Inspection on 25/02/09 for 2 Warwick Road

This inspection was carried out on 25th 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 Warwick Road 24/07/07

2 Warwick Road 08/05/06

2 Warwick Road 06/10/05

2 Warwick Road 11/01/05

2 Warwick Road 14/09/04

2 Warwick Road 17/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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: Warwick Road 2 Warwick Road 2 New Barnet Hertfordshire EN5 5EE     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: Teferi Degeneh     Date: 0 3 0 3 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 28 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 28 Information about the care home Name of care home: Address: Warwick Road 2 Warwick Road 2 New Barnet Hertfordshire EN5 5EE 02084412988 02084405661 margie.gilding@tamarisktrust.org.uk 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) : Tamarisk Trust care home 17 Number of places (if applicable): Under 65 Over 65 17 learning disability Additional conditions: 17 Limited to 17 service users with learning disabilities some of whom may be elderly. Date of last inspection Brief description of the care home Warwick Road is a care home registered for a maximum of seventeen adult residents with learning difficulties. Tamarisk Trust, a registered charity, runs the home. The home is a four-storey corner house with an extension added to it. On the ground floor are located the kitchen, office, laundry room, two lounges and a dining room. There are also additional kitchen and dining room facilities on the first floor and second floor. The bedrooms are located on the lower ground floor, the ground floor and the first and second floors. All bedrooms are single. There is a unit on the second floor designated for training residents in independent living skills. There is a small garden to the front of the home with off street parking and a paved area to the side. There is also a long partially paved garden to the rear. The home is situated in a residential part of New Barnet, with shops; buses and rail links a short walk from the home. The fees for residents living in the home range from #478.80 - #919.90 per week. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 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 a surprise inspection which meant that the home did not know in advance it was taking place. The inspection started at 8:30 and finished around 3:30 in the afternoon. The manager was present throughout the inspection. An expert by experience, supported by their personal assistant, were also present during part of the inspection. An expert by experience is a person who has an experience of using a service, and who can give a better picture of what it feels to receive a service. The expert by experience and their assistant spent over three hours engaging with the people who use the service, the management of the home and the staff. Parts of the report produced by the expert by experience are used as evidence to support the judgments. Care Homes for Adults (18-65 years) Page 6 of 28 The inspection activity undertaken by the inspector included a tour of the building, the examination of the residents files including care records, the examination of health and safety records, the viewing of staff rotas and discussions with and observation of people who use the service, care staff and the homes management. A relative who was visiting the residents was also spoken to. The evidence collected through discussions with the people who use the service, the visitor and the staff showed that the people who use the service are well cared for. The relative commented that they are happy with the manager, and staff and the home. The residents commented that they are happy living at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 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 9 of 28 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. The people who use the service are confident that their admission to the home is based on their assessment and the ability of the home to meet their needs. Evidence: Five residents files were selected randomly for the inspection. All the files contained assessment of needs and care plans. The manager said that there have been no new admissions since the last inspection. She also stated that a resident whose needs could not be met at the home has recently moved to an alternative accommodation. From discussions with the manager it was clear that the home requests detailed assessments of new residents from social workers before developing care plans and admitting them. The people who use the service have lived at the home for a number of years. Care Homes for Adults (18-65 years) Page 10 of 28 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. The people who use the service can be reassured that their care plans and risk assessments are updated and their needs met. Evidence: All the five care plans seen contained detailed care plans. Each care plan states the residents needs and how the staff can support them to meet these needs. Each residents likes and dislikes are also given in the care plans. The care plans are reviewed and updated regularly. The manager said families and social workers are involved in the reviews. The home has a key working system which means that named staff are assigned to monitor and review the support provided to certain residents. A key worker has a special or additional interest in the care of the resident they are a key worker for. In some residents files it was noted that the staff update care plans by writing any changes and dating them on the existing plans. Even though this practice would Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: appear convenient and quick, it would appear to be not the best way of updating a care plan. At the last inspection it was that it would be timely for the home to ensure an update to care plans soon after each persons individual reviews, even if it is just to state that the present care plan remains unchanged. We recommend that when care plans are updated, the new plans should be written on new piece of paper. The feedback from the expert by experience was positive about the care provided to the residents. The expert by experience confirmed that the residents can make decisions and are clear about what activities they have and what they do not have. For example, in their report the expert by experience quoted residents and wrote the following:I like music,..; I am going to America to watch bats. I stay in my room when I practice drumming. The five resident files checked contained up-to-date risk assessments. The risk assessments have details of possible risks to the residents and how to manage them. Discussion with the manager confirmed that the home encourages the residents to take responsible risks. The AQAA stated: All service users have a care plan, they are person centered and have relevant goals and action on how goals can be met. All service users have risk assessment which reflect the support given to enable people to take risks. We observed the residents accessing all communal facilities and using their own bedroom keys independently. A residents comment was quoted by the expert by experience: I make my own sandwiches and help with cleaning. I helped with painting my room. I chose the colour and decoration. I chose my TV. Care Homes for Adults (18-65 years) Page 12 of 28 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. The people who use the service can be sure that the enjoy activities that meet their personal preferences. There are systems in place to enable the residents to have meals that meet their individual needs. Evidence: Observations of the people who use the service showed that they are engaged and not bored at the home. We saw the residents chatting with the staff or playing games. The manager said that each resident has their own activity which includes going to a day centre or a college. A weekly activities programme seen by the expert and experience and ourselves showed that the people have access to adult education classes, multimedia community focus sessions, cooking, arts and crafts photography and learning about London course. A resident told the expert by experience: I went out doing photography this morning and I went to the internet coffee to email my sister. The Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: resident also showed the photographs they have in their camera to the expert by experience. The AQAA confirmed that the people who use the service are supported to visit their families and friends. Discussions with some friends also indicated that they visit families and the families visit them at the home. On the day of the inspection we had an opportunity to speak to a family visiting a resident. The visitor said they occasionally visit due to the distance where they live but there are other members of the family who regularly visit the resident. They said they keep in touch with their relative through a telephone or an email. The manager said that there is a residents meeting where all residents are encouraged and supported to discuss common issues. We confirmed this from the minutes of the meetings. Also the residents told the expert by experience how they attended meetings and the things they discussed. The expert by experience reported what the residents told by saying that the residents can choose what they want to eat. The expert by experience also wrote what the staff told them as follows: We have cookery books with photos of meals which we show to service users to choose a meal from. They cook their own meals. A resident said to the expert by experience: I choose my own meals, what time to go to bed and I wake up when I want to. The manager confirmed in the AQAA that the home ensures that the residents choose what to eat. The manager has confirmed in the AQAA that the residents are supported to practice their belief: We ensure that people are supported in there beliefs by supporting them to attend their preferred place of worship. It was evident from discussions with the manager, residents, staff and from the AQAA that the home tries hard to promote the independence of the people who use the service. Care Homes for Adults (18-65 years) Page 14 of 28 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. The people who use the service can be confident that their health and personal care needs are met by the systems of the home and the staff. They can also be confident that their medication is administered to them in a safe way. Evidence: The expert by experience commented how the staff ensure privacy and dignity of the residents: I observed that the staff respected residents privacy and dignity because [the staff] didnt enter service users rooms who were out doing activities. [The staff] asked service users who were present to show their bedrooms to us if they wished to do so. I felt pleased that [the staff] looked at me rather than my PA [personal assistant] when answering my questions throughout the interview. [The staff] also appeared in tune with service users, being sensitive and responsive to their needs. We saw the staff interacting with the residents using sign language in a way that showed respect and acceptance of their needs. As mentioned earlier above each resident has a key for their bedroom. During an interview with the inspector the staff demonstrated their knowledge of how to ensure the residents rights to make decisions for themselves when they are at the home or in the community. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: From the residents files, the AQAA and discussion with the manager it was evident the people who use the service have regular health checks. We have seen in the files and the diaries records of health care appointments and confirmation of attendance of the appointments. Each resident has a diary where appointments are recorded. Medication is administered by the staff. The medicines and medication administration record sheets (MARS) were checked and found to be in order on the day of the inspection. Medication errors, which had been spotted by the manager, had been dealt with by talking to the staff and by providing training. The manager has also put a system in place to monitor medication regularly. The manager confirmed that all staff members who administer medication have attended relevant training. Care Homes for Adults (18-65 years) Page 16 of 28 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. The people who use the service are reassured by the homes complaints and safeguarding policies and the practices which enable them to be listened to. The residents are confident that the management of the home deals with their concens and any incidents that may occur. Evidence: The home has a complaints policy, which is prepared in a format appropriate to the needs of the people who use the service. The AQAA says that the residents are encouraged to talk about any concerns they may have in their meetings or individually. All complaints and concerns are recorded and dealt with. There have been five recorded complaints since the last inspection. These have all been investigated and resolved by the manager. We observed that the manager and the staff are approachable and are friendly with the residents. The manager said she keeps her office open for the staff and residents to come in and talk to her. We saw an example of this when a resident came into the office to see the manager. The home has a safeguarding policy and procedure. We have also had notifications, that is, information sent to us from the home to tell us about serious incidents which have been reported to the local authority and the police, when needed. This showed to us that the home puts its policy and procedure into practice. The staff we spoke to have good knowledge about adult safeguarding and the actions that need to be taken Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: if an abuse of any sort has happened or suspected. The manager and the service manager are currently dealing with an incident of money missing. We are aware that there has been a similar issue at the home where the residents money went missing before. The manager and the service manager reassured that the residents money will be refunded and appropriate action will be taken to address the incident. Care Homes for Adults (18-65 years) Page 18 of 28 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. The facilities and location of the home are good to meet the needs of the residents. This can be improved through further maintenance of the home, for example, by repairing the ceiling that has a crack. Evidence: All the areas of the home were clean, tidy and bright on the day of the inspection. The residents shared their views of the home with the expert by experience and they noted these in their report: All the service users said that they were happy living in the home. The expert by experience also noted that the bedrooms are personalised to reflect each residents preferences and family photographs and other personal items are kept in the bedrooms. Each resident has their own bedroom. The communal areas are spacious and accessible to the residents. The home is located in a quiet residential area with easy access to shops and public transport nearby. During a tour of the premises with the manager we noted that a ceiling on the first floor had a crack through which water leaked. The manager said she was aware of this and work was ongoing to address the problem. From past inspection reports we are aware that the home has a plan to improve the way the service is provided by providing a purpose built accommodation for the residents. It was also noted from Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: discussions with the staff and observations that the dishwasher in the kitchen was too small for the required job at the home. The manager and service manager said they would look into this with a view to buy a more appropriate dishwasher for the home. Some refurbishments have been done to the home since the last inspection. Care Homes for Adults (18-65 years) Page 20 of 28 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. The residents are confident that they are supported by staff team who are experienced and knowledgeable to deliver care that meets their individual needs. Evidence: An assessment of the staff rota, conversations with the staff and the manager showed that there are four staff during morning and afternoon shifts. There is also a fulltime house assistant who is responsible for cleaning communal areas. It was discussed that the staffing level may not be sufficient during peak hours, for example, during morning and evening when the staff have to administer medication, help some residents with personaal care and prepare breakfast. The manager said she would look into ways of increasing the staffing level. Three members of the staff, who were intereviewd, were confident in their experience, knowledge and skill of supporting people in a care home. They all confirmed that they have similar work experience before starting work at the home. The expert by experience appreciated how the staff communicated with the residents by using makaton and by treating them as individuals and not as groups. The expert by experience wrote: I could see staff had rapport and good relationship with service users. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: We selected randomly and inspected five staff files. All these contained application forms, job descriptions, two written references and evidence of criminal record bureau checks. The home has a recruitment polcy. There is also evidence in the staff files to confirm that they have attended a range of care related training programmes including medication, safeguarding, manual handling, first aid and basic food hygiene. Care Homes for Adults (18-65 years) Page 22 of 28 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. There are good arrangements in the home to ensure that the facilities and services are managed in the best interest of the residents. Evidence: The manager has worked for the company for a number of years at different sites with different responsibilities. Some of her responsibilities included the management of a domiciliary care agency that the company operates. The manager said she has attended care management related training and is currently in the process of applying to the CSCI to be registered. A visiting family member commented positively about the manager. They said she always welcomed them and dealt with issues without taking time. From the interviews with the staff and during the feedback session it was revealed that there was a of misunderstanding or dissatisfaction in the way the home is managed. The service manager said was aware of this and was dealing with it. The service manager visits the home regularly to check the quality of the service and the facilities. Copies of the Regulation 26 visit reports were available for inspection. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The weekly residents meeting minutes were also seen. These have enabled the residents to give their views about the services and facilities. The manager said quality assurance questionnaires are sent to the families to seek their opinion of the home. A visiting family member of a resident said they have been consulted about the homes plan to provide a new accommodation and service for the residents. The home has a system for recording, reporting and managing incidents and accidents. The premises looked clean and tidy. There are procedures for checking and maintaining facilities of the home. the manager has confirmed in the AQAA that gas appliances, emergency lighting, heating systems and portable electrical equipment have been checked within the last twelve months. An officer from the environmental health visited the home on 25th September 2006 and made a recommendation regarding the storage, handling and preparation food items. The manager said these have already been implemented. However, there is a note in the complaints files about pests in the surrounding area. In view of this it would be advisable that a request was made to an environmental health officer to check that the home is free from pests and there is no risks to the residents. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 23 20 A Safe and appropriate way of managing the residents money must be established. A report of the investigation and the actions taken regarding the missing residents money must be sent to the CSCI. This ensures that the residents finances are managed well and used only by the residents. 30/04/2009 2 24 23 Work must be done to stop the leaks that come through the ceiling that has a crack. This is to make the home safe and comfortable for the residents. 15/04/2009 3 42 23 The registered person must make sure that the home is free from pests of any kind. An environmental health visitor must be asked to visit the home. 29/05/2009 Care Homes for Adults (18-65 years) Page 26 of 28 This is to ensure that the residents are free from a risk which associated with pests or poor environmental hygiene. 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 6 The registered person should ensure that all care plans and risk assessments should be written on new pages and should not be amended on the existing plans. This ensures that the plans are appropriately reviewed and are easy to refer to. The staffing level of the home should be increased especially during peak hours. This will enable the residents to receive a reliable and unhurried service. 2 33 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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