Care Home: 15 Manor Crescent

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What the care home does well People who use the service have individual care plans which are person centred and contain the necessary information to allow staff to care for them. The care plans contain a good variety of risk ssessments and more detailed risk assessments are held in a seperate folder A range of activities are available for the people using the service including college, shopping, visits to local pubs and restaurants and day trips. All people using the service have enjoyed a holiday this year either on their own accompanied by members of staff or with a friend. The service have received no complaints but many compliments had been given to the home in the form of letters. The manager provides training for all staff on a regular basis. The home provides a modern, comfortable environment for the people using the service. There is a range of specialist equipment available to ensure activities of daily living are made as easy as possible. What has improved since the last inspection? No requirements were made following the inspection in September 2007. The manager has stated throughout the completed AQAA that they are continually reviewing their procedures and improving the service they provide. What the care home could do better: Two requirements were made following this key inspection. The home`s internal safeguarding policy and procedure should match that of the local authority. The staff recruitment folders should be reviewed to ensure they contain all the information required particularly two references and an explanation for any gaps in employment. Key inspection report Care homes for adults (18-65 years) Name: Address: 15 Manor Crescent Byfleet Surrey KT14 7EN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lesley Garrett     Date: 0 6 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 15 Manor Crescent Byfleet Surrey KT14 7EN 01932343799 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): david@ngcl.org.uk New Generation Care Ltd The registered provider is responsible for running the service care home 4 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 4 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following categories: Learning disability(LD) Physical disability (PD) Date of last inspection Brief description of the care home 15 Manor Crescent is a large detached bungalow that has been refurbished in order to provide accommodation for up to 4 people with learning difficulties and who may also have a physical disability. The home is located in a quiet residential crescent close to the shops and amenities of Byfleet in Surrey. The accommodation is arranged on one level and consists of four bedrooms with en-suite bathrooms, a lounge/diner, kitchen, utility room, office and communal toilet with sink. All bedrooms are in excess of 15 Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 0 4 4 Brief description of the care home square metres excluding the en-suites and have a square layout. The home is owned by New Generation Care. The company was set up in 2006 by Mr David Horsgood (coowner/manager) and a silent partner to provide services to younger people making the transition from children to adult services. There is another four-bedroom home owned by the company in the adjacent bungalow. The home is staffed on a 24 hour rota system by a team comprising a manager, a deputy manager and support workers. Care Homes for Adults (18-65 years) Page 5 of 27 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 inspection of the care home was an unannounced Key Inspection. Mrs L Garrett, Regulation Inspector, carried out the inspection and the manager responsible for the sister property next door and the deputy manager for the service assisted in the process. The registered manager/provider was on annual leave during this inspection. He is also the provider for the recently opened home next door. The inspector arrived at the service at 11:00 and was in the home for five hours. It was a look at how well the home is operating. It took into account information provided by the home and any information that Care Quality Commission (CQC) has received about the service since the last inspection in September 2007. The manager had supplied CQC with an Annual Quality Assurance Assessment (AQAA) prior to the key inspection.This document had been returned to us late and a reminder letter was sent to the registered manager for return of the document within seven days. Care Homes for Adults (18-65 years) Page 6 of 27 We looked at how well the service was meeting the key national minimum standards and complying with the regulations and have in this report made judgements about the standard of the service. Documents sampled during the inspection included the homes care plans, risk assessments, daily records, some policies and procedures and staff employment records. We also spent time with the people using the service to seek their views. From the evidence seen by the inspector and comments received, the inspector considers that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. No complainant has contacted the commission voicing concerns about the service. Care Homes for Adults (18-65 years) Page 7 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 27 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 wishing to use the service have their needs assessed prior to admission to ensure the service can meet their needs. Evidence: The home has in place a Statement of Purpose and Service User Guide. Both documents are well written in plain English and include pictures to assist people in making a choice if they wish to live at the home. Both documents need to be updated to include the current contact details of CQC. The home has an admission and assessment procedure, which ensures that all prospective people have a care needs assessment prior to admission to the home to ensure that the home is able to meet the individuals needs. The care plan of the most recent admission to the home was sampled. The pre-admission assessments are not kept in the care plan folder but filed separately in the office. This was available for us to view. Care Homes for Adults (18-65 years) Page 10 of 27 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. People using the service have care plans and risk assessments in place which are reviewed regularly and contain enough detail to enable staff to adequately care for the needs of the people living there. Evidence: People living at the home have a care plans in place. We sampled two care plans in detail and looked at the other two. They were clearly written to describe the individualised personal care needs and how care and support were provided taking into account the persons choices and preferences on how they liked to receive care and support; for example times of getting up and going to bed and their likes and dislikes. The care plans detailed the peoples religion, next of kin or significant people in their life, and their current medication. Daily records written by staff were looked at and included reporting on their daily activities, their interactions, achievements and general demeanor throughout a 24- hour period. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: There was evidence in the care plans to indicate that formal and informal reviews of the care provided to the people using the service had taken place. There was no evidence that the care plans and risk assessments had been agreed by the individuals. This was discussed with the person in charge who said that this was something that could be rectified easily and will now be incorporated into the care plans and risk assessments. During the inspection we spoke to people using the service and they told us they were aware of their care plans and had been consulted. The care plans also contained some risk assessments, which documented potential hazards in the peoples daily lives. Brief details are held in the care plan folders to give the reader an insight into potential problems and actions to be taken. The more detailed versions are held in a separate risk assessment folder. During the inspection the people using the service told us that they are always given choices in their daily lives. Choices they told us about included going to bed and getting up in the morning and the food they would like to eat. They could choose what to do during the day and any of their free time and also who to spend time with. Holidays had been discussed and chosen by the people using the service. Care Homes for Adults (18-65 years) Page 12 of 27 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. People who use the service are supported to make choices about their lifestyle and their recreational activities and this is all documented in their care plans. Evidence: It was observed during the day that people using the service are encouraged to learn and use practical life skills. One person was preparing to go shopping to purchase a folder that was required for college work. Other people told us about their shopping trips either locally or into Woking where there is a larger selection of shops. On their timetable it was observed that people using the service help with some household tasks. People using the service told us that they are able to keep in touch with people who they want to and that the staff and the manager are nice and they feel well looked after. Talking with the people who use the service and looking at their care plans Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: demonstrated that people are encouraged and supported to keep in contact with people close to them. The people spoken to on the day spoke freely about their family and friends and looked forward to their visits home and having visitors into their home. The person in charge told us that all people using the service have access to keys for their bedroom door. She told us that the people using the service had asked that the staff look after them. It is the policy of the home that when an individual is not occupying their room because they may be on holiday, away for the weekend or in hospital the room is always locked until they return. Staff speak to the people using the service advising them to respect each others privacy and to knock on the bedroom doors before entering and to leave if asked to. The staff said this works well between them. The person in charge told us that if the homes office door is closed the people using the service always knock prior to entering. The home holds weekly meetings with the people using the service to discuss the menu for the following week. They look at the menu for the previous week to try to avoid repetition and try to include a healthy living option. The menus demonstrated that the home is able to cater for special diets and the likes and dislikes for all of individuals have been discussed. The home has written menus to offer what was considered a well-balanced meal with healthy living options. All meals are home cooked and varied. The dining area is located in the large lounge with open plan kitchen. On the day of inspection people using the service were all helping the staff to prepare the evening meal and told us that they were having a curry. It was observed in the care plans that staff at the home manage special dietary needs for the individuals. Care Homes for Adults (18-65 years) Page 14 of 27 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. All people using the service receive appropriate support for their personal care needs and the home ensures that each individual has access to healthcare support when required. Evidence: The care plans have been developed from the pre assessment records and included the peoples care and support needs. The care plans were well written to allow the reader to gain a good overview of the individuals medical, social and personal care needs including complexities in their mental and physical wellbeing. The plans also evidenced that regular and appropriate health care appointments are attended including visits to the individuals General Practitioner (GP) when necessary. It was evident from the records that the home has maintained good working partnerships with health care professionals which included ongoing psychiatric/psychological support when required to ensure that the peoples health care needs continue to be met. The home has a monitored dosage system in place and all administration cards were Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: fully documented. The home has good, clear procedures in place for the monitoring and recording of all medicines administered and those entering and leaving the home. Staff training in medication has been conducted and there are clear procedures in place for the administration of the as required medication. Care Homes for Adults (18-65 years) Page 16 of 27 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 using the service can be confident that their complaints would be listened to and that they should be protected from abuse as training has taken place. Evidence: The home has an established complaints procedure and this was observed during this inspection. We were told that any complaints received by the home would be fully investigated using the homes complaints procedure but they had not received any complaints since the last inspection. The home keeps a log book to record any complaints received. This method of recording is not confidential and a discussion took place with the manager from the sister home who said they would change the system and use a folder in the future. The home has a copy of the local authoritys safeguarding procedures for the protection of vulnerable adults. The home also has an internal safeguarding policy but this does not match the local authoritys procedures. A requirement will be made at the end of the report for the homes internal policy to be bought into line with those of the local authority. There has been no safeguarding alerts made by the home. Staff spoken to on the day were aware of their responsibilities in reporting any incidents they may witness. The home also has copies of the whistle blowing procedures. Staff training records sampled confirmed that staff had received training in safeguarding and this is repeated regularly. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a safe, well-maintained, comfortable environment for the people using the service Evidence: The home provides a homely environment for people using the service. The premises were viewed as well decorated, comfortable, bright, airy, clean and free from offensive odours. People using the service were pleased to show us their bedrooms. They were well decorated and contained a variety of personal items and were appropriately furnished. The home also had specialist beds for those people who require that equipment. All bedrooms are en suite with some adaptations so that they can bath or shower easily with assistance when required. People using the service told us that they visit one another rooms when invited and two of the individual said they liked to get together to listen to music in the evening. There is a communal area to sit and watch television but they also have televisions and music available in their bedrooms when they wish to be on their own. There is a good sized garden which is also wheelchair accessible. The AQAA told us that the home blends in with other properties in the road and does not stand out as a care home. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: The laundry facilities at the home were good and met the needs of the people living at the home. There was a good standard of housekeeping and it was free from offensive odours. The AQAA told us that the home benefits from the latest fire alarm systems and equipment available. Care Homes for Adults (18-65 years) Page 19 of 27 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. Evidence: The home had the benefit of a registered manager, deputy manager, team leaders and care staff who between them work full or part time shifts. The people spoken to on the day of inspection were complimentary about the staff and the care they received. People using the service knew who their key worker was. The staff rotas are written by the manager or the deputy and occasionally they have to use some agency staff. The person in charge told us that they try to get agency staff who are familiar to the people using the service. The home had a relaxed atmosphere and and the staffing levels of the home were evidenced and considered adequate to meet the current needs of the people using the service. National Vocational Qualification (NVQ) training is available for all staff and this can be commenced following their three month induction which links into a national body induction programme. This prepares individuals for the NVQ training. The person in charge told us that this training is always on going and available to all staff. Two staff recruitment folders were viewed and shortfalls were noted in both. Both Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: folders sampled had only obtained one reference and one folder had no explanation for the gaps in employment. A requirement will be made at the end of the report. We were told that the deputy manager is currently compiling a training matrix. This will identify training that has taken place and when it is due for updating. Staff records sampled on the day confirmed that mandatory training had taken place which included first aid, food hygiene, manual handling, health and safety and safeguarding. Specialist training is also made available depending on the needs of the people using the service. We spoke to staff during the day who all confirmed that they had received training that was relevant to their role and all had a good knowledge of their responsibilities regarding safeguarding adult procedures. Staff spoken to also had a good knowledge of the people they were caring for. Care Homes for Adults (18-65 years) Page 21 of 27 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. People who use the service benefit from good management arrangements and that they are consulted about the running of their home. Health and safety checks have been put in place. Evidence: On the day of inspection the registered manager, who is also the provider, was on annual leave. We were assisted by the manager from the sisiter home and for a little time by the homes deputy manager. The person in charge told us that the manager is usually in the home every day and always supernumerary. Prior to the inspection CQC requested that the manager complete an AQAA. This document was not completed during the timescale set and a telephone call to him was made and a reminder letter sent. It is important that when requested to return documents to us by a certain time this is carried out. The AQAA forms part of the inspection process. The manager is supported by a deputy who has achieved the NVQ at level 3. There Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: are clear lines of managerial responsibility with the manager and deputy sharing on call responsibilities. The home benefits from having the support of their sister home next door which has recently been registered. The home has developed an effective quality assurance system and questionnaires are sent out every year to the people using the service, their relatives or representatives and healthcare professionals. There are weekly resident meetings and minutes are taken. Records indicated that health and safety checks are maintained and certificates are kept. No health and safety issues were identified during this inspection. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 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 13 The homes internal 21/09/2009 safeguarding policy and procedure should match that of the local authoritys This will ensure that staff follow and have knowledge of one procedure for the handling of any safeguarding incidents in the home. 2 34 19 The staff recruitment folders 21/09/2009 should be reviewed to ensure they contain all the information required particularly two references and an explanation for any gaps in employment. This ensures that people using the service are protected by the homes recruitment practises. Care Homes for Adults (18-65 years) Page 25 of 27 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 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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