Care Home: Butterpark Residential Home

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What the care home does well The home was found to be performing well in all the areas we examined. People had enough information about the home before they moved in and the home checked it could meet their needs by thorough assessments. The health and personal care being provided was an accurate reflection of what was described in people`s individual plans. Individual needs and choices were respected and promoted and people were generally treated with respect. People feel confident that their concerns will be listened to and there are robust systems in place to protect them from abuse. The environment at Butterpark is clean, comfortable, safe and reasonably homely. Staff recruitment procedures protect people from potentially unsuitable staff. There are enough staff to meet the people`s needs and they are trained appropriately. Staff are clear about their respective roles and responsibilities. Butterpark is well managed by a qualified and competent Registered Manager. She has put systems in place to ensure that the quality of the service is monitored and that people living and working in the home remain healthy and safe. What has improved since the last inspection? New carpeting has been fitted and a cushioned floor in one room. A new sluice and medication room are also being provided. What the care home could do better: All staff need to be aware that some people may find it difficult to say "no" to greeting that involve physical contact. Key inspection report Care homes for older people Name: Address: Butterpark Residential Home Brook Road Ivybridge Devon PL21 0AX     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: Graham Thomas     Date: 1 6 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 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) 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 Older People Page 3 of 26 Information about the care home Name of care home: Address: Butterpark Residential Home Brook Road Ivybridge Devon PL21 0AX 01752891025 01392385136 paula.hannaford@devon.gov.uk http/www.devon.gov.uk Devon County Council care home 30 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) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 30. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Dementia (Code DE) maximum of 22 places Old age, not falling within any other category (Code OP) Physical disability (Code PD) Date of last inspection Brief description of the care home Butterpark is a care home registered to provide care for up to 30 older people, which is owned and managed by Devon County Council. It is located within the town of Ivybridge and has easy access to the town centre and community facilities. The premises are a two-storey detached building that has a large enclosed garden at the rear. Accommodation is provided in single rooms. The home is comprised of three Care Homes for Older People Page 4 of 26 Over 65 0 30 0 22 0 30 Brief description of the care home units, which are accessed through the main entrance. These have lounge, dining and bathroom/toilet facilities, and a small kitchen for the preparation of drinks and snacks. There is also a large shared lounge that is used for social events. The three units are: Harford View. This is on the ground floor and provides intermediate care for up to five people and respite care for up to two people. Stowford. This provides care for seven people with dementia. Seven places are for long-stay and two for respite care. Brooklands. This is on the upper floor and provides 13 long-stay places. Written information is provided for people considering using the services and those who are resident. A copy of the most recent CSCI inspection report is displayed in the reception. Care Homes for Older People Page 5 of 26 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: Before our visit to the home we looked at our records and information we had received since our last visit. We visited the home and spent one day there. During our visit we toured the premises and spoke with five people living in the home, five staff and the manager. We looked at individual care plans and examined how these plans were being followed through. This involved talking with staff and people living in the home, time spent observing a lunchtime meal and touring the home to see that appropriate facilities were in place. We also looked how peoples medicines were managed. Staffing arrangements were checked by looking at staff records, rotas and training plans. We spoke with staff and the manager to confirm what we had seen. An interview with the Manager and examination of various records told us how well the Care Homes for Older People Page 6 of 26 home was managed. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 3 and 6 People moving into Butterpark can be confident that their needs will be understood. Those receiving intermediate care can be assured that they will have access to good facilities and services to aid their rehabilitation. Evidence: We spoke with people who had recently been admitted to the home and looked at their records. People told us that they had enough information about the home before they moved in. They said that staff were kind and welcoming. The files we examined all contained assessment information about the persons needs. These included, for example, single assessment process forms and Joint Agency Plans. Information had been gathered about specific needs and this had been carried forward into a plan of care for each person with specific instructions for carers about the persons daily needs. Care Homes for Older People Page 10 of 26 Evidence: People referred for intermediate care had access to facilities and professional services providing rehabilitation to enable people to return home. For example an Occupational Therapist and Physiotherapist are employed part-time in the home. Facilities include a kitchen used for rehabilitation. Care Homes for Older People Page 11 of 26 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. Standards 7, 8, 9 and 10 The care and support of people living at Butterpark is well planned and organised. Personal and health care is well monitored and individual needs are met. Some care is needed over greetings and forms of address Evidence: We spoke with people living at Butterpark about their care. One person told us You couldnt have a better place than this!. Another told us that Staff always ask what you want and when you want it. All the people we spoke with complimented the homes staff and and felt that they were treated respectfully. We looked at four peoples individual plans of care to see how the home planned to meet their needs and whether these plans were followed through. We found that individual plans were well organised and provided carers with sufficient detail about the persons daily care needs. The plans we examined had all been signed by the person or their representative to show that they had been involved in their own plans. New personal profiles had been introduced that provided carers with information about Care Homes for Older People Page 12 of 26 Evidence: the person, their interests, life history and so on. This is particularly important for people whose memories and personality might become obscured by dementia. We could see that elements of individual plans were being followed through. For example, where one persons skin was vulnerable we noted that they had been provided with pressure relieving equipment. In another persons file we could see how a programme recommended by the Physiotherapist was being applied. The plans were regularly reviewed and showed how peoples health needs were monitored. This monitoring included, for example, nutrition and hydration. In our tour of the home we noted that people were supplied with plenty of fluids and were being encouraged to drink. As older people may be prone to dehydration, this is an important aspect of their daily care and monitoring. In the plans we saw up-to-date risk assessments for individuals relating to, for example, moving and handling. Equipment was available for this purpose and our observations and discussions with staff indicated that they were confident and competent in moving and handling vulnerable people. People with whom we spoke confirmed that they had access to a doctor and other medical professionals when necessary. We looked at how the service managed the administration of medicines. We found that where people administered their own medicines, risk assessments were in place and secure storage was available in which people could keep their own medicines. Medicines were stored separately in each area of the home. Storage in each instance was secure with additional security for controlled drugs. We found that the recording of the use of medicines was generally accurate and up to date. It was possible from the records to account for the amounts of medicines received, used and disposed of. This is important to ensure that people receive their medicines and to safeguard against possible misuse. Medication records included information sheets for staff about the medicines. The use of homely remedies was covered by a list approved by a medical practitioner. Where variable doses of medication were being administered (for example, Warfarin) this was being well recorded and managed. Effective monitoring of the medication system was in place. It was discovered during the inspection that a refrigerator used to store medicines had been unplugged in error. Immediate action was taken to restore cool storage and replace medicines that may Care Homes for Older People Page 13 of 26 Evidence: have been rendered ineffective. We also noted that an error made by the supplying pharmacy had been spotted by staff and taken up promptly with the supplier. During our observations we noted that staff generally spoke with people respectfully and maintained their privacy and dignity. For example, we saw staff closing doors during personal care-giving and knocking before entering individual rooms. However, we saw one staff member greeting people by hugging and kissing them and referring to them by terms of endearment such as darling. Although people did not appear to object to this it is important that staff should be aware that some people might find this intrusive and find it embarrassing or difficult to say no to such a greeting. Care Homes for Older People Page 14 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 14 and 15 People living at Butterpark enjoy a lifestyle that meets their social needs and reflects their individual choices. Evidence: We talked with people about activities that went on in the home. One person told us that they went for a nice drive on the moor and another told us about a trip to Totnes. Other people told us that they always enjoyed games and sing songs that took place regularly. On the day of our visit to the home a donkey had been brought to the home. This proved popular with people living in the home who went into the garden to see the donkey and talk with its keeper. Staff assisted people who could not get to the garden by themselves and those who did not wish to join the group were able to follow their own routines. The home has an activities co-ordinator with whom we spoke. The co-ordinator told us that she read through individual histories to see if there were individual hobbies or interests that could be maintained or cultivated. She confirmed what people had told Care Homes for Older People Page 15 of 26 Evidence: us about mystery tours in the homes minibus and visits with animals such as the donkey, hawks and other wildlife. We also discussed other activities such as coffee mornings held on alternate Thursdays in the home. Photographs, scrap books and activity records also showed evidence of tea parties, visiting musicians and cooking. Files of information about activities were available for staff reference. People told us that their visitors were made welcome in the home. One person said, my daughter visits every other day. She can visit at any time. During our visit we saw visitors being welcomed into the home and invited to join the group in the garden who had gone to see the donkey. During our visit, people were seen to be exercising choices about their routines, what they ate and where they wished to spend time. One person, for example was assisted to go to the garden to see the donkey. When they changed their mind at the last minute, staff respected this choice and returned the person to their room. We saw menu sheets that reflected a varied and balanced diet. We saw records that detailed each persons daily choices. In one unit we saw that the menu was displayed on a notice board. The choices available included casserole, curry or salad for the midday meal and poached egg or sausages in the evening. People with whom we spoke said that choices were always displayed on the board. We observed a midday meal and saw that the dining room had been attractively laid out. People were offered a choice of where they wanted to sit and what drink they wished to take with their meal. We saw that different meals were served to individuals according to their choice and that alternatives were offered if the person decided they did not want the meal they had chosen. Pureed meals were served in separate portions in order to preserve individual appearance and flavours of the different constituents of the meal. Discussion with kitchen staff confirmed that individual dietary needs were being catered for. This included, for example, sugar free ingredients for people with diabetes. Care Homes for Older People Page 16 of 26 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. Standards 16 and 18 People living at Butterpark can feel confident that their complaints and concerns will be taken seriously and dealt with appropriately. There are sufficiently robust systems in place for safeguarding people from abuse. Evidence: People with whom we spoke told us that they felt confident that staff would take any concerns seriously and deal with them. Butterpark has a written complaints procedure that is on display and is included in the residents guide. A system was in place for recording complaints and any action taken. Since our last inspection visit to the home we have received no complaints about the service. There is a safeguarding adults policy and procedure which is accessible to staff. All staff attend training in this as part of a rolling training programme by Devon Social Services Department. Staff with whom we spoke were able to tell us how they might respond to any abuse they might witness or suspect. Copies of the new Mental Capacity Act and Deprivation of Liberty Safeguards codes of practice were available for reference. Devon County Council was rolling out training for its staff in these subjects at the time of this inspection visit. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 19 and 26 Butterpark provides a clean, pleasant and safe environment for people living there. Evidence: Since our last inspection visit to the home, it has undergone some internal changes and modifications to the number of people for who its provides care in different categories. Accommodation is now organised into three areas, namely Harford View, Brooklands and Stowford. Harford view provides five places for intermediate care and two places for respite care. Brooklands provides 13 long-stay places. Seven long stay and two respite places are provided in Stowford. Improvements since our last visit include new carpets and cushion flooring in one room. Internal upgrading was being undertaken at the time of our visit to include a new sluice room and a new room for medication. We saw that all areas of the home were clean, well decorated and furnished in a reasonably homely style. Maintenance records showed that routine maintenance tasks and safety checks are carried out. For example, we saw evidence of recent testing of personal electrical appliances and maintenance of the homes assisted baths. The Care Homes for Older People Page 18 of 26 Evidence: Registered Manager told us that regular fire tests and drills take place and that an evacuation plan is in place. These matters are regulated by the fire authority. Outside the building there are well-maintained, accessible gardens that were being enjoyed by people living in the home at the time of our visit. The Laundry facilities are sited away from food preparation areas. The laundry had facilities for hot wash cycles and procedures were in place for dealing with infected and heavily soiled items. The laundry floors were impermeable and the walls washable. In the laundry there were hand washing facilities including liquid soap and paper towels. Care Homes for Older People Page 19 of 26 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. Standards 27, 28, 29 and 30 People living at Butterpark are supported by a sufficient number of staff who are appropriately trained to carry out their duties. Evidence: People living at Butterpark made many complimentary remarks to us about the homes staff. These included comments such as the staff are great and the staff are wonderful. During our visit we saw staff spoke with people in a relaxed but respectful manner. We looked at staff rotas and discussed these with the assistant manager with responsibility for managing them. We saw that staff were allocated on a daily basis. Typically the staffing complement was 10 carers and a senior staff member on duty from early morning to mid afternoon. The number of carers reduced to seven until 9:30pm. Overnight, the home is staffed by one night carer and two assistants. In addition the home has separate staff for domestic and laundry duties, catering maintenance and clerical tasks. Assistant managers are allocated specific tasks in support of the work of the Registered Manager. This includes, for instance, managing rotas and absence monitoring. Care Homes for Older People Page 20 of 26 Evidence: We looked at how staff were recruited. In the files of three recently recruited staff we saw evidence of a robust recruitment procedure. This included a formal application requiring references, an interview and criminal records checks. The criminal records checks were being renewed on a three yearly basis. Staff had not been allowed to commence duties before these checks had been completed. This is important in order to protect people from potentially unsuitable staff. The Registered Manager told us that approximately eighty five per cent of the homes staff have a National Vocational Qualification in care. We saw evidence in staff files that training was well organised and included topics relevant to the needs of people in the home and the roles of individual workers. For example, care staff had received training in dementia care and continence care. An assistant Managers file showed evidence of training in managing performance and supervision skills. The training programme included a variety of training sources such as distance learning, in-house short courses and attendance at college. Staff with whom we spoke confirmed the recruitment and training arrangements described in their files. Care Homes for Older People Page 21 of 26 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. Standards 31, 33, 35 and 38 People living at Butterpark benefit from living in a well-managed home where staff have a clear understanding of their respective roles. The health and safety of staff and people living in the home is well maintained. Evidence: Paula Hannaford, the registered manager, has many years experience in working in the care of older people including several as a manager. She holds the Registered Managers Award and National Vocational Qualification in Care at level 4. Mrs Hannaford has also completed courses in business management, life coaching, counselling and other relevant topics. Our discussions with staff and the management team indicated that staff have clear areas of responsibility and understand their roles. This is referred to in the previous section of this report. Systems are in place for staff to give and receive feedback. Care Homes for Older People Page 22 of 26 Evidence: These include regular management meetings, staff meetings, supervision and appraisal. Documentary evidence of this was seen such as minutes of meetings. This was also confirmed in our discussions with staff The home has undergone a recent period of uncertainty about its future ownership and this appeared to have been managed well so that people continued to receive a good service despite the understandable impact on staff morale. There were systems in place to monitor the quality of the service provided and ensure that it continues to improve. For instance summaries of recent questionnaires were seen as well as minutes of residents meetings and summaries of visits conducted by the Responsible Individual. We were able to confirm that ideas put forward at the residents meetings concerning, for example, menus and activities, had been followed up and implemented. People staying in the home are encouraged to control their own money, if possible. Any money held on their behalf is kept in an interest- bearing account. Records inspected showed that clear processes were in place to account for all income and expenditure. We examined how health and safety is maintained in the home. Staff training records showed that they had received training in health and safety topics such as moving and handling, fire safety and food hygiene. This was confirmed by staff in our discussions. We saw up to date risk assessments for environmental risks such as slips, trips and falls and window restriction in the long-stay unit. Risk assessment questionnaires had been completed by staff in February 2009. Records of a recent gas safety check and fire safety equipment inspection were seen. Maintenance of an assisted bath and the passenger lift were also recently recorded. This suggested a sound approach to the maintenance of the homes environment and equipment. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 11 The should be clear guidelines, adhered to by all staff, concerning addressing and greeting individuals in the home Care Homes for Older People Page 25 of 26 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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