Care Home: Albion House Care Home

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What the care home does well Before a person moves into the home the manager or one of her senior care assistants carry out an assessment of the person`s needs and lifestyle choices. Admissions to Albion House only take place if the staff team are confident they can meet the prospective service users identified needs. This allows service users to have confidence they are moving into a home that can meet their identified needs. Service users receive personal and health care support using a person centred approach with support provided being based upon the rights of service users to be treated with dignity, equality and respect. The following information was gained through discussions with service users during our visit and in returned surveys: `The home is very friendly and welcoming`. `My relative came here on a temporary basis which became permanent. It is the next best option to living at home with their family`. `I like living here`. Records show service users are supported to access health care services when required. The home has an efficient medication policy and a procedure that is clear and easily understood for the staff team to follow. Medication records are fully completed and signed by members of the staff team trained to administer medication. The home has an open culture that allows service users to express their views and concerns in a safe and understanding environment, resulting in service users feeling valued and respected. Service users spoken with told us they are happy with the level of service provided, feel safe and supported by the manager and the staff team who promote their protection and safety. Rotas show Albion House is staffed efficiently and in a way that supports service users daily routines enabling them to feel in control. The manager is open and transparent and is supportive of both service users and the staff team. What has improved since the last inspection? This is the home`s first key inspection since being registered on 08/12/2009 What the care home could do better: We discussed with the manager the need to review the pre admission assessment document to ensure it allows the assessor to provide comprehensive details of prospective service users care needs and lifestyle choices.We looked at a sample of care plans which indicated that basic information is held in these documents with reviews taking place each month. The manager told us she is in the process of reviewing the care planning and risk assessment processes to ensure they are more person centred and meaningful. Albion House provides a comfortable environment for service users to live in however some areas of the home require some maintenance work and refurbishment. This was discussed with the manager who told us redecoration and refurbishment of the main lounge and dining room was a priority. We looked at a selection of staff files and on the whole found them to be well maintained. However a procedure needs to be put in place to ensure that if a criminal records bureau check is returned with criminal convictions documented. A risk assessment is undertaken to ensure service users are being supported by appropriate people who will act in their best interests and promote their safety and well-being. The home pays for a private company to undertake a annual quality assurance audit of the service the most recent audit indicated the home is operating to a good standard. We advised the manager to look at ways to engage service users and their relatives more directly to support them to become more involved in the daily running of the service. She agreed to look at this area of how the home works and the communication systems currently in place. Key inspection report Care homes for older people Name: Address: Albion House Care Home 41 Albion Street Wallasey Merseyside CH45 9LE     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: Helen Carton     Date: 1 7 0 5 2 0 1 0 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 Older People Page 2 of 29 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 Older People 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Albion House Care Home 41 Albion Street Wallasey Merseyside CH45 9LE 01516397144 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Harinderpal Singh Grewal Name of registered manager (if applicable) Mrs Judith Glenys Trevithick Type of registration: Number of places registered: care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 14 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: Old age, not falling within any other category - Code OP. Date of last inspection Brief description of the care home Albion House is a three storey detached property situated in a residential area of New Brighton, Wirral. There are ten single and two double bedrooms one of which has en-suite facilities. There are two assisted bathrooms and a shower room a large lounge dining room and a separate conservatory which leads to a large well maintained garden. Care Homes for Older People Page 4 of 29 Over 65 14 0 Brief description of the care home The home is situated near to local social and leisure facilities including shops, cafes, pubs and a theatre, there are good local transport links to other parts of Wirral, Liverpool and Chester. Currently the fee charged to live at Albion House is 442.00 Care Homes for Older People Page 5 of 29 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: As part of the inspection process we sent Albion House an Annual Quality Assurance Assessment (AQAA) document, which was completed prior to our visit to the home. This document was to provide information about the service and to tell us where they felt they had made improvements to the way they support service users and the staff team. As part of the inspection process surveys were sent to the home six surveys were completed and returned to us. This is the first key inspection of the home since a new provider was registered with the Care Quality Commission (CQC) on the 08/12/09. We visited Albion House to enable us to look at records and to discuss how the home supports service users in all aspects of their lives. Part of this process involved Care Homes for Older People Page 6 of 29 speaking with the manager, members of the staff team and spending time with service users to find out their views on living at the home. We spent approximately five hours at the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: We discussed with the manager the need to review the pre admission assessment document to ensure it allows the assessor to provide comprehensive details of prospective service users care needs and lifestyle choices. Care Homes for Older People Page 8 of 29 We looked at a sample of care plans which indicated that basic information is held in these documents with reviews taking place each month. The manager told us she is in the process of reviewing the care planning and risk assessment processes to ensure they are more person centred and meaningful. Albion House provides a comfortable environment for service users to live in however some areas of the home require some maintenance work and refurbishment. This was discussed with the manager who told us redecoration and refurbishment of the main lounge and dining room was a priority. We looked at a selection of staff files and on the whole found them to be well maintained. However a procedure needs to be put in place to ensure that if a criminal records bureau check is returned with criminal convictions documented. A risk assessment is undertaken to ensure service users are being supported by appropriate people who will act in their best interests and promote their safety and well-being. The home pays for a private company to undertake a annual quality assurance audit of the service the most recent audit indicated the home is operating to a good standard. We advised the manager to look at ways to engage service users and their relatives more directly to support them to become more involved in the daily running of the service. She agreed to look at this area of how the home works and the communication systems currently in place. 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 Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall prospective service users can be confident the home can meet their identified care needs and wishes in a safe and supportive environment Evidence: The statement of purpose and service users guide provides information about the services and facilities provided at Albion House. We have advised the manager to attach a copy of a standard contract to the service user guide to ensure full transparency regarding fees to be charged. Before a person moves into the home the manager or one of her senior care assistants carry out an assessment of the persons needs and lifestyle choices. The assessment process involves talking and spending time with the person who wishes to move into the home and talking to their relatives and other professionals involved in their care. Admissions to Albion House only take place if the staff team are confident they can meet the prospective service users identified needs. This allows service users Care Homes for Older People Page 11 of 29 Evidence: to have confidence they are moving into a home that can meet their needs. We discussed with the manager the need to review the pre admission assessment document to ensure it allows the assessor to provide comprehensive details of prospective service users care needs and lifestyle choices. Care Homes for Older People Page 12 of 29 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Service users personal and health care needs are met by a staff team who are skilled, respectful and sensitive to their needs. This results in them receiving a person centred service which respects and promotes their individual needs and lifestyle choices. Evidence: Service users receive personal and health care support using a person centred approach with support provided being based upon the rights of service users to be treated with dignity, equality and respect. We discussed with the manager the need to seek information about service users life experiences. This information will further support the staff team to offer service users individualised care and support based on their needs and lifestyle choices. We looked at a sample of care plans which indicated that basic information is held in these documents with reviews taking place each month. The manager told us she is in the process of reviewing the care planning and risk assessment processes to ensure they are more person centred and meaningful. We looked at a sample of daily records Care Homes for Older People Page 13 of 29 Evidence: and found the information held in these documents very detailed and service user focused. The following information was gained through discussions with service users during our visit and in returned surveys: The home is very friendly and welcoming. My relative came here on a temporary basis which became permanent. It is the next best option to living at home with their family. I like living here. The girls are lovely nothing is too much trouble. Records show service users are supported to access health care services when required including GP, hospital, podiatry, district nurse services and optical services. This information was confirmed by service users spoken with during the visit and in completed surveys sent to us. We looked at a number of risk assessments and discussed with the manager the need to review them more frequently this is to ensure issues of concern are identified early and additional support or equipment is accessed to support service users to remain as independent as possible. The manager told us she carries out reviews as soon as an issue of concern is identified. The home has an efficient medication policy and a procedure that is clear and easily understood for the staff team to follow. Medication records are fully completed and signed by members of the staff team trained to administer medication. This ensures service users receive their medication at the correct intervals and dosages to support them to maintain their physical and mental wellbeing. We observed members of the staff team supporting service users in a respectful and affectionate manner. Care Homes for Older People Page 14 of 29 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users views and wishes are valued and form the basis of social and leisure activities provided by the home. Evidence: The manager and the staff team support service users to develop friendships within the home and to maintain important personal and family relationships. Enabling service users to remain connected to their lives prior to moving into Albion House. The manager told us regular activities are provided for service users to take part in including bingo, sing a longs, board games and trips to local cafes and shops. The manager told us she intends to further develop the activities programme following discussions with service users and their relatives. We advised the manager to formally draw up an activities programme to allow service user to decide in advance if they wish to take part or suggest alternative activities. The following information was gained through discussions with service users and relatives during our visit and in returned surveys: Because the home is small the staff are very close to the residents and their families. Care Homes for Older People Page 15 of 29 Evidence: They are very personable and very caring. The home is very nice and homely and always kept clean and tidy. Staff are very friendly. More staff interactioin with residents. The dining room has seating for fourteen, service users are encouraged to eat their meals together however if they wish to have their meals in their bedrooms they are supported to do so. New tables have recently been purchased and the manager told us the dining area would be redecorated and new curtains purchased within the next six months. We discussed with the manager the issue of using table cloths and napkins to enhance meal times and to make them a social occassion. She agreed to look at suitable table coverings. Menus have recently been reviewed and a new chef has been appointed. Service users spoken with during our visited said they were happy wih the type and size of meals provided. Care Homes for Older People Page 16 of 29 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Service users views and opinions are sought and acted upon. This results in a service that proactively promotes service users rights as citizens to be protected from discrimination and abuse. Evidence: The home has an open culture that allows service users to express their views and concerns in a safe and understanding environment, resulting in service users feeling valued and respected. Service users spoken with told us they are happy with the level of service provided, feel safe and supported by the manager and the staff team who promote their protection and safety. The registered provider Mr Grewal visits the home regularly and once a month carries out a service audit which involves speaking with service users, members of the staff team, the manager and when possible relatives. This contact offers all parties involved in the home to raise any issues of concerns, complaint or to offer positive feedback about the service being provided at Albion House. The following information was gained from discussions with service users and comments made in returned surveys: I know who to talk to if I am not happy with things. Care Homes for Older People Page 17 of 29 Evidence: I would talk to Judith if I was worried. All staff employed at the home have received safeguarding vulnerable adults training. Members of the staff team spoken with demonstrated a good understanding of their roles and responsibilities regarding protecting service users from all forms of abuse and neglect. This results in service users living in an environment which respects and supports their lifestyle choices and promotes their wellbeing. Guidance books with regard to the Mental Capacity Act 2005 are availble to the staff team and the manager has a good understanding of the processes involved in making a deprivation of liberty safeguarding referral. Care Homes for Older People Page 18 of 29 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current environment adequately meets the needs of service users and offers them a homely and comfortable place to live. Evidence: Albion House provides a comfortable environment for service users to live in however some areas of the home requires maintenance work and refurbishment. This was discussed with the manager who told us redecoration and refurbishment of the main lounge and dining room was a priority. With new dining room tables and chairs having been purchased in the last six months. Since December 09 the following works has been carried out: the fire alarm system has been upgraded and two bedrooms have been decorated and new carpets fitted. Service users are supported to personalise their rooms and to have a say in how areas of the home are decorated. Service users spoken with told us they felt comfortable living at Albion House. All areas of the visited were clean and tidy. There is a large garden to the rear of the home which is accessed through the Care Homes for Older People Page 19 of 29 Evidence: conservatory on the day of the visit we noted service users enjoying the garden and the good weather. Care Homes for Older People Page 20 of 29 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Service users are supported by a trained and skilled workforce resulting in their individual needs and lifestyle choices being met in a person centred way. Evidence: Rotas show Abion House is staffed efficiently and in a way that supports service users daily routines enabling them to feel in control. The manager and the registered provider support the staff team to undertake training courses to enable them to gain the skills, knowledge and expertise to support service users needs and lifestyle choices effectively and safely. We discussed with the manager the need to look at specialised training particularly regarding dementia care. Members of the staff team spoken with and comments made in returned surveys provided the following information: I really enjoy working here its like a home from home. Judith is great supportive and very approachable. This was my first job in the care sector twenty years later Im still here. Care Homes for Older People Page 21 of 29 Evidence: We looked at a selection of staff files and on the whole found them to be well maintained. However a procedure needs to be put in place to ensure that if a criminal records bureau check is returned with criminal convictions documented a risk assessment is undertaken. This is to ensure service users are being supported by appropriate people who will act in their best interests and promote their safety and well-being. Care Homes for Older People Page 22 of 29 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 management and administration systems within the home promote the health, safety and welfare of service users. Evidence: The registered manager, Ms Judith Trevithick has approximately 20 years experience working in the care sector five years of which was as the deputy manager of Albion House. Mrs Trevithick was recently registered with CQC as the manager of the service. The manager is open and transparent and is supportive of both service users and the staff team. The home works to a clear health and safety policy, with the staff team being supported to undertake their mandatory training at regular intervals. The home pays for a private company to undertake an annual quality assurance audit Care Homes for Older People Page 23 of 29 Evidence: of the service the most recent indicated the home was operating to a good standard. We advised the manager to look at ways to engage service users and their relatives directly to support them to become more involved in the daily running of the service. She agreed to look at this area of how the home works and the communication systems currently in place. We looked at a selection of service users financial records they were well maintained with purchase receipts held on each file. A selection of health and safety records were examined they demonstrated the manager and the staff team work hard to ensure service users live in a safe and healthy environment. Care Homes for Older People Page 24 of 29 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 Older People Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 The pre admission assessment document must be reviewed. This is to ensure service users holistic needs through the assessment process are fully documented. And incorporated into the proposed plan of care. 12/07/2010 2 7 15 A review of the care plannning processes must be carreid out. This is to ensure service users receive appropriate care and support refective of their needs and wishes. 25/08/2010 3 8 13 Risk assessments must be 30/06/2010 routinely reviewed at regular intervals. This is to ensure service users, members of the staff team and where appropriate relatives and carers can Care Homes for Older People Page 26 of 29 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 raise their concerns about their wellbeing. 4 19 16 Damaged or badly worn furniture in the loung must be repaired or replaced. This is to ensure service users live in a safe and comfortable environment. 5 19 23 Damaged paintwork and decoration must be repaired or replaced. This is to ensure service users live in a homely and pleasant environment. 6 29 19 A risk assessment must be carried out when criminal convictions are documented on a returned criminal records bureau check. This is to ensure service users are being supported by appropriate people who will act in their best interests and promote their safety and well-being. 7 33 24 Robust quality assurance systems must be implemented in the service. This is to ensure service users and the management team can be confident the services being provided are effective and meet the 23/08/2010 12/07/2010 30/12/2010 30/09/2010 Care Homes for Older People Page 27 of 29 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 needs and aspirations of service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The statement of purpose and service user guide should be updated to include an up to date copy of the current terms and conditions of residency. Further work should be carried out to ensure all care plans have personal profiles of service users life experiences. The manager should seek to provide dementia awareness training to the staff team to promote good practice and provide them with the skills to support service users with dementia. 2 3 7 30 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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