Care Home: Elston House

What the care home does well If anyone new wanted to come to the home they would be assessed to see if their needs could be met, and that they fit in with the people already living there. The help and support people need is written in a care plan. People are helped to make choices for themselves. Someone decided not to go to the gym and another person got up later as he had a lie in. Staff make sure residents can do things for themselves without getting hurt. One person goes horse riding. Everyone has their own plan of what they do each day. One person helps look after the dogs at a local kennels. There is a room where people can take part in crafts like drawing and painting. People are able to keep in contact with their families, and have visits and phone calls. There is a mini bus to take people out in. People can help prepare meals and they eat things they like. People are able to wash and keep themselves clean. Staff make sure people have the healthcare they need. Staff will help anyone make a complaint if they need to, and know how to keep people safe. The home is kept clean and tidy and everyone has their own room. Only staff who have been checked to make sure they are the right sort of people to help others come to work in the home. The home is well run, and people are helped to say what they think about living there. What has improved since the last inspection? This is the first inspection of this home since it was registered in August 2009. What the care home could do better: Only keep things in people`s files that are needed. Use more signs and symbols to help people understand better. Someone must check that people`s medication is copied down correctly. Make sure repairs are carried out as soon as possible. Key inspection report Care homes for adults (18-65 years) Name: Address: Elston House Elston House Top Street Elston Newark Notts NG23 5NP     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: Stephen Benson     Date: 2 0 0 1 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 Adults (18-65 years) 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 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 29 Information about the care home Name of care home: Address: Elston House Elston House Top Street Elston Newark Notts NG23 5NP 01636526067 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jane.bellamy@cambiangroup.com Cambian Education Limited Name of registered manager (if applicable) Mrs Jane Bellamy Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 8 The registered person may provide the following category of service only, Care Home, Code PC to service users of the following gender, either, whose primary care needs on admission to the home are within the following category, learning disability, Code LD. Date of last inspection Brief description of the care home Elston House is a care home providing personal care and accommodation for up to 8 younger adults, aged 19 years and over with autism and severe learning difficulties. The home is owned by Cambian Healthcare Limited who provide services in education and mental health. The home is located in the village of Elston between Nottingham and Newark, and consists of an adapted residential property. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 Brief description of the care home All of the bedrooms are single and have ensuite facilities. There are six bedrooms in the main house and a further two bedrooms in an anexe building. The home has extensive grounds, including a woodland area and there is ample care parking to the front of the home. The fees for the service range from £3173 - £3750 per week. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2009. This inspection involved one inspector; it was unannounced and took place in the daytime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. We sent survey forms entitled Have your say about... to staff, relatives and service users We had 8 staff surveys and 2 relatives surveys returned. Service users were unable to complete them. Care Homes for Adults (18-65 years) Page 6 of 29 The main method of inspection used is called case tracking which involves looking at the quality of the care received by the service users living at the home. We also use evidence from our observations; we look at records and talk with staff about their understanding of the service users needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Only keep things in peoples files that are needed. Use more signs and symbols to help people understand better. Someone must check that peoples medication is copied down correctly. Make sure repairs are carried out as soon as possible. Care Homes for Adults (18-65 years) Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 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 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, 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. There is a system in place to ensure anyone new coming to the home will be fully assessed. Evidence: There have been five people admitted to the home since it became registered to operate as a care home. All of them came from a residential college owned by the same provider, allowing a planned and phased move into the new home. Staff visited the college prior to people moving to the home to get to know them, and staff from the college spent some time at the home once they moved in to help them settle. The placement plans held at the college have been updated to take into account the new surroundings. We were told in the assessment they completed that, We conduct assessments for new residents and only admit residents after an assessment where it has been established and identified that we can meet their future individual needs and aspirations. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The manager said she expects the majority of residents to come from the college, although there is a system in place to assess any applications received from elsewhere. The manager has been to assess several people who have been referred for a place, but none of them were felt to be appropriate. Staff said they had got to know the residents before they moved into the home, which had been very useful. Care Homes for Adults (18-65 years) Page 12 of 29 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. Peoples lifestyle and ability to make choices and take risks are promoted through a well thought out care planning process. Evidence: We were told in the assessment they completed that, We continue to communicate with the residents and involve them with their planning. We provide weekly plans and activities within the community and based within the home, these are then broken down into small time lines to enable them to understand their daily plans and routines. The care files for each of the residents have been transferred from their previous residential college placement, and the relevant information has been updated to take into account their new home. There is also information on the care file that was relevant to peoples placement at the college, but not necessary now, and files would be easier to use if this was removed. Each resident has a journal where information is recorded about how they have spent their day. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Each file seen included a personal profile, a person centred placement plan, a Mental Capacity assessment and a behaviour support plan. There were some signs and symbols used within the plans, however in view of peoples communication abilities they would benefit from these being used more frequently. The manager said she intends to do this, as well as making more of the plans person centred. Staff said they had the care planning system explained to them and have had training on how to use it. In our survey forms seven staff said they are given up to date information about the needs of the people they support, and one person said they usually are. Staff said that residents are not made to do anything they dont want to, and said one person had stayed at home today as she did not want to go on the trip to the gym, which had been arranged. Staff said residents are able to make decisions for themselves as long as they are safe and do not present them to any unacceptable risk. They gave an example that one person is assessed as not being able to go into a supermarket, as his behaviour places him at risk, but he is able to decide when he gets up in the mornings. Risk assessments were seen in care files for activities in and out of the home. These included going horse riding, to the gym and swimming. A comment on one of our survey forms was that the home Focuses on the residents choice. We have residents meetings etc. where residents can have a say in what they want. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to follow a lifestyle that suits their interests and abilities, and they enjoy their meals. Evidence: We were told in the survey they completed that, We employ a dedicated activities coordinator who supports the staff team and residents to engage in home management, to include aspects of the premises, gardening etc. We support the residents to engage in activities both within the home and community. Each resident has their own individual weekly planner in their room, which has been designed in line with their interests. These include things such as crafts, baking, bowling and horse riding. One resident helps at a nearby kennels and takes a dog for a walk. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: There is a designated room where activities such as arts, crafts and computer use can take place. The activities coordinator said she has started to hold residents meetings where suggestions can be made about other activities through using pictures, signs and symbols. One person said she would like to try horse riding and everyone has started to have aromatherapy. A relative commented on one of our survey forms, They make life interesting, giving him a variety of things to do. They go that extra mile. I could not be happier for him. The home has become a registered centre for an educational qualification (ASDAN), which residents will be able to work towards. The activities coordinator is going to be training staff in supporting residents to do this. The home has a mini bus to take residents out. There is a local shop which residents use, and one person went to collect the bread and milk that had been ordered. Comments on our staff survey forms included that the home Always trying to improve the activities and the home would be improved with more community activities. Details of how people maintained contact with their families is written in their care files. This includes making and receiving regular phone calls, writing letters, having visits at the home and visiting their family home. The manager said there is a daily routine, which people can opt out of if they wish, but care has to be taken as some people may opt out of everything. One resident has a care plan that states he needs to be given advance notice of anything, so he has time to think about whether he wants to take part, which he will normally do, if this plan is followed. The cooking of meals is shared between a cook, who works Monday to Friday, and support staff who cover at weekends, and when the cook is on holiday. Staff are aware of peoples likes and dislikes, and were seen ensuring these were met. A record is made of what each person has to eat every meal in their journal. Residents were seen eating their lunch. One person likes to have a small amount of vinegar with every meal, and this was provided. Staff said one resident can be fussy with their food so they have to make sure she eats sufficient, but everyone else is happy with the food they are given. Residents are able to help in some food preparation. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive the personal support and healthcare they require to promote their well being. Evidence: We were told in the assessment they completed that, All our residents have en suite facilities to maintain their privacy and dignity within the home when they are supported with any personal care. We have in depth placement plans that outline the way in which the residents prefer to receive personal and health care. Care files provided information on how peoples personal care needs are to be met and showed that residents are able to manage their own self care with prompting, and staff were seen doing so when the need arose. Each resident has a separate healthcare file where details of their healthcare needs and any treatment received are recorded. The manager said they have built up good working relationships with the local healthcare services and a psychiatrist comes to the home every month to review Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: peoples medication and behaviour. Staff said they are provided with information about peoples healthcare conditions, which they find helpful. A nurse is employed for 4 hours a week to provide support with managing medication. Staff are required to have completed medication training before they are allowed to take part in administrating medication. There are systems in place to ensure medication is safely managed, although where medication records are written out by hand, these are not being checked for accuracy by another person. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assisted to make a complaint, are protected from abuse and kept safe from harm. Evidence: We were told in the survey they completed that, As a large company we provide regular staff training in the protection of individuals, we have comprehensive complaints and concerns policies and processes. We have comprehensive systems for the reporting and recording of such occurrences. There have not been any complaints made since the service opened, and the manager said keyworkers would be able to advocate on behalf of residents to make a complaint. The manager said that she plans to prepare the complaints procedure in a picture format to make it more understandable to residents. Staff were aware of the complaints procedure and agreed they could raise a complaint on behalf of the residents. In our survey forms relatives said they know how to make a complaint about the care provided if they need to. A comment in a staff survey form said the home, Provides the residents with a homely place to live where they are safe from harm and given every opportunity to live a happy relaxed life. Staff were aware of different forms of abuse, and of their responsibility to report any allegation or suspicion of abuse. There was a copy of the local safeguarding Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: procedures in the office. Staff are provided with training on the use of restraint and there have been some instances where staff have restrained a resident in order to to keep them safe, or protect others. A record is made when any form of restraint is used. Care Homes for Adults (18-65 years) Page 20 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, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a comfortable and clean home to live in, that is suitable for their needs. Evidence: We were told in the assessment they completed that, Elston House has excellent facilities, the environment is to a very high standard with high quality fixtures and fittings. Although the home is registered for up to 8 residents two of the bedrooms are in a separate annexe building and will not be used until the buildings have been joined with a covered walkway. Planning permission has just been approved for this and work is due to be completed by the end of February 2010. Staff said they thought the building had worked pretty well, and when they had identified a problem of accessing the laundry in bad weather, alterations are planned to resolve this. Comments made by relatives in our survey forms included, Great place well designed staffed and managed and A great example of how such a facility should be set up and run. A comment in a staff survey said things could be done to, make the house feel a Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: little more homely and personal, especially the lounge/living areas. Staff said there are sufficient supplies of protective clothing available, and they have had training in infection control. Areas of the home seen were clean, tidy and fresh in odour. There were some curtains that have been pulled down in residents bedrooms that were waiting to be put up, but staff were not aware of when this will be done. Care Homes for Adults (18-65 years) Page 22 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, 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. People are supported by sufficient trained staff. Evidence: We were told in the assessment they completed that, We have an in depth recruitment procedure to employ staff suitable for the positions, we provide a very in depth induction programme, with staff shadowing after to ensure they are confident and comfortable to begin their role. A new staff group has been recruited to work in the home. They work in designated teams, led by a senior member of staff. The manager said they have established themselves as strong and competent teams. Each team works a set pattern of shifts, which includes a training day every three weeks. In our survey forms staff said they either always or usually have enough staff to meet the individual needs of all the people who use the service. Relatives said they thought care workers have the right skills and experience to look after people properly. It was stated on the assessment they completed that all staff who have started work in the home had satisfactory pre employment checks carried out. There is an Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: arrangement in place with us to hold staff files at a nearby college owned by the provider, however the records held in the home recorded that the required pre employment checks had been carried out. All staff who completed our survey forms said they had a Criminal Records Bureau (CRB) check and references taken up before they started working. All staff had a two week induction period before starting to work in the home. They are able to access further training through the nearby college, and further training is organised in the home. Staff said they are able to request training they think they need. Care Homes for Adults (18-65 years) Page 24 of 29 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. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: We were told in the assessment they completed that, The manager has the required qualifications and experience to manage the home, providing clear leadership ensuring the home is well run and maintained. The manager, who was registered in August 2009, has a professional qualification and considerable experience in working with this client group, including previously being a registered manager of another service. Staff told us they thought the home was being well run and they felt able to contribute to the running of the home and felt valued. In our survey forms all staff said the manager gives them enough support and meets with them to discuss how they are working. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Residents meetings have just been started and this will be one forum where people can express their views. The manager said questionnaires will be sent out to relatives and other methods of seeking views will be explored. The assessment we ask the provider to complete and send back to us was returned on time. The information contained in this was detailed. and reflected what we saw when we visited. We were told in the assessment they completed that equipment is serviced or tested as recommended by the manufacturer or other regulatory body. Dates were provided showing this to be the case. Staff said they did not have any concerns about health and safety within the home. Care Homes for Adults (18-65 years) Page 26 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 Adults (18-65 years) Page 27 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 20 13 Ensure any handwritten medication records are checked for accuracy by another person. This will ensure people do not receive the wrong medication through a copying error. 15/02/2010 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 2 3 6 6 26 Remove information that is no longer relevant to peoples lives from their care files. Increase the use of signs and symbols in care plan documentation. Ensure minor repairs are carried out in a timely manner. Care Homes for Adults (18-65 years) 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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