Care Home: 18 Kings Park Road

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What the care home does well People who are considering using the service have their needs fully assessed before making a choice. People who use the service are actively involved in planning the care and support they need. People who use the service are able to make choices about their lifestyle and are supported to develop their life skills. The health and personal care that people receive is based on their individual needs. People who use the service are able to expressed their concerns and have access to a robust and effective complaints procedure. People who use the service live in a safe, well maintained and comfortable environment. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. The home is well managed. What has improved since the last inspection? At the end of the last key inspection in 2006 there was one recommendation, that the service consider the layout of the kitchen area which they have done. This area is more open and accessible for students. What the care home could do better: At the end of this key inspection there are no requirements and no recommendations. Key inspection report Care homes for adults (18-65 years) Name: Address: 18 Kings Park Road 18 Kings Park Road Boscombe Bournemouth Dorset BH7 7AE     The quality rating for this care home is:   three star excellent 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: Tracey Cockburn     Date: 1 5 1 2 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: 18 Kings Park Road 18 Kings Park Road Boscombe Bournemouth Dorset BH7 7AE 01202729911 01202397438 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cambian Asperger Syndrome Services Ltd care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The age range of young men to be accommodated to be between 16 years and 19 years. Date of last inspection Brief description of the care home 18, Kings Park Road is a large detached house situated in a residential area of Boscombe. It provides term-time education and care for nine young men aged between 16 and 19 years with a primary diagnosis of Asperger Syndrome. There are nine single bedrooms, one being en-suite and suitable for someone with a physical disability, the other bedrooms share bathrooms and showers. There is a lounge, dining room, kitchen, living skills area, laundry and garden. The library, shops and recreational facilities are within fifteen minutes walking distance and bus and train routes are similarly close. The students all attend The Wing Centre, a residential and educational resource specialising in meeting the needs of young men diagnosed with Asperger Syndrome. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 9 Brief description of the care home Educational programmes include a curriculum co-ordinated at The Wing Centre, work experience and college courses organised by the Educational Vocational Manager who links with all local colleges assessing special educational needs on an individual basis. Some of the curriculum is delivered at 18, Kings Park Road where there is scope for the young men to practice independent daily living skills. Kings Park and The Wing Centre are part of the Cambian Group, an independent provider that nationally provides a range of services to people with autism and related needs. All staff who work at 18 Kings Park Road also work with the young men at the Wing Centre. Waking staff are on duty at all times. 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: 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 peterchart Poor Adequate Good Excellent How we did our inspection: We visited the service and did not tell them we were coming. We looked at information sent to us by the service such as the annual quality assurance assessment. This document tells us how the service thinks its doing in providing good outcomes for students who use the service. We sent out survey forms to be completed by students who use the service and staff who work in the service. We received nine surveys back from students, eight of which had been completed. We received eight surveys back from staff who work in the service. Their comments are used in the report. When we visited the service none of the students were at home. We looked at paperwork in the service such as placement plans and focus files, as well Care Homes for Adults (18-65 years) Page 6 of 27 as information on audits, recruitment and training. We toured the building, we spoke to staff and we spoke to the registered manager and the service manager. 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. Care needs are well assessed prior to admission ensuring that care staff have sufficient information to develop accurate care plans to meet students needs. Evidence: The Annual quality assurance assessment says: We have had more student assessments days enabling them to stay over night. This has enabled the potential new students to meet current students and given them more choice in the suitability of the home that they will live in. Information for the initial assessments is gathered from a variety of sources including, past schools, psychologists, parents, students and the Statement of Educational Need. The majority of the core paperwork is held on file at the Wing Centre. The home has the students Focus File and a copy of the Statement of Educational Need. A baseline care plan is developed prior to admission from known information. 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 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 are involved in the development of their plan, supported to make decisions about their own lives and a robust risk assessment process supports their independence. Evidence: The annual quality assurance assessment says: The Wing Centre Placement Plans, Individual risk assessments and individual medical regime are reviewed every three months. The students also have an Education plan and Transition plan which forms part of their overall person centred plan. All students take part in each process and have a focus file which enables detailed and relevant support for each individual from all of our departments. Each term we hold a multidisciplinary meeting for each student reviewing care,education and therapy targets which make up their IEP(Individual Education Plan). The Annual quality assurance assessment also says they are planning to introduce the following to support better outcomes for students: To look more closely at the Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Transition department. To introduce CASPA(educational tracking software) which tracks realistic progress over real time, thus enabling the student to clearly see their own levels of progression, resulting in increased levels of motivation. The plans were completed in the first person, embellished with appropriate artwork and clearly identified the students perspective in addition to the how the staff were encouraging the student to attain their full potential. Within the plan the Statement of Need clearly cross references to National Minimum Standards and the companys own standard documents. Education targets also link to the Statement of Special Educational Need. Levels of independence are ascertained in collaboration between staff and student and there was evidence through the compilation of weekly summaries. In addition students have a formal house meeting each week where they also arrange menus for the forthcoming week. Plans also detail specific objectives for the coming year and include goals such as supporting someone with relationships, supporting someone to use the bus or walk into town, there was evidence that these goals are worked on and reviewed. There are risk assessments to demonstrate that they are keen to ensure that students have access to life experiences and the community. Evidence of these risk assessments was seen on files. One student told us in a survey form: look after me well and help me independently and another student said in their survey form look after me well and safe 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 develop their leisure interests, they are also supported to make healthy choices about their diet. Evidence: The annual quality assurance assessment says: We have a activity co ordinator within each home, and personal tutors provide our students with support to develop and maintain their own interests and hobbies. Individual Educational and Recreational timetables and plans are developed for each student. Some students have their own personal menus as they are encouraged and supported to take part in an independence week, which includes support if required from our school nurse to ensure all diets are balanced and nutritious. We also have a specialist therapy department. One member of staff told us in a survey form that the service is good at: taking the Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: students interests into account when we look at activities The manager told us that the students had made a cake at the wing centre in the shape of a Christmas tree and they had taken a photograph and this was their Christmas card from the service. There was a photograph of the cake on the notice board in the dining area. Eight students who returned survey forms told us they are able to do what they want in the evening, two students told us that they are not always able to do what they want at the weekend and six students told us they can do what they want during the day, one student said no to this and stated the reason for saying no was because of college One student told us in their survey form under the heading what could the home do better? trips out more often and better vegetarian options One student told us in the survey form under the heading what does the home do well? activities One student told us: Im happy with everything 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. People who use the service are supported to take responsibility for their own physical and emotional health needs. There is a system in place for supporting students to manage their medication. Evidence: The annual quality assurance assessment says: We have a medical file for each student which is kept safe, secure and confidential information is only accessible to those persons authorised. Each staff member is trained in first aid and there are adequate staff to provide 24 hrs emergency care who hold a 4 day first aid certificate. We use local GPs close to each house within the community. Medication risk assessments for students who are able to self medicate. See our controlled drugs and medical policies and procedures, statement of purpose, prospectus. We looked at the focus file for one student which contains information on their health care needs including dietary needs and behaviours. The information in the plan detail how their behaviour might be and what it would mean and how to keep the person safe and support them. The baseline assessment for on e person was completed on before the start of term and includes information on social communication skills, Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: speech and language therapy as well as support needed from clinical psychologist. In one file we looked at the person has had a full SALT assessment, a food diary is also kept. The plan has been signed and agreed by the individual. We talked to the manager who told us that the furniture in the lounge is being replaced as they had an assessment completed by a professional who told them that the seating was not appropriate particularly for one student who has a health condition. We looked at medication practice in the home and noted that the system is the same as in other services run by the provider. Medication is audited weekly and this includes homely and prescribed medication. At the start of each term there is an internal medication audit, we saw evidence that the audits take place as per the services own guidance. 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 who use the service have access to information and people who can help if they are unhappy or concerned. Staff are trained in child and adult safeguarding. Evidence: The annual quality assurance assessment says: It is our desire to resolve any issues with families and students that may from time to time arise as speedily and smoothly as possible. Our complaints policy and procedure is available on admission. We ask each student on a weekly basis through personal tutor meetings one to one with them if they are happy. When a student, carer, neighbour complains we have a set procedure to enable the individual to feel supported and ensure they are guided through the complaints procedure. The procedure ensures that we take all matters seriously and there is a positive outcome. Our over-riding purpose is to ensure that all students feel safe at all times. We follow child and vulnerable adult safeguarding procedures as directed by legislation. Our staff are trained on both internal and external courses. Eight students who use the service sent back survey forms and seven said they knew how to make a complaint, one person did not make any comment. The registered provider has produced a leaflet for students which tells them what they can do if they are unhappy about something, think something is wrong or have a Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: problem. There is also the contact information for childline as well as the Independent person who comes to the service, this persons name, photograph and contact details are displayed prominantly in the service. The students handbook which is given to every student and copies available in the hall details the complaints procedure and what to do if their are incidents of bullying. Eight students told us in the surveys they returned that they knew who to talk to if they were not happy, seven students told us they knew how to complain. Care Homes for Adults (18-65 years) Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students live in a comfortable, homely environment. The home is clean and hygienic with procedures in place for controlling infection. Evidence: The annual quality assurance assessment says: We have now appointed a person in each house responsible for ambiance. This is to ensure that all furnishings are in good order and the house is comfortable for the students. One member of staff wrote in a survey form that: it would be nice for an extra room to let the students relax and chill as there is only a lounge and small dining area for nine students living together The manager told us it is in the development plan to make a den for the students so they have another space to use and relax in apart form their own room. At the last key inspection one recommendation was made regarding the kitchen area, since that inspection some work has been completed and opened up the kitchen area addressing the recommendation. The front entrance porch is warm and welcoming with a signing in book, small table and chair, with a small bookcase. Four students told us that the house is always clean and fresh, one student told us it Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: was sometimes clean and fresh and three students told us it was usually clean and fresh. Care Homes for Adults (18-65 years) Page 20 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. The systems in place to recruit and train staff ensure that students have the support, understanding, protection and skill from the staff working with them. Evidence: The annual quality assurance assessment says: We have our own Human Resource Training Officer and procedures to ensure quality carers are employed and, where possible, a student will be on the interview panel. We ensure that our staffing establishment is sufficient to provide individualised person centred support. Excellent support for staff e.g regular supervision and appraisals by trained managers and private 1:1 counselling support. We employ staff with various skills and abilities and encourage their input into our service. All care staff are trained to HSC Level 3. Managers to a level 4. We use a company staffing calculator to ensure that sufficient staff are employed. We ensure that external qualifications are gained. We looked at two recruitment files, both contained the required information such as two written references, criminal records bureau checks, proof of identity and training. One member of staff told us that training is good and done throughout the year keeping pace with changes. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: One member of staff also thought that the amount of paperwork they had to complete detracted from time with the students. One member of staff wrote under the heading what does the home do well? supports staff to develop a good team morale which in turn helps the young people in our care to have the support required another member of staff wrote under the same heading works extremely well as a team and supports each other very well Seven students who returned survey forms told us that the staff always treat them well, one person wrote that staff usually treat them well. We spoke to the manager about training and she confirmed that staff are supported with ten training days a year, before the start of a new term and at the end of term. Staff will be undertaking attachment disorder training. Care Homes for Adults (18-65 years) Page 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager and staff ensure that the needs of the students are at the centre of the homes ethos ensuring they are listened to and the development of the service considers their wishes. There are systems in place to ensure the health and safety of people living and working in the home are protected. Evidence: The annual quality assurance assessment says: The Manager promotes best practice and quality assurance, to improve the home and promote customer satisfaction. We have quality monitoring systems on seeking the views of the students, families and the relevant professionals in order to measure the success achieving the aims and objectives and the statement of purpose. The Manager has complete involvement in the implementation of reviewing and developing our policies and procedures. On a termly basis we audit our service unannounced to ensure quality assurance, this is carried out by our Care Services Manager. We also half termly complete unannounced night visits and on a monthly basis an Independent Person completes an unannounced visit. The Registered Care Manager has regular meetings with the Care Services Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Manager. Managers provide an excellent role modeling for employees. We looked at the maintenance file; all requests are signed and dated when complete. We looked at the management of health and safety within the service, an audit is completed every six months the last one on 1/12/09. The health and safety audit covers, the fire system, grounds, lighting, doors and furniture. A record is kept of all physical interventions, the last intervention was on 6/12/09 and touch support was used to support someone with disruptive behaviour. Following any intervention a life space interview is completed with the student which explores with the student their feelings about what happened and why. The purpose of this is to connect the feelings with the behaviour, asking students to think of other ways of handling their feelings. The home has an up to date fire risk assessment and a variety of environmental and generic risk assessments. Weekly and monthly health and safety audits are also undertaken. All staff had completed relevant first aid training and had undertaken food hygiene training. These training courses are provided on a rolling rota system to ensure all staff are appropriately trained. Temperatures of fridge and freezer and food cooking were all recorded. Coshh substances were stored safely and had accompanying data. Water temperatures are kept at 43 degrees C and are also tested regularly. PAT testing is undertaken on a regular basis. All fire records were complete and show that necessary in house and specialist checks, fire training and fire drills had been undertaken. Accident and incident records cross referenced successfully to students files. Care Homes for Adults (18-65 years) Page 24 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 25 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 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!