Care Home: 56-58 Turnbull Close

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What the care home does well It is evident through us talking to members of staff that the emotional health of the residents is of a high priority to the home and that staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life in accordance to their plan of care. Staff demonstrate their commitment to achieving best outcomes for residents. Staff stated they expressed job satisfaction and confidence in the management of the home. The service actively encourages and provides varied opportunities for residents to develop and maintain social, emotional, communication and independent living skills. The staff have a good ethos and focuses on involving Residents in all areas of their life. It was confirmed that residents are enabled to maintain contact with relatives and friends where they wished to do so. The AQAA showed that residents are encouraged to use all aspects of their home according to their ability and wishes. Staff encourage spontaneity and will often take advantage of good weather and vehicle availability to undertake outings. Residents undertake a wide variety of activities and social functions. Key workers encourage integration within the community. What has improved since the last inspection? It was evident through the inspection process that the home is taking steps to improve the standards of care. Improvements have also been made in many areas including decorating cleaning and maintenance from the last inspection. The staff team work towards constantly trying to improve the service and see`s improvement as always ongoing. The home has addressed the issues raised within the last report. What the care home could do better: We identified that not all staff had received all the required basic training. It was recommended that such training is sought as a priority. Difficulties have also arisen due to the use in the past of a high levels of agency staff. This had been recognised by the management and regular agency staff are now being employed and the provider is actively recruiting for new permanent staff. Evidence of this was seen from a pile of completed application forms. Some further recommendations were made with regard to the service provision. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 56-58 Turnbull Close 56/58 Turnbull Close Greenhithe Kent DA9 9EB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Robert Pettiford     Date: 0 8 1 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.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: 56-58 Turnbull Close 56/58 Turnbull Close Greenhithe Kent DA9 9EB 01322381568 01322381852 turnbullclose@walsingham.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Walsingham care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category/ies 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 Date of last inspection Brief description of the care home 56/58 Turnbull Close residential home (part of Walsingham group) provides twentyfour hour care and accommodation for up to twelve people with physical and learning disabilities. The home supports service users who have profound learning and physical disabilities. The staff work closely with speech and language therapists and encourage families, friends and representatives to play an active role invoicing views and opinions. Accommodation is in a bungalow that is divided into two units, each with its own communal areas. All residents have single bedrooms that are individually furnished and equipped with significant support from relatives and supporters. Some service users have motability vehicles. Other organisations (e.g. Yew Tree Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home Centre and Social Education Centres) supplement the homes own transport provision in enabling residents users to attend specialist day centres. The premises have landscaped gardens used by service users. The home is within easy reach (by car) of a range of local amenities and public transport. There are good parking facilities. Weekly fees information is available frome the home. 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: The inspection took place on 8th December 2009. We agreed and explained the inspection process with the manager present at the time of the inspection . The manager was not available. The focus of the inspection was to assess the home in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Younger Adults. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. We used a varied method of gathering evidence to complete this inspection, preCare Homes for Adults (18-65 years) Page 6 of 28 inspection information such as the previous report and discussion and correspondence with the registered provider/manager was used in the planning process to support the inspector to explore any issues of concern and verify practise and service provision. The home had completed an annual quality assurance assessment questionnaire (AQAA) within the last year. This provided us with information relating to What the home considers it does well, What we could do better, What has improved within the last 12 months and plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the CSCI to be able to make an informed decision about outcome areas. Further information can be found on the CSCI website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, rotas, training records and recruitment records. In addition an environmental tour took place. We had the opportunity to speak with several of the residents and a number of staff. Additional evidence was gained to inform judgements following the observation of many of the residents and their interactions with staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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. Residents can be confident that their needs will be properly assessed prior to moving to the home. Evidence: The standard relating to the assessment of residents prior to them moving into the home was met from the previous inspection. No evidence or intelligence would suggest that the process does not continue to meet with the required standard. Records showed at the previous inspection that residents have an assessment, which identifies their individual needs prior to or on admission to the home. This is then reflected into the care plans and these are developed in agreement with the individual where possible. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet the needs of the individual. The AQAA also confirmed information with regard to ensuring that the home can meet the needs of residents. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: The assessment process as shown in the AQAA recognises cultural needs and the importance of promoting equality and diversity rather than just meeting needs in a reactive manner. The home evidenced in its AQAA and discussions with the manager that it reviews it equalities and diversity policy and policies relating to residents are inclusive to all members of the community. 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. Residents benefit from having clear individual plans that are comprehensive, identify their needs and are specific to the individual. Care plans showed that residents are enabled to make decisions and choices and enabled to take responsible risks through a thorough risk assessment process. Evidence: The care plans fully documented all physical and emotional health care needs. Evidence was available that the resident is central to the care planning process.Evidence was noted that the plans of care were person centred in that they put the resident central to the process. This is a area which has improved since the last inspection. Within the care plans records of health care provided by G.P, chiropodist, dentist, and opticians were evident. Residents physical and emotional health is monitored on a daily basis. Through their daily records and these correspond with records held in the care plans. This system Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: ensures that all Residents receive continuity of care and supports potential complications and problems at an early stage. It is evident through records that the emotional health support is of a high priority to this home and the staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life. Many of the residents are profoundly disabled and with the exception of one residents all went to the day centre. The one remaining resident who was unable to communicate, but through observations and interactions with staff the commission was able to make a judgement on quality of care given. There were clear guidelines in respect to routines and supporting the residents with their needs. The manager confirmed that these are reviewed with health care professionals, relatives and residents where possible on a regular basis. We viewed a sample of three care plans, which showed short and long term goals. The plan focuses on current need. The plans of care follow the principles of person centred planning. Staff support and encourage the individual to be fully involved. Residents rights to make decisions are respected and the care plans reflected their ability to make an informed judgement where possible. Care plans included information concerning the preferred lifestyle and choices. Care plans include risk assessments. Management of risk takes into account the specialist needs and age of people who use the service, balanced with their aspirations for independence, choice and normal living. The home has all the necessary moving and handling equipment to meet residents needs. The home is purpose built with hoists and ramps in all the key areas. Comment cards received expressed a wiliness by the staff to support residents with their needs and provide good quality care. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that they are offered a range of opportunities for personal development and feel part of the wider community. Residents engage in a good level of activities which are appropriate to their needs and capabilities.Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The residents benefit from the appetising meals and balanced diet offered at the home. Evidence: Discussion with staff confirmed that the level of activities were of a good level and that they enjoyed many leisure and recreational activities both inside and outside the Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: home. Many of the residents attend a day centre and participate in a wide range of activities suitable for their needs and interests. The service actively encourages and provides varied opportunities for residents to develop and maintain social, emotional, communication and independent living skills. The staff have a good ethos and focuses on involving Residents in all areas of their life. It was confirmed that residents are enabled to maintain contact with relatives and friends where they wished to do so. The AQAA showed that residents are encouraged to use all aspects of their home according to their ability and wishes. Staff encourage spontaneity and will often take advantage of good weather and vehicle availability to undertake outings. Residents undertake a wide variety of activities and social functions. Key workers encourage integration within the community. From observation, records viewed it was evident that residents were offered a choice of menus that meet their dietary needs and individual preferences. Meal times are flexible to suit the residents activities and schedules. Residents are able to choose where to eat. Specialist diets are available according to need.Residents on evidence seen have had been involved in planning and choosing what to eat where possible. 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. Residents receive discreet personal support in the manner they prefer. Residents can feel confident that their health and medication will be supported in accordance to their needs and guidance. Evidence: The care plans fully documented all physical and emotional health care needs and what level of support the resident wanted or needed. Within the care plans records of health care provided by G.P, chiropodist, dentist, and opticians were evident. We viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of PRN/As Required Medication. MAR sheets were seen to be completed correctly and medication was stored appropriately. Quality assurance systems confirm that policy is put into practice. Prn or as required medication protocols were written up. The home could demonstrate Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: that as required medication is given following an agreed protocol. The manager confirmed that all staff that dispenses medication has received the appropriate training. 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. Residents can feel confident that their concerns and complaints are taken seriously. Residents are are protected from the risks of abuse. Evidence: A copy the complaints procedures was reviewed. The procedure included details of how to complain, timescales for response and information for referring a complaint to the service provider. The complaints procedure is not however highly visible within the service and available in different formats for the residents needs. The manager was requested to review the complaints procedure and develop different methods of presentation. The procedure had the name of the Commissions legacy organisation and old contact details. The procedure additionally needs to show that a complaint can be referred to the Commission at any stage of the complaint for the Commission to direct it to the most appropriate authority for investigation and it should not state that there is no further right of appeal. The name and address of the local social service department and telephone number should also be shown. This is a good practice recommendation. Any complaints had been received from information contained within the AQAA and have been dealt with appropriately. The homes Policy for the Protection of Residents and staff Whistle blowing procedure were discussed. These include procedures for the reporting of suspicion or evidence of Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: abuse with a format for the recording of any allegations and action to be taken. Full training has been provided for staff. However some newer staff have not as yet been trained. The manager is aware of this and is organising training as a priority. No requirement has been made at this time.The home has a copy of the local protocols for managing any safeguarding alerts. The manager stated that Criminal Record Bureau Checks (CRB) had been obtained for all staff evidence of this was seen. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a good well maintained environment which provides a homely warm atmosphere with safe access to comfortable indoor and outdoor communal areas. Residents are protected by the homes infection control procedures and policies Evidence: We observed that the home is set in well-maintained gardens. The manager stated that the home meets with the requirements of both Fire and Environmental Health Departments. It was apparent that the individual and collective needs are being met in a comfortable environment. The standard of internal decoration and fixtures and fittings are well maintained and of a very high quality. The environment has been improved since the last inspection with a complete redecoration. The home benefits from a wide selection of communal areas thus affording residents space should they so wish desire. The premises are kept exceptionally clean, hygienic throughout and systems are in place to control the spread of infection, in accordance with relevant legislation, published professional guidance and the purpose of the home. Care Homes for Adults (18-65 years) Page 20 of 28 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. Residents care, social and emotional needs are promoted by the employment of caring staff in such numbers to support their needs who put the interests of the residents first. The standard relating to staff recruitment procedures was not inspected. Evidence: Staff members spoken with discussed the training they had undertaken and felt well supported. From discussions with the manager, observations and reviewing the staff rotas more than sufficient staff were on duty at the time of inspection to meet the residents needs. The manager was seen to be competent and experienced in ensuring that the home was run to meet the needs of the residents. The availability of deputy managers meets with the needs of the service and sufficient staff are available at all times. Staff are receptive to residents needs and work together as a team. However difficulties have arisen due to the use in the past of a high level of agency staff. This had been recognised by the management and regular agency staff are now employed and the provider is actively recruiting for new permanent staff. Evidence of this was seen from a pile of completed application forms. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: The staff training records indicated planned and undertaken training in all the key areas. Core training in Infection control,Moving and Handling, Basic Life support, fire training, food hygiene, and Adult protection has been provided. However shortfalls were noted in training with regard to required updates and training for new staff.The manager evidenced that individual and group staff training needs had been identified and is aware that the identified shortfall is a priority. No requirment has been made at this time. Core courses are undertaken by staff to maintain current qualifications and for protection of residents. Staff have achieved NVQ qualifications in Care to level 2 or above. The manager confirmed that the home has a development programme for all new staff, which meets Sector Skills Councils workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of residents, and that all members of staff receive induction training to specification. The manager stated that staff receive supervision on a regular basis. The inspection of the recruitment files at the previous inspection evidenced that the required checks had been carried out and that the standard was met. 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. Residents benefit from living in a well managed home that provides them with good outcomes and is monitored to a good standard. Evidence of health and safety safety checks were not fully inspected on this occasion. Evidence: The manager is actively involved in the day-to-day management of the home and works with staff and residents. Surveys expressed a great deal of satisfaction of the care provided and the staff are very supportive of the manager and have a positive ethos. The outcomes for people who use the service are good and the management of the service recognise that there are areas for improvement and have expressed a willingness to work with the Commission to address these. There is strong evidence that the ethos of the Home is open and transparent. The views of both residents and staff are listened to, and valued. Quality assurance was discussed and the views and opinions of many of the residents Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: and stakeholders sought. Surveys have been carried out by the home to contribute to the quality assurance process. The home operates a key worker system to identify an individual staff member to directly to work with a service user on a one to one basis. An appointed person of the registered provider of the home does regularly visit the home and complete what is known as a Regulation 26 visit. This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required National Minimum Standards. The service demonstrates a level of self-awareness and recognises the areas that it still needs to improve. It has clearly detailed the ways in which it plans to do this. The service fully recognises the importance of the AQAA and has used the content to inform its own quality assurance. Evidence of health and safety safety checks were not fully inspected on this occasion. The manager confirmed that fire risk assessments had been reviewed and that all the checks were in place. 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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!