. This will shortly mean that the home will achieved a ratio of more than 50 per cent
Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: having an NVQ. Staff recruitment records inspected evidenced that staff have undergone the necessary clearances before they commenced employment at the home. An induction programme for new staff is implemented. Care staff have individual training records and those interviewed during the inspection confirmed that the training has been beneficial to their work. The staff team have now received training in infection control, moving and handling, and fire training. Adult protection training is on going. From the evidence presented it is apparent that staff receive regular supervision. Care Homes for Adults (18-65 years) Page 24 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. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The homes manager has now been successfully registered with the CSCI. The home is well managed for the benefit of people who live there. There are systems in place to protect those who live, work or visit the home from avoidable harm and injury. Evidence: On the 1st November 2007 Ms Jo Kitts was appointed as manager for The Willows and is now the registered manager for the home. She has gained a NVQ level 3 and is in the process of completing her NVQ level 4 in care. She has also completed the NVQ 4 in management and has many years experience in working in this care sector. Staff spoke highly of Ms Kitts skills and felt that she was approachable and listened to their ideas or concerns. From observations people who use the service were comfortable in her presence. Ms Kitts has sixteen hours dedicated administration time.
Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Records are stored confidentially and were seen to be competently maintained. The homes environment in the main appeared safe and there is written individual and environmental risk assessments in place to minimise risks to people who use the service and staff working in the home. Maintenance of the home and its equipment are satisfactory. A quality assessment survey has been completed and the required regulation 26 notices were available at the home. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R 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 1 30 13(3) The manager must ensure 30/01/2008 that the home promotes and actions infection control guidance so that people who live, work or visit the home are not placed at unnecessary risk. Care Homes for Adults (18-65 years) Page 27 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 30 8 The Manager Must Ensure That The Home Promotes And Actions Infection Control Guidance So That People who live, work or visit the home are not placed at unnecessary risk. Refrigerators should not be placed in the laundry 28/02/2009 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 3 23 32 41 The complaints procedures should contain the address of the sponsoring Local Authorities. At least 50 of the care staff team should have qualifications to NVQ level 2 or above. Where applicable the current address of the CSCI should be listed in policies and procedures. 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!
