Care Home: Falmouth House Residential Care Home

Similar services:

• Ashlea Mews Residential Home
• Eastwood
• West Lodge
• Arran House
• Avenue Community Nursing Home
• Cosin Lodge
• Farmborough Court
• Cragston Court

What the care home does well The service is aware of equality and diversity and encourages staff to explore issues relating gender, ethnic origin, culture, religion, education and social histories. Service users, where able, describe good relationships with the staff and say they are all polite and helpful. Staff are friendly and relaxed and show a good understanding of service users` needs. Arrangements for service users to maintain contact with their family and friends are good. Meals are varied, well balanced, offering good choice and nutritious food at all meals. All service users are pleased with the quality and choice available. Meals are seen as a relaxed and social occasion. Service users are involved in menu planning and weekly food shopping. Hygiene practices are good, protecting the health of service users and staff. The home is staffed with a skilled, consistent and trained staff team giving security to service users. The staff have a good understanding of each individual needs. More than ninety percent of staff are qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing service users with a trained, skilled staff team. Other professionals who know the service have been very complimentary about the home. Comments included: " I find that the staff use a very person centred approach towards the clients which is enlightening. They work hard to integrate new residents into the home culture." " In my experience Falmouth House provide a high quality service to people with a learning disability, meeting their needs in a holistic manner and providing support to both residents and their families." What has improved since the last inspection? The service user plans are more individualised and service users are involved in their development. The decor, furniture and fittings have been improved further since the last inspection. What the care home could do better: Make sure that all medications are stored as securely as possible in order to avoid errors and keep service users safe from harm. Ensure that the pre employment checks for staff are renewed on application and periodically, to ensure service users continue to be protected by up to date information. Key inspection report Care homes for adults (18-65 years) Name: Address: Falmouth House Residential Care Home 24 Edwards Road Whitley Bay Tyne & Wear NE26 2BJ     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: Carole McKay     Date: 0 3 0 9 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 Adults (18-65 years) Page 2 of 28 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 28 Information about the care home Name of care home: Address: Falmouth House Residential Care Home 24 Edwards Road Whitley Bay Tyne & Wear NE26 2BJ 01912513729 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: falmouth24@yahoo.co.uk Mrs Anne Elkin care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding Learning Disability or Dementia, Code MD, maximum number of places 10 Date of last inspection Brief description of the care home The home is located close to the town centre and sea front of Whitley Bay. The home provides personal care and accommodation for up to 10 younger adults with a mental disorder or a learning disability. The home is a large converted terrace house. The accommodation is on three floors; there is no passenger lift. The laundry and office are located in the basement of the home; service users do not have access to these areas. The home has a large lounge and a separate dining area; there is an additional lounge where service users can see visitors in private. The service users have access to a rear yard with seating. Fees for the home range from £300 to £400. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 10 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: SUMMARY: This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use the services are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit we looked at: Care Homes for Adults (18-65 years) Page 5 of 28 Information we have received since the last inspection; How the service dealt with any concerns and complaints since the last visit on 20 August 2007; Any changes to how the home is run; The providers view of how well the care for people; The views of people who use the service and their relatives, staff and other professionals. The Visit: An unannounced visit was made on 3 September 2009. During the visit we: Talked with people who use the service, staff and the deputy manager; Looked at information about the people who use the service and how well their needs are met; Looked at other records which must be kept; Checked that staff had the knowledge, skills and training to meet the needs of the people they care for; Looked around the building/parts of the building to make sure it was clean, safe and comfortable; Checked what improvements had been made since the last visit. We told the deputy manager what we found. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Make sure that all medications are stored as securely as possible in order to avoid errors and keep service users safe from harm. Ensure that the pre employment checks for staff are renewed on application and Care Homes for Adults (18-65 years) Page 7 of 28 periodically, to ensure service users continue to be protected by up to date information. 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users will be able to make an informed choice and have their needs fully assessed before deciding to live at the home. Evidence: Service users told us that they had been involved in choosing to live at the home. They had visited this and other homes before reaching a decision. They confirmed that their needs had been assessed before they moved in. All said that they had made the right choice. Each service user has a written contract. The records we looked at showed that each person had a full needs assessment carried out by their care manager or social worker and by the staff at the home. The homes assessments are comprehensive and include family and other contacts that are important to the service user. Choices, wishes, personal goal and risks are also included. Where service users require specialist assessments, copies of these have also been obtained by the home. For people who are over 65 years old the home carries out additional assessments, that are specifically related to ageing. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: These documents were signed by the staff from the home and the service users. In surveys all staff who returned these to us confirmed that they receive enough information about the needs of each service user, to offer appropriate support. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are involved in decisions about their lives and are encouraged to play an active role in planning the care and support they receive. Evidence: In the records we examined each service user had a very clear and comprehensive service user plan. These had been devised from the assessment process. There was evidence that service users had been involved in producing these. Their choices and decisions were clearly recorded, particularly in circumstances where their consent was required. Plans had been reviewed recently. Plain language is used in the service user plans. And for one person a part of the assessment has been produced in the service users first language. In response to surveys, we received very positive comments from professionals who know the home. One person commented that - I find that the staff use a very person centred approach toward their clients which is enlightening. They work hard to integrate new residents into the home culture Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The service user plans include risk management plans and these also show that service users have been involved in reaching agreements about these. In surveys returned to us service users confirmed that they could decide how and where they spend their time. This was confirmed in the descriptions of social activity and in the daily reports in service user plans. Each plan includes a statement about confidentiality and access. Each service user has a keyworker on the staff team to support their individualised care. There is evidence in the records that family support and other forms of representation are encouraged. Daily reports are maintained and meetings take place with service users on an individual basis and as a group. The records from all of these show that the home acts upon the results of consultation with service users. Service user told us that they have plenty of opportunities to talk to staff and the manager and that they felt they are listened to. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are able to make choices about their lifestyle and are supported to build and maintain life skills and relationships. Evidence: Each service user has a daily living and life skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users are supported to live a normal life in the community. They are supported and encouraged to be in control of their own lives, to enjoy their own interests. All service users are supported to maintain very close links with their families and their friends. They can choose who they want to see and when. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Daily routines promote independence, choice and freedom of movement. Service users are involved in housekeeping tasks. The Homes menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. The service users confirmed that they are always offered a choice, and that the meals are always good. Service users have access to the kitchen and can prepare snacks for themselves if they wish. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health and support needs will be recognised and their choices will be respected. Generally medication is well managed. Storage can be improved. Evidence: The people who live at the service currently are all relatively independent requiring minimal support with personal care. Some people may need prompting and reminders from time to time. To protect the privacy and dignity of service users, their preferences and any decisions reached are clearly recorded in the service user plans. For example decisions to do with managing illness are recorded. Each service user plan we examined included information about the health care needs of the service user concerned and this was clearly recorded. In surveys the staff confirmed that they receive training that provides them with the correct level of knowledge about health care and how to manage certain illnesses. We found certificates for training in these matters in staff files. The following comment was made by a visiting professional in a returned surveyCare Homes for Adults (18-65 years) Page 16 of 28 Evidence: ...one of the residents with whom I work recently experienced a serious physical health concern. The level of both practical and emotional support offered by the staff team was excellent. Service users do not need any technical aids or equipment. Service users care records showed that they have access to external health care services. G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The medication systems were examined for ordering, receiving, administering and disposal. These are well managed. All staff have had accredited medication training. The home has developed clear policies, procedures and codes of practice to do with safe handling of medication. Other professional policy and guidance documents are also available. Controlled drugs are not currently prescribed. However the home has a storage facility for this purpose. Other medications are securely stored in a lockable cupboard. One set of keys is available. Medications requiring refrigerated storage are kept separately in a fridge that is not lockable. But the staff said that the door to the stairs leading to this room would be kept locked when not in use. Some additional safeguards were discussed with the deputy manager. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff training, policies and procedures protect service users from harm and people feel their concerns would be acted upon. Evidence: The home has a written complaints procedure. A copy of this is openly displayed in the hallway. A copy of the service user guide is also available here and this contains a large print version of the procedure. In surveys both staff and service users told us that they know what to do and who to contact if they have any concerns. Service users said that they would feel comfortable raising their concerns and felt that staff would listen to them. The home keeps a record of complaints. The last recorded complaint was dated July 2007. The matter had been fully investigated and resolved. The records of meetings with service users show that these take place on a regular basis. The home has written procedures for staff to follow if raising concerns about the treatment or well being of service users. These are- a whistle blowing and an adult protection procedure. The latter is a very clear and helpful guide for staff in dealing with protection of service users. It includes steps to be taken and the details of persons to be contacted. The staff files show that staff have received awareness and updated training in Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: safeguarding vulnerable adults. Other guidance documents to do with this matter, such as the procedures of the Local Authority, are also available in the home as reference. The staff said that they had received training in responding to challenging behaviour and had found this very helpful. Staff files showed that some staff have had training in legislation to do with service users rights and supporting independent decision making. The deputy manager said that further training in this subject is planned for later in the year. The home has clear written polices and procedures for the handling of finances belonging to service users. The transaction records were not examined at this inspection. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for the people living there. Evidence: The home was clean, well decorated and well maintained. The home is in a residential location, near to all the amenities of the town. The grounds were tidy, safe, and accessible. The home has an appropriate amount of sitting, recreational and dining space. Service users can see visitors in private in their own rooms. But the following comment was made in a service use survey in response to the question about what the home could do better- no private room in which to see visitors. And in response to what the home does well, the following comment was made- Room is well furnished, well heated, and kept clean There is a designated smoking area with good ventilation. Furnishings and fittings were domestic in design and in good condition. Lighting was bright and domestic in design. Doors have privacy locks. Service users bedrooms have opening windows. The rooms are centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes are Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: guarded. There is emergency lighting throughout the home. Water is stored at over 60 degrees C. Valves at water outlets ensure water is provided close to 43 degrees C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are located in the basement, and are well organised. Service users do not have access to the basement area. The washing machine has the specified programme to meet disinfection standards. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user are supported by a trained and confident staff team. The homes recruitment process protects service users, but some checks not up to date. Evidence: The staff files show that staff are recruited through formal procedures that take up necessary background checks and references. Some of the background checks had not been updated recently. For example some criminal record checks were dated 2004. One of these was for a person recently recruited. Some did not include protection of vulnerable adult checks. Staff turnover is very low. In surveys staff confirmed that enough staff are on duty to meet the individual needs of service users. This amounts to two care staff on duty through the day and one in the evening and one person overnight seeping in. The staff said that they are rarely required to get up through the night. But on call arrangements are in place out of daytime hours, should they be needed in an emergency. All the staff are over 18 years of age and staff left in charge are over 21. The staff surveys confirmed that staff feel that they are supported fully. The files show that staff receive regular supervisions and appraisal and that past training is certificated and future training is planned for the year ahead. Staff could give specific examples Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: where training had supported them to care for service users. Three of the five staff employed hold a national vocational qualification (NV) at level 2 or above. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed. Service users views are taken into account in self monitoring, review and development of the service. Evidence: The management arrangements at the home have not changed since the last inspection. The manager/provider is a qualified and experienced person who also manages another home and covers the rota for this home for part of the week. The deputy manager also holds the registered managers award and deputises fully in the managers absence. Staff understand their roles and the manager takes on quality assurance responsibilities additional to managing the service. The quality assurance process is very clear and well documented. It includes taking up the views of service users, staff and other interested parties. There is a system for analysing the results and objectively scoring the outcomes. Most outcomes are positive or very positive and the manager has responded to areas highlighted for improvement. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The home is well maintained and improvements have been made to the fabric of the building since the last inspection. New carpets were being laid on the day of the visit and there is an ongoing maintenance plan for the year ahead. Certificates for safety checks, such as gas fittings and appliances, are available and there is written evidence that electrical and fire safety checks have been carried out. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 The registered manager should consider providing a lockable metal box for the storage of refrigerated medications, such as insulin. The registered person should consider updating those criminal record checks that were taken up by previous employers or do not include protection of vulnerable adult checks. 2 34 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!