Care Home: Brickbridge House

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What the care home does well You have good care plans that tell staff the support you need. Staff ask you how you want your care giving.Staff give information in different ways to help you to understand things better.The staff ask what you want to do, and help you to arrange activities and go to places you like.The home makes sure you are healthy. You go to see the doctor if you are ill and have eye and dental checks.You can choose to go on holiday and people living in the home have recently been to Wales.You can go to church if you want to. Staff will support you to do this.The home is a nice place to live and it is clean and tidy. What has improved since the last inspection? You have information about the home and which is available in different ways to help you understand.You have the medicine you should do. Medicine is checked to make sure it is the right one.The care plans have been changed so staff know how you want to be supported. What the care home could do better: The law says the manager is to become registered with us, and we have been told she is going to do this.The staff should have training to support people with how people can make decisions and how they will help you. Key inspection report Care homes for adults (18-65 years) Name: Address: Brickbridge House 98 Bridgenorth Lane Wombourne Staffordshire WV5 0AQ 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: Mandy Brassington Date: 2 1 0 7 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 33 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 33 Information about the care home Name of care home: Address: Brickbridge House 98 Bridgenorth Lane Wombourne Staffordshire WV5 0AQ 01902892619 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Positive Living Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category of service only: Care Home Only (Code PC) the service users of the following gender: Either Whose Primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) 6 Date of last inspection 1 6 0 6 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home 6 People live at the home, which is in Wombourne, The home is opposite open fields in the country. Everybody has a room of their own and can bring in their own things. All bedrooms have a toilet, or a toilet and shower. Care Homes for Adults (18-65 years) Page 5 of 33 Each person has information about the home to tell them about how they will be supported. This is called a Service User Guide. Care Homes for Adults (18-65 years) Page 6 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: two star good service Our judgement for each outcome: Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 33 How we did our inspection: This is what the inspector did when they were at the care home We spoke to people who live in the home and asked if they were happy and supported by staff. We spoke to some staff that work at the home. We looked at three care plans to make sure the staff know how to support you in the way you want. Care Homes for Adults (18-65 years) Page 8 of 33 We looked around the home to check if it is a nice place to live. What the care home does well You have good care plans that tell staff the support you need. Staff ask you how you want your care giving. Care Homes for Adults (18-65 years) Page 9 of 33 Staff give information in different ways to help you to understand things better. The staff ask what you want to do, and help you to arrange activities and go to places you like. The home makes sure you are healthy. You go to see the doctor if you are ill and have eye and dental checks. Care Homes for Adults (18-65 years) Page 10 of 33 You can choose to go on holiday and people living in the home have recently been to Wales. You can go to church if you want to. Staff will support you to do this. The home is a nice place to live and it is clean and tidy. Care Homes for Adults (18-65 years) Page 11 of 33 What has got better from the last inspection You have information about the home and which is available in different ways to help you understand. You have the medicine you should do. Medicine is checked to make sure it is the right one. Care Homes for Adults (18-65 years) Page 12 of 33 The care plans have been changed so staff know how you want to be supported. What the care home could do better The law says the manager is to become registered with us, and we have been told she is going to do this. Care Homes for Adults (18-65 years) Page 13 of 33 The staff should have training to support people with how people can make decisions and how they will help you. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Mandy Brassington CQC West Midlands Citygate Gallowgate Newcastle upon Tyne NE1 4PA 03000 616161 Care Homes for Adults (18-65 years) Page 14 of 33 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 15 of 33 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 16 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with relevant information to enable them to make a decision of the homes suitability to meet their assessed care needs. This information is provided in a format which people are able to understand. Evidence: The home has a Statement of Purpose which has information about the service and facilities available to people. Information includes the number of bedrooms and communal areas, social activities, and how to make a complaint. People have a Service User Guide, which is in a pictorial format to promote peoples understanding. The Guide informs people about what they can expect from staff and how they will be supported, and also clearly describes how people in the home are expected to respect others. Discussion with staff and two people who use the service revealed that people were able to visit the home and spend time with people, including having meals and an over night stay before moving into the home. One person said, I chose this room because it was the best one, I got to look at them all. Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: There have been four new referrals to the home since our last visit, and the plans of care included information regarding the initial assessment. Staff reported that important people to the person were involved in the assessment, to enable the service to make an informed decision about whether they would be able to meet their individual needs. Care Homes for Adults (18-65 years) Page 18 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident their assessed care needs will be met and are able to make decisions on the support and assistance they need to ensure their health and welfare. Evidence: The manager reported within the Annual Quality Assurance Audit (AQAA) that each person has a care plan that covers all aspects of personal and social support, and each person is involved in the development of the plan. We reviewed three plans of care and found each plan contained detailed information regarding the support to be provided to meet individuals needs. The plans included information about how to help people meet personal hygiene needs and how to maintain peoples independence, and any dietary needs to promote peoples health; for one person an agreement had been recorded about the amount of one type of drink consumed in a day due to health advice, all other drinks were unlimited. The Plans of care provide staff with information on how to manage complex behaviours. For example, redirecting people; this is where staff will try to remove or distract the Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: person away from what may be upsetting them. This will ensure the persons safety and the safety of other people. Another plan contained information about promoting awareness of personal space and what had been agreed as acceptable with the individual in different environments. This supported the persons personal development and social skills. Discussion with the manager confirmed staff had received training about the management of complex behaviours. This should ensure staff members are skilled and competent to manage behaviours properly. There are assessments of risk in place to provide staff with guidance on how to manage complex behaviours and other potential risks such as bathing, making hot drinks and visits in the community. These assessments promoted peoples independence whilst ensuring their safety. The plans gave very specific instructions, and discussion with staff demonstrated people had an in-depth knowledge of the plans and how to support people. Staff commented its important we all work together, we all need to be consistent., and our manager has helped us work together as a team, so we can provide consistent care. Care records showed plans were reviewed regularly to reflect peoples changing care needs. The manager stated a formal review took place every six month with the individual and important people, including care professionals. This ensured people received the appropriate support and assistance to meet their needs. Care Homes for Adults (18-65 years) Page 20 of 33 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. People are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. Routines are very flexible and people can make choices in all areas of their life, and support is given to promote peoples rights and independence. Evidence: People are able to be involved in a variety of leisure activities. Discussion with individuals revealed that they were able to choose to go to places of interest, and staff are flexible to enable activities where support is required to take place. On the day of the inspection, two people visited the Wolverhampton Training ground to join in Football practice and two people played ten pin bowling. One person was out for most of the day, as had chosen to go to a summer activity scheme. One person commented, I like it here, we get to do things I like to do. One survey completed recorded how they were supported to watch their football team across the country at League games. People were enthusiastic to show photographs of recent activities including a holiday in Wales, and a birthday celebration. During lunch, people reported that they had stayed Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: near a farm house and visited the beach and enjoyed their holiday. The AQAA recorded that people are able to continue to have active family and friend involvement, and visiting takes place at a time that is suitable for both people and their visitors. They recorded the visiting can take place in the privacy of peoples rooms and family and friends can visit any time of the day. On the day of our visit one person was preparing to go home and stay the night with family. The person said I go home quite often, I like staying there and going out with my family. There is a wide age range of the people living in the home and activities are organised according to peoples preferences. Other recent activities have included going to a Girls Aloud concert, watching Wolverhampton Wanderers and Manchester United play football. People are encouraged to be responsible for all personal daily activities, and two people have a daily planner which supports plans of care. One person has this completed with pictures on a daily basis as this reduces anxiety to have a plan and understand what needs to be done each day. There was no one living in the home from an ethnic background, the staff confirmed they would be able to provide a service for people from different ethnic groups and would access relevant services to assist with communication and culture awareness. From discussion with the manager and staff, it was evident the team are committed to ensuring that people who use the service are able to live an ordinary life, and have access to all community facilities and services. The manager, through discussion and observation demonstrated her commitment to ensuring that people are aware of their rights and able to take responsible risks. Care Homes for Adults (18-65 years) Page 22 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to ensure their assessed care needs are met, promoting their health and welfare and receiving medication to keep well. Evidence: Three plans of care were examined and all plans included information about peoples health care needs. Each person is registered with a local General Practitioner, and people who use the service stated they are supported to attend appointments. Where any health care is provided or appointments attended, the plan of care is updated to incorporate the changes. The AQAA recorded that all aspects of personal care is undertaken in a sensitive and professional manner, taking into consideration the specific wants and needs expressed by each person. Everybody has a health action plan and peoples health is monitored on a regular basis, and appropriate action is undertaken as and when required. Discussion with staff and inspection of records revealed where health needs had been identified prompt action and advice was taken, and we saw that people were supported sensitively to meet any need. The home operates the Boots Monitored Dosage System (MDS). We looked at medication administration records (MAR), which showed staff had signed these when medicines were Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: given out. This provided a record to show people were receiving their prescribed medicines to ensure their health. We watched the medicines being prepared for a visit home and saw that two people were responsible for administering medicines and checking everything was accurate. Staff stated they had received training to safely administer medication and the manager had developed a book about all the medicines and what they are used for so people were able to understand the importance of why each medicine was given. Care Homes for Adults (18-65 years) Page 24 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to the homes complaint procedure, enabling them to share their concerns and promote their rights. The Policies and procedures adopted by the home protect people from the risk of abuse. Evidence: People have access to the homes complaint procedure which is published in plain English and pictorial format to promote peoples understanding. Individuals are encouraged to raise any concerns and a record of concerns and complaints are maintained. During our visit, we asked how people would share any concerns, and all people responded that they would talk to staff, and they were confident that staff would listen. One person reported they would also talk to family members. The AQAA recorded that a copy of the local safeguarding procedure is in the home and staff, as part of their induction have an opportunity to read and understand this policy. Staff training records and the services Statement of Purpose showed staff members had received safeguarding training. This should ensure staff are aware of the various aspects of abuse and are able to recognise the signs to ensure peoples protection. We spoke to one staff member who confirmed she had received safeguarding training; they also informed us that signs or allegations of abuse would be reported to Social Services and to us. Care Homes for Adults (18-65 years) Page 25 of 33 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. People who use services are encouraged to see the home as their own. The home is a pleasant, safe place to live and people have personalised their home to reflect their interests. Evidence: The home is on the outskirts of Wombourne and the front of the house looks across open fields. On the ground floor there is a lounge, dining room and kitchen, along with four bedrooms. two bedrooms are on the first floor. All bedrooms have an en-suite toilet or en suite toilet and shower facilities. People stated they were able to style their room according to individual preferences. All bedrooms inspected contained a variety of personal electrical equipment, gaming consoles, pictures and photographs. People are able to have a key to their room. One person commented, I have a key, but I dont always lock my room, nobody ever takes anything and people dont come in unless you want them to. The manager reported they have received a visit by Environmental health and received Five Stars, which is the highest rating awarded. The means that Environmental health are happy with the standards in the kitchen and cleanliness and procedures in the home to keep people safe. Care Homes for Adults (18-65 years) Page 26 of 33 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. Skilled and competent staff ensure peoples assessed care needs are met to ensure their safety and welfare, and staff recruitment practices ensure people are protected from potential abuse. Evidence: The usual pattern of shifts is three people working a morning shift and three people working an afternoon shift, which people reported means they are able to support people and meet identified needs. The staff stated that the roster is flexible to allow activities within the home or the community. Staff personnel records showed the homes recruitment procedure was thorough to ensure people were protected from potential abuse. Three staff records were inspected and demonstrated the organisation has robust recruitment practices. All records included a photograph, an application form, two written references, a Protection of Vulnerable Adults (PoVA first) check and a Criminal Records Bureau Check (CRB). Staff confirmed they had these safety checks. These checks should provide some assurance that staff members are suitable to work in the home. Discussion with staff revealed that people have attended the training for management of complex behaviour, safe administration of medication and Food hygiene. The manager Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: reported that all staff have received the required updates for Health and Safety and Moving and Handling, and training is planned for all staff for the Mental Capacity Act. Keeping up to date with skills and knowledge enables staff to assist people to meet their needs and ensure the persons health, welfare and safety. The manager and Deputy are planning to attend Training for Deprivation of Liberty. It is recommended that all staff receive training for the Mental Capacity Act including Deprivation of Liberty to ensure staff know what course of action to take, understand the assessment processes and are clear of their legal responsibilities. People confirmed they were happy with the support provided and comments included, The staff are very polite, kind, caring, and help me if I need them and the staff helped me to have a holiday and go on trips to the pubs and shops and They help me stay in touch with my family. Care Homes for Adults (18-65 years) Page 28 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to benefit from a management style based on promoting independence and rights and enabling people to live a lifestyle of their choice. Evidence: It is evident from observation and discussion with staff, that the manager is extremely enthusiastic and committed to promoting peoples rights and providing a quality service. The manager discussed at length how she had helped to develop the service over the past months, including developing systems in the home to support people, and giving staff opportunities to develop as a team to provide a good service. The manager has submitted her Criminal Records Bureau Check (CRB) with us and this has been cleared as satisfactory. The manager showed us the completed form and is awaiting all references and will submit the application to begin the Fit Person process to become the registered manager of the home. Staff commented they feel valued and part of a supportive team and would have no hesitation approaching the manager who is supportive and recognises personal Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: achievement. Staff were very positive about the experiences and opportunities they have had since the manager joined the team and said, I feel valued by the management team, and The home manager is very supportive to the team and to me as an individual and The manager has been instrumental in developing my role and I feel I have gained and learned new skills and experiences. Prior to our visit the manager completed an Annual Quality Assurance Audit (AQAA) for us. The AQAA was completed to a good standard and related to the National Minimum Standards for each outcome area. Evidence within the AQAA was sampled and found to be accurate. The registered person visits the home on a monthly basis to check people are receiving a good service; as part of this visit, they talk to people using the service and staff. A report is written and kept in the home and the manager records how any concern is identified to maintain standards in the home. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes  No  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 31 of 33 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 Description 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 Description 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 1 32 All staff should receive training for the Mental Capacity Act including Deprivation of Liberties. This is to make sure staff know what course of action to take, understand the assessment processes and are clear of their legal responsibilities. The manager is to submit the application to become the registered manager upon receipt of all references 2 37 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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