Inspection on 08/10/08 for Tregarland Care Home

This inspection was carried out on 8th October 2008.

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

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

Other inspections for this house

Tregarland Care Home 03/10/06

Tregarland Care Home 01/03/06

Tregarland Care Home 09/08/05

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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: Tregarland Care Home 51 Whitchurch Road Tavistock Devon PL19 9BD The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anita Sutcliffe Date: 0 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 33 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Tregarland Care Home 51 Whitchurch Road Tavistock Devon PL19 9BD 01822618460/618533 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): tregarland@btconnect.com Tregarland Limited Name of registered manager (if applicable) Mrs Caroline Maria Hay Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 20 20 0 0 care home 20 learning disability physical disability Additional conditions: Date of last inspection 1 6 1 0 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home It is two large houses. Each has bedrooms, a lounge, dining room, laundry and kitchen. 18 people live at Tregarland at the moment. Everybody who lives at the home has their own bedroom. Nobody has to share a room. This is what we did when we were at the home. We sent surveys so people could write about the home. We talked to lots of people who live at the home and three let us visit their room. We also spoke to staff and the manager. Care Homes for Adults (18-65 years) Page 5 of 33 An Expert by Experience helped us to meet people there. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. What the home does well People are helped to plan how they want to live and asked what they want to do. Staff help them to do this. Care Homes for Adults (18-65 years) Page 6 of 33 People at the home have the same rights as anybody else. Staff make sure this always happens. There is lots to do at the home and people have a good time. Everybody went on holiday this year and they all went to Goosey Fair when we visited. People help learn new skills, like shopping and cooking. Some go to work. Staff are very good at helping them to learn things. The house is nice. It s clean and bright and has been well looked after. Care Homes for Adults (18-65 years) Page 7 of 33 What has got better since the last inspection? People’s money is now kept in their own bank account and not by the people who run the home. What the home could do better The manager and staff make sure they know how to get better. That is why the home is so good. Care Homes for Adults (18-65 years) Page 8 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: Three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 9 of 33 How we did our inspection: This is what the inspector did when they were at the care home Information toward this report has been collected since the previous key inspection in October 2006. Toward this inspection the home told us what is currently happening there and gave some data, such as how many people live there and how many staff there are. We sent surveys to people who live at the home and staff and there was a good response. We did one unannounced visit which took six and half hours. During this we met and talked with a visiting district nurse. There was also a visit by an Expert by Experience. They are people who, because of a shared experience or ways of communicating, visits a service with the inspector to help them get a picture of what it is like to live there. At the home we looked closely at the care of three people who use the service. We also met other people and watched to see how staff and people got on together. We looked at records of how support is planned and provided and some staff records, such as recruitment and training. We talked with staff and the manager. We looked around most of the home and were invited to see some peoples rooms. People who use the service may be described as clients, residents are service Care Homes for Adults (18-65 years) Page 10 of 33 users within this report. What the care home does well People who use the service are the priority at Tregarland. People are understood and supported to be as individual as they wish; they are treated with respect and dignity. People are encouraged and supported to lead fulfilled lives. The range of activities is broad and life-skills and employment encouraged. Risk is understood but not used as an excuse not to try new things. Care and support and properly planned and documented. Staff recruitment ensures that only staff safe and suitable to work at the home are employed. The numbers of staff are suitable to meet the needs of the people and staff training is considered by staff to be good. People like living at Tregarland and staff like working there. People are consulted about many things, including how the home is run, how staff behave and who should be employed (or not). There are very good measures in place to ensure peoples views are sought and those views are acted upon. The standard of health care provided at the home is high and the home works closely with health care professionals who Care Homes for Adults (18-65 years) Page 11 of 33 hold the home in high regard. The home environment is light, fresh, clean, well maintained and well furnished. Peoples rooms are very individual to them and they say they like them. Comments from people about the home include: I am very happy and contented at this houseand I like Tregarland. Staff say: I enjoy working at Tregarland so much. I really do feel the service users have a great quality of life. Its a lovely place to be and An enjoyable place to work. What has got better from the last inspection The one previous requirement was met. Now peoples money is not paid into any bank account associated with the business and each person has their own bank account. This means people are more in charge of their own money and is better protection for people. When people are recruited there is a more detailed employment history gathered so that a better judgment can be made about their suitability. The home now has the Department of Health Guidance on Physical Intervention available and a copy of the guidance in relation to the Protection of Vulnerable adults for staff information. Both will help ensure staff act in line with good practice Care Homes for Adults (18-65 years) Page 12 of 33 guidelines. Peoples ownership of their own plans is improved but could still be further improved in some cases. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Anita Sutcliffe 33 Greycoat Street London SW1P 2QF Care Homes for Adults (18-65 years) Page 13 of 33 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 14 of 33 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 15 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People do not move to Tregarland unless it is the right place for them to live. Evidence: Tregarland does not provide Intermediate Care. We looked at what it is like to move to Tregarland. Eleven people told us in their survey that they had been asked if they wanted to move to the home and one person said they had not. One said that had been brought to the home to spend a day there before they decided to move in. Information from the home shows that people are always encouraged to visit the home and spend time before making a decision about it. This gives them, people currently living there, and the manager an opportunity to see if the home is the right place for them to live. There have not been any new people move to Tregarland since the last key inspection, but we saw that peoples needs are regularly reassessed. Care Homes for Adults (18-65 years) Page 16 of 33 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 who use the service can be sure their needs and aspirations are understood and planned for. Their rights as citizens of value are promoted. Evidence: We looked at how well people were able to influence the support they received and achieve the goals they wish whilst remaining safe. Seven people who use the service said they always make decisions about what they do each day and five said they sometimes do. Eleven said the carers always listen and act on what they say and one said sometimes adding: They are good at their job. We looked in detail at two plans of care. They were very detailed and contained important information which would tell staff how they are to provide the necessary care and support. One person we spoke with told us why there were some restrictions placed upon him. He said he agreed that they were necessary. We saw that they were clearly recorded in his care plan. Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: Care plans had been regularly reviewed and we saw that risk had been considered with steps taken to keep this to a minimum. The manager said that properly managed risk did not stop people living as they wish. Seven staff said that they are given up to date information about the needs of people and two said they usually are. One said: The care plans are updated every six months or before if necessary. Another said: All care plans are regularly updated; any important information is passed on immediately. The home operates a key working system. This means that each person has a special member of staff who can ensure their changing needs and personal goals are understood. They are able to influence who that staff member will be. The Expert by Experience was told that there are regular meetings where people discuss any problems, things of importance to them and holidays. He was also told that any problem can be discussed with the manager one to one. People are encouraged to be involved in how the home runs. For example, they have a say in who is recruited and who comes to live at the home. People are able to handle their own finances if they are able. Each person has their own bank account and any restrictions on their handling money are part of their plan of care and in place to protect them. Care Homes for Adults (18-65 years) Page 18 of 33 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 are well supported to lead fulfilled and valued lives. Evidence: We looked at peoples lifestyle at the home. All twelve people surveyed said that they could do what they want during the day, the evenings and weekends. Comments included: I definitely need support at all times to help me and can never thank the staff enough. The day of the inspection visit each person went to Goosey Fair, a yearly event held in the town centre. People told the Expert by Experience that three of them work in a pub, one does conservation work, some go to college for Life-skills courses, some work on a local farm, there are cookery courses as well as swimming, horse riding, dance classes, Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: shopping, the cinema and theatre visits. We saw photographs of events and certificates of achievement. We were told that each year a dog show is held at the home to get funds toward activities. There are two minibuses available for transport but we saw that travel cards are also available so that public transport can be used. Staff were very positive about the lifestyle people have with comments including: We treat everyone as individuals and try to encourage them to have as much independence as possible and as much FUN!! as possible and: The service treats everyone as individuals and gives them the quality of life they deserve. We saw that diverse needs are understood and the manager and staff work hard to ensure they people are treated with respect. Staff told us that family and friends are always welcomed at the home. We discussed relationships and how the home supports peer friendships/relationships whilst protecting people. The manager had a good understanding of how to do this. We were told that people clean their own rooms and a domestic worker cleans the shared rooms. One person told us he hoovers. Another said: I help clean around the house which I enjoy. We were told that household tasks are rotated to help people learn and to be fair. People told the Expert by Experience that they can choose and cook their own food. The kitchen is available to all but the fridges are kept locked to protect two people who would be in danger if this was not so. However, one of them told us how much he had enjoyed his chips at Goosey Fair. We were also told about the Christmas meal out. The food provided for the home is varied and of good quality. The menu is only monitored to be sure people receive an adequate and balanced diet. Care Homes for Adults (18-65 years) Page 20 of 33 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 are well supported toward meeting their health care needs. Evidence: A district nurse who regularly visits the home said: They make appropriate referrals, follow advice, provide excellent care and I have complete confidence in them. Staff said through survey, and we saw, that care plans are kept under review and staff use them to keep themselves up to date about the needs of people at the home. Those interviewed were able to describe how peoples personal and health care needs are met. The manager described occasions where people have been to hospital and how staff have stayed with them for support; also to make sure each persons individual needs were understood. Where people have had surgery they have been able to come home quickly, supported by the district nursing service. We saw records of routine health care appointments such as dentist, chiropodist and optician which indicate that preventative health care is properly managed. People looked well care for. Each person has a designated key worker and their care Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: plan describes their preferred routines, likes or dislikes. This indicates that care is delivered in the way they would choose. The home uses a monitored dosage system to administer medicines and staff have received training in how to use that system. We saw that medicines are properly stored, recorded and are handled safely. Where specialist training is necessary for staff this has been provided and the way emergency medicines are to be used is clearly documented. Care Homes for Adults (18-65 years) Page 22 of 33 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 are listened to and protected by the way the home is managed. Evidence: One person said: Staff make us feel happy. Another said: The staff are brilliant. We saw that people were relaxed and comfortable around staff at Tregarland and the Expert by Experience also found the same. The Expert by Experience was told that the home holds meetings where any problems can be discussed. Also that if the problem is personal they can talk to the manager. Each of the twelve people said in the surveys that they knew who to talk to if they were unhappy and that they knew how to make a complaint. There have been no complaints at the home and we have received no complaints about Tregarland. The nine staff who responded to surveys said they knew what to do if any person associated with the home had concerns about it. Comments from staff included: I would go to my manager or if the concerns were about my manager I would go to the CSCI or police or social services. We discussed the use of restraint at the home with the manager. She described the additional support, and staff training, that had been put in place as the use of restraint is possibly required. People who have behaviour that is a problem to themselves or others have detailed plans on how this is to be managed. Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: Previously peoples money was paid into an account related to the running of the business. We were shown how this has now been changed. Each person now has their own account and the business does not handle any persons money. Care Homes for Adults (18-65 years) Page 24 of 33 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 warm, well maintained, clean and homely environment. Evidence: We visited some rooms and were shown around the main parts of both buildings. The home is light and airy, clean and homely. There seemed to be a good standard of furnishings and fittings that would suit young people. Three people showed us their bedrooms. They said they had what they needed and liked their rooms. Each room was very individual and decorated to express things of interest to them, such as football. People told the Expert by Experience of the new bedroom furniture they had bought. The twelve people who completed surveys said the home is fresh and clean adding: I hoover, My room is lovely, Its a nice clean home and I help clean round the house which I enjoy. Each side of the home has a laundry room. We visited one and it contained equipment suitable for the needs of the home. One staff said there were some maintenance issues not dealt with quickly enough (the tumble dryer) and another said they wanted better equipment to work with. We saw no maintenance or health and safety concerns although the main carpet throughout the home is somewhat worn and is taped to prevent people tripping. The home already had quotes for a replacement and were Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: asking peoples opinion about the new style of carpet they wanted. Care Homes for Adults (18-65 years) Page 26 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can be assured that staff recruitment is robust and in their best interest, staff are well trained and in sufficient numbers to meet their needs. Evidence: We looked at how well staff are recruited, trained and deployed. Comments about staff from people included: The staff definitely deserve a 60 million pound pay rise and Staff makes me feel happy. All comments about staff were positive. Talking to staff it was clear they have a good understanding of the needs of people at the home. A recently employed support worker described how she was recruited. This included two interviews, one meeting the people who use the service who then give their opinion about them to the manager. She was extra to numbers at first, said she feels quite confident to ask for advice and added: Its really good here. Employed in August she has since received training in health and safety, fire safety and protecting people from abuse and so training began promptly. Staff said through survey that their induction training covered everything they needed to know to do the job well although adding that induction is: Only a starting point. Staff said of their training: We are offered good training on a regular basis, Our Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: training is updated as necessary and My employer always answers questions I have and I was given good training and support. Training records also showed that training is ongoing and appropriate. It included: Epilepsy, advocacy, first aid and fire prevention. Asked if there are enough staff to meet the individual needs of all the people who use the service two said always and six said usually. Reasons why staffing numbers might be compromised were sickness and unexpected absence. However, they added that regular increased staffing would ensure they can always do Special things with residents. We looked at the recruitment records of the last staff to be employed. All checks had been completed to see if anything indicated they are not safe to work with vulnerable adults. People who use the service also give their opinion of the person. Care Homes for Adults (18-65 years) Page 28 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is run competently and very much in the best interest of the people who use the service. Evidence: Mrs. Hay, the Registered Manager, has completed the Registered Managers Award which is an indicator of her competence. We feel that the distinctive spirit at the home, and attitudes of staff, indicate good leadership, people who use the services are the priority and staff are well supported and valued. Comments from staff include: The service is always prepared to take on new challenges that could improve the living environment for all that live at the home and Overall a good place to work. Good team work and relationships with staff and residents. The Expert by Experience said: I have nothing bad to say about the home. I think it is excellent. Arrangements at the home to ensure the service delivered is one of quality include: meetings for people who use the service and staff, senior carer procedure reviews (for example, the way medicines are handled) and a formal yearly questionnaire for people, family, parents and advocates. The information received from people using the service is fed into staff supervision and appraisal so there is a direct link between their Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: opinion and review of staff performance. Staff are trained in aspects of health and safety, such as first aid. Risks are properly considered. We saw nothing of concern regarding health and safety whilst at the home. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 31 of 33 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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