Care Home: 18 Leafdown Close

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Polesworth Group 70 Long Street
• Breme
• Polesworth Group 64 Long Street
• Polesworth Group 68 Long Street
• 10 Whitfield Avenue

What the care home does well The routines and practices within the home promoted the rights, choices and independence of the person using the service. Survey feedback, and discussions with the person living in the home, confirmed that she was offered the necessary care, support and assistance, to live a lifestyle of her choice. There was a positive emphasis focused on promoting the persons independence within a risk assessment framework, whilst stimulating and encouraging appropriate activities and social inclusion. What has improved since the last inspection? The Annual Quality Assurance Assessment completed by the care manager told us: "I have felt no need to make any changes, however I continue to find a marked improvement in the service user, who continues to gain more confidence. I have been registered for 15 years and to date no complaints have received, or I presume made. Parking spaces for two cars available on the drive. There is a shed in the garden, the service user shows a great interest in gardening, growing tomatoes and strawberries. Intends to continue to grow produce." What the care home could do better: There were no requirements and or recommendations made at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: 18 Leafdown Close 18 Leafdown Close Hednesford Cannock Staffordshire WS12 2NJ     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: Pam Grace     Date: 1 8 1 1 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 28 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 28 Information about the care home Name of care home: Address: 18 Leafdown Close 18 Leafdown Close Hednesford Cannock Staffordshire WS12 2NJ 01543425637 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Valerie Bullman care home 1 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 1 The registered person may provide the following category of service only: Care Home Only (Code 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) 1 Date of last inspection Brief description of the care home Leafdown Close is a residential home located in Hednesford, Staffordshire; the home is registered to provide a service for one adult, category of registration - learning disability. The two-storey semi detached property comprises of a lounge, leading to a dinning area and a fitted kitchen. On the first floor level there are three single occupancy bedrooms and a bathroom that is equipped with a toilet, washbasin and a shower. There is a well-maintained garden at the rear of the property, adequate car parking facility is provided at the front of the premises. Leafdown Close provides a warm and welcoming atmosphere with a positive emphasis focused on normalisation, providing the necessary support and assistance to ensure that the person living in the Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 1 Brief description of the care home home has access to leisure facilities and to have a valued role within her local community. All healthcare services are accessible to the individual, to ensure and maintain all healthcare needs. The Registered Manager provides support and supervision on a daily basis to meet the assessed needs of the individual. The fees charged for this service are not included in this report. The reader may wish to make enquiries directly to the service. 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 key unannounced inspection was carried out over one day, by one inspector. The inspection was planned using information gathered from the Care Quality Commission database, the Annual Quality Assurance Assessment completed by the registered care manager, and the survey feedback and comments received from the person using the service. The key National Minimum Standards for Adults 18 to 65 were identified for this inspection, and the methods used included case tracking, general observations, document reading, speaking with staff and the person using the service. Observation of the environment was also undertaken. The person using the service was very positive about the service they were receiving. There had been no complaints received by the service, and no Safeguarding referrals Care Homes for Adults (18-65 years) Page 6 of 28 had been made since the previous inspection. The feedback and comments we received about the service were generally very positive. At the end of our inspection, feedback was given to the registered care manager, outlining the overall findings of the inspection. There were no requirements and no recommendations made as a result of this unannounced inspection. Care Homes for Adults (18-65 years) Page 7 of 28 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 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 homes admission process, ensured that people wishing to access the service, would be provided with relevant information, enabling them to have a choice as to where they live. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us : Adequate information is available should the present situation change. I feel that I provide and excellent service, and disappointed only to receive a two star rating. The service user could not receive more attention, better health care, diet, a better social life. Since my last assessment the service user has progressed to work one hour a day at the day service. I do feel it would be difficult to improve my service but am open to suggestions. The previous inspection report identified that the homes Statement of Purpose provided relevant information, relating to the service and provisions available. We discussed the need to ensure that when reviewing this document a date should be Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: included on the original, and the address and contact details for the Care Quality Commission (CQC) needed to be updated. 18 Leafdown Close was registered to provide a service for one person. Discussions with the registered care manager demonstrated her understanding of the need to undertake a pre-admission assessment for any future prospective person wishing to use the service. We were told that this would usually be undertaken in conjunction with the Local Authority. Survey feedback and discussions with the person using the service confirmed that she was offered relevant support and assistance to live a lifestyle of her choice. She told us that she continues to attend church services on a regular basis and maintains contact with her friends and her key worker based at the day care centre. She also said I am very happy here, and I dont want to be moved anywhere else. A formal contract relating to the terms and conditions of residency was issued to the person using the service, this was signed and dated by the relevant parties. Care Homes for Adults (18-65 years) Page 11 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 care manager provides a positive ethos to normal daily living which promotes the rights and choices of the individual, within a risk assessed framework. This enables a fulfilled lifestyle that reflects the persons wishes and needs. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: I promote the rights and choices of the service user and her goals are set out in her personal care plan. Generally speaking the service user makes her own choices, but willingly accepts my advice if her decision is unacceptable or unsafe. The service user is involved in all activities within the home, should she wish to be so. Survey feedback and discussions with the person using the service confirmed that she was very actively involved in the development and review of her care plan. The format of which reflected the individuals wishes and needs as well as goals to achieve. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The person using the service was integrated within a family setting, discussions confirmed that the person was provided with the necessary support and assistance to maintain an independent lifestyle and was able to make decisions, in regard to daily routine and welfare. We were told that the person continues to attend day care services, has paid part time employment, and also had access to a key worker and an advocate. With reference to financial affairs, we were told that this is managed independently by the person using the service. A small element of ongoing support was required within this area, which was provided by the care manager. There were appropriate person centred risk assessments in place which identified potential hazards. The risk assessments provided information relating to the control measures put in place to reduce or eliminate the identified risk. The overall aim for the care and support given, is a positive approach, to enable the individual to take an informed risk. This in turn enables her to live a fulfilled lifestyle. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person using the service was able to make choices relating to her lifestyle to reflect her needs and expectations. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: Service user is involved in many activities appropriate to her age and ability. She is popular in her peer group, and indeed with everyone with whom she is in contact, and it is fantastic to see her flourish. The service user has integrated well into many community activities. She attends a club for learning disabled fortnightly which she enjoys, and a club once per month for the more abled. Her relationships and activities are appropriate to her age, and her choices and rights are respected. We discussed the ways in which the person is encouraged to be as independent as Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: possible, which ensured that the person living in the home lived a fulfilled lifestyle. This included day to day involvement with peers, going to work, managing personal finances, going on holiday, visits to places of interest and short breaks, completing daily living tasks, for example shopping, cooking, washing up, planning meals, cleaning and washing clothes. We were told that plans were being made to go on holiday next year, and the person using the service said she was looking forward to Christmas, and I am saving up again to go on a cruise. She also told us I go to work every day, and get paid for it. I have a weekly programme at the day centre. Survey feedback told us I enjoy living at my home, I am well looked after, and I feel safe. The routine within the home was relaxed, where the individual was able to engage in pastimes of her choice. I go to my friends house for tea and see my sister sometimes. I like the food here, I can choose what I want to eat, On the day of the inspection, she had arrived home from the day centre and had brought her uniform home for washing and ironing. Care Homes for Adults (18-65 years) Page 15 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 person using the service was provided with the necessary support and assistance to maintain her general health and personal care, in accordance with her assessed needs. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: The service users healthcare is paramount. The service user has 6 monthly health checks with our practice nurse, 12 monthly visits to the dentist, 5 weekly chiropody treatment, 6 monthly check ups at the hospital for an intermittently troublesome ear, and an optical test every 2 to 3 years. The service user administers her own medication where appropriate, this is carried out by the manager in accordance with the homes policy. 18 Leafdown Close is a standard domestic dwelling. The registered care manager provided the necessary care and support. Survey feedback, discussion with the care manager and discussions with the person living at the home, confirmed that she had access to a dentist, optician and a general practitioner, records seen also confirmed Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: this. The person using the service confirmed that she continued to self administer her medication, and that her medication was regularly reviewed by the general practitioner. The individual was fairly independent and mobile and there were no requirements for any specialist aids or adaptations. Discussions with the person living in the home confirmed that she was happy with the care and service provided and wished to remain at 18 Leafdown Close indefinitely. Care Homes for Adults (18-65 years) Page 17 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 homes complaint procedure was readily available. The person had access to a key worker and an advocate, thus ensuring that the individual would be able to share any concerns with other people outside the service. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: A complaints procedure is in place, and the service user is well aware of the action she should take, should she be dissatisfied or unhappy with any aspect of her life. There was a complaints procedure in place, which was accessible to the person using the service, information relating to the Care Quality Commisson (CQC) and contact details needed to be amended to reflect recent changes. Survey feedback and discussion with the person using the service told us that the person using the service knew how to make a complaint. She said, I would tell you, my key worker, or my advocate. I have no complaints at present. The Care Quality Commission had not received any complaints about the service since the previous inspection. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: We discussed the need to have a copy of the current procedure for Safeguarding and the Protection of Vulnerable Adults. To ensure up to date information is available to the service. Two friends of the family very occasionally provide some support, previous examination of records identified that they had both been subject to a Criminal Record Bureau clearance. Care Homes for Adults (18-65 years) Page 19 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design and layout of the property was suitable in meeting the needs of the person using the service. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: The home is located on an estate in Hednesford Staffordshire. The home is a 3 bedroomed semi detached house, in keeping with the local community and is registered for one person. There are ensuite facilities but the bathroom is adjacent to her bedroom. The ground floor comprises lobby, lounge, dining room and kitchen. The home is comfortable and has a high standard of cleanliness. The service user has access to all areas. We observed that the service is located in Hednesford, Staffordshire and is accessible via public transport. The property was in keeping with the local community, and provided three single occupancy bedrooms (registered to provide residential care for one). An en suite facility was not provided. However, the bathroom was located in close proximity to the bedroom. The bathroom was situated on the first floor, equipped with a bath, toilet, washbasin Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: and shower. On the ground floor there was a lounge area, which provided a comfortable area for relaxation. Leading from this area was a separate dinning room. There was a fitted kitchen in place. The garden at the rear of the property was well maintained. Parking facility was provided at the front of the property. The general cleanliness and hygiene of the home was of a very high standard. Smoke detectors were installed throughout the home and records confirmed that fire fighting equipment were serviced on a regular basis. The person living in the home showed us her bedroom, the bedroom was well maintained, tastefully decorated, and was equipped with essential furnishings and items to provide a comfortable area. Adequate heating, ventilation and natural lighting were provided throughout the home. This service is a normal domestic dwelling, there were no specific systems in place with regards to infection control. As previously identified the cleanliness and hygiene within the home was of a very high standard. There were no specialist systems or adaptations required, past discussions with the Registered Manager confirmed that if and when necessary, every effort would be made to provide the necessary adaptation to meet the needs of the person accessing the service. Care Homes for Adults (18-65 years) Page 21 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 level of support and assistance provided to the person using the service was appropriate to meet her assessed needs. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: The service user is supported solely by the homes manager, as no other staff are employed, other than two very casual helpers, who are friends of the family and are CRB checked. They are competent, decent people. The service users needs are well met with suitably trained and experienced people. As previously identified within this report, this service is a normal domestic dwelling. There was no management structure or permanent staffing. The registered care manager provided the necessary support and assistance to ensure that the persons needs were met in accordance with her plan of care. The registered care manager was experienced within social care and had obtained the National Vocational Qualification (NVQ), level 2 in care. Discussions with the care manager confirmed that she does not undertake periodical training with reference to her roles and responsibilities. However, we have noted that this had not impinged on Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: the quality of the service delivery. Two friends of the family provided additional support, if and when necessary, and previous examination of records identified that a Criminal Record Bureau check had been undertaken for both. Care Homes for Adults (18-65 years) Page 23 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. The conduct of the registered care manager was open and transparent, promoting the rights and independence of the person using the service. Evidence: The Annual Quality Assurance Assessment completed by the care manager told us: The home is run in an efficient open honest and lucid manner, promoting independence, careful consideration is given to the rights of the person using the service. Health and safety are paramount, and a full and active life is enjoyed. The registered care manager was experienced in social care, and demonstrated a sound knowledge of the needs of the individual. She maintained good links with the day centre, and had formed good working relationships with other health professionals. Observations made during the process of this inspection evidenced, that she was proactive in promoting the rights of the person in her care, and that she actively promoted and encouraged her to participate in all activities within and outside of their home. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Systems and practices that promote the health, safety and welfare of the person accessing the service, ensured that all safety records were up to date and well maintained. Care Homes for Adults (18-65 years) Page 25 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 26 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 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 27 of 28 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 28 of 28 - 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!