Care Home: Girtrell Court

What the care home does well Girtrell Court is purpose built and provides a spacious, comfortable home for the people who live there. There are a lot of mobility and moving aids so people can be assisted in comfort, safety and dignity. Staff are well motivated and well trained. They support a range of activities of the residents` own choice. People who live there told us that they enjoy the meals provided at the home. Medication is safely stored and administered and safety checks are kept up to date to ensure a safe environment for the residents. What has improved since the last inspection? All but one of the care staff now have an NVQ2, the appropriate qualification for care workers. There is an extensive staff training programme and safety and risk assessments have been carried out. What the care home could do better: Care plans contain a lot of detail but are not organised in a way that makes them easy to use. Reviews are carried out but need to be done regularly to make sure that the plans are up to date. If an activities co-ordinator was appointed it might be possible to further extend the range and quality of activities for the residents. There should be a programme of one to one supervision for all staff. Parts of the home, such as bathrooms and the gardens, need to be better maintained and decorated Key inspection report Care homes for adults (18-65 years) Name: Address: Girtrell Court 5 Woodpecker Close Saughall Massie Wirral CH49 4QW     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: Peter Cresswell     Date: 0 5 0 8 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 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 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 26 Information about the care home Name of care home: Address: Girtrell Court 5 Woodpecker Close Saughall Massie Wirral CH49 4QW 01516051806 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: grahampenny@wirral.gov.uk Metropolitan Borough of Wirral care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: 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: Physical disability - Code PD The maximum number of service users who can be accommodated is: 20 Date of last inspection Brief description of the care home Girtrell Court is a care home for twenty people who have a physical disability. Some of the people who live in the home also have a learning difficulty. It provides permanent accommodation for fourteen people and there are also bedrooms which can be used to provide respite care. Girtrell Court is all on the ground floor and there is plenty of car parking space at the front of the home. There is a large garden - mainly grass - at the rear and side of the building. Everyone who lives in the home has a single bedroom. There is also a spacious dining room and a number of lounges. Everywhere in the home is easily accessible to wheelchair users and there are many aids and adaptations to meet the needs of the people who live there. The home is generally well maintained, and there is a continuing programme of redecoration. Girtrell Court admits people for short term respite care but there are not usually more than two in the home at any Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 20 Brief description of the care home one time. Care Homes for Adults (18-65 years) 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 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: As part of this inspection we visited the home without telling anyone that we were going. The visit lasted about seven hours. We talked to the manager, several staff and a number of the people who live in the home. We handed out several surveys but none had been sent back by the time we wrote this report. During the visit we looked at all areas of the home, had the same lunch as the residents and looked at a range of documents, including care plans, safety records, staff files and training records. We also checked the medication records of a number residents. Before we went we asked the manager to send us an Annual Quality Assurance Assessment which includes the services own assessment of how they are meeting peoples needs and statistical information about the home. We last inspected Girtrell Court in August 2007 and we carried out an Annual Service Review in 2008. Fees for Girtrell Court are asessed individually but start at £737.50 a week. Care Homes for Adults (18-65 years) Page 6 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 Adults (18-65 years) Page 7 of 26 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 8 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, 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. Peoples needs are assessed but not all people know that the home will meet their needs and aspirations. Enough information is provided to enable people considering moving in to make a choice. Evidence: Girtrell Court has an illustrated easy-read service user guide and statement of purpose. Some details in the guide are now out of date and should be corrected. The manager assesses people before they are admitted to Girtrell Court and we looked at some of the written assessments for people who had recently been admitted. In one case, an assessment carried out by the previous manager did not set out how the home could meet the needs of the person in question and since then it has become apparent that the placement is not ideal. Assessments should clearly identify that the manager feels that the home can meet the needs of the person should they move in. There were contracts in place in all of the files that we looked at. Care Homes for Adults (18-65 years) Page 9 of 26 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. Care plans set out the needs of most people, though they need to be made more usable as a working tool. Service users are fully involved in the day to day life of the home. Evidence: We looked at the care plans for several people who live at Girtrell Court and others who go there for respite (short term) care. The files contained a great deal of useful information on the people concerned, with separate plans for matters such as mobility, self care and health. However, they were not organised so as to make them readily accessible and understandable to the people who need to use them. Documents were scattered through the files rather than kept together in a usable form. The files need to be reorganised. The daily reports were often quite detailed but need to be more focused on the action set out in the care plans. It would therefore be helpful to include summaries of the care plans with the daily reports file. Two people did not have a care plan of any description and plans need to be drawn up as soon as possible. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Care plans are supposed to be fully reviewed every six months but this had not been done consistently and there was still no diary for reviews. This would help to make sure that reviews are held when required. Residents take part in reviews and are fully involved in making decisions about their lives, as are families when they so wish. Staff hold regular meetings with the people who live in the home. Girtrell Court has an administrative worker and files are kept safely and securely. Staff have been trained in the implications of the Data Protection Act. Care Homes for Adults (18-65 years) Page 11 of 26 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 can take part in activities and pastimes that they enjoy and choose. People who live at the home enjoy a healthy diet. Evidence: People who live at Girtrell Court are encouraged to pursue their own interests and pastimes and to develop their personal lives. We spoke to a number of the residents and they told us about the activities that they choose to pursue. These included shopping, swimming, meals out and going to day centres. The manager told us that the home is seeking to improve access to short breaks and holidays. Two people told us about holidays that they were about to go on. They were both looking forward to going and the holidays were ones that they had chosen for themselves. The home still uses Merseylink transport service but the service will not take people to Liverpool plainly part of Merseyside - for some reason. This may be a matter which the manager could take up with the management of Merseylink. People who want to go to Liverpool Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: use taxis or public transport. Other people reported that Merseylink sometimes finishes too early and one person had needed to leave a concert early. There is no dedicated activities organiser at Girtrell Court and all care staff play a part in arranging collective or individual activities. There is a record of activities but it has not been used since we last inspected the home and notes of activities tend to be kept on individual files. A central record of activities could help staff to make judgments about what has been popular and can help as a guide to future planning. A nominated activities organiser would be able to focus exclusively on the issue of activities without the inevitable distraction of other tasks. The home does have parties, barbecues and other social events in the home, but most of the pictures on the wall of social events were over a year old which does not give the impression of an active social calendar. Family and friends are always welcome in Girtrell Court, though we did not have the chance to speak to any on this occasion. The home does not use volunteers, which may restrict the range of activities to some extent. An activities organiser might be able to take on the role of organising some local volunteers. People told us that they enjoyed the food in the home and the cook was chatting to some of them about what they would like for their evening meal. The printed menu is varied but is being changed at the moment on the basis of talking to residents about what they like. Lunch is usually a lighter meal and when we visited there was a choice of three meals. We ate one of them which was tasty and well prepared with fresh ingredients. Residents had fresh fruit with their meal after the cook had asked them what they would like. The evening meal is usually the main meal of the day and again there is always a choice of main course and sweet. The kitchen staff prepare their own puddings and sweets. Care Homes for Adults (18-65 years) Page 13 of 26 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. Personal support and care is provided as people prefer and in line with their wishes. Evidence: Peoples care needs are set out in care plans and personal care and support is provided in individual bedrooms or the specialised bathrooms. Residents are encouraged to retain their independence as much as possible, consistent with their personal safety. Everyone who lives at Girtrell Court has access to community and specialist health care services of their own choice. These are well recorded in their personal files, including details of doctors and specialist appointments. Medication is kept in the spacious medication room which is kept locked when it is not being used. Medication is administered by staff who have been appropriately trained. We checked the medication for three people. Most medication is supplied by the pharmacist in a monitored dosage system, where tablets are in individualised blister packs, with medication administration record (MAR) sheets. The records we checked were accurately kept, though the pharmacist had not put one particular treatment on the MAR sheet and this should be taken up with them. There is a controlled drugs (CD) cabinet though when we visited there were no controlled drugs being used. The CD register showed that when they had been used in the past they had been properly Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: recorded. Some other medication was kept in the CD cabinet for safe keeping and the manager should show some caution in doing this so as to avoid any confusion between drugs that are controlled and others. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected from the risk of abuse. Evidence: There have been a number of safeguarding referrals in the past year and they have been dealt with properly by the management of the home, protecting the interests of the people who live there. The outcome of one safeguarding issue that had been resolved satisfactorily was not recorded. It is important that the outcomes of complaints and safeguarding issues are properly recorded. Girtrell Court uses Wirral Borough Councils complaints procedure which is accessible to everyone who lives at the home and their families. Staff are trained in all safeguarding issues. Care Homes for Adults (18-65 years) Page 16 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, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home enjoy a spacious, well equipped, accessible environment. Evidence: We toured the whole building and looked at every room as well as the garden. Girtrell Court was specially built to meet the needs of disabled people and the home is very well equipped. All of the building is accessible to people who use wheelchairs and specialist equipment such as Arjo (assisted) baths are available. Every bedroom and bathroom has electric ceiling mounted lifting equipment and automatic electronic locks. Everyone has their own individual bedroom; all of them are spacious, some of them especially so, and all of the rooms have specialist beds. Most people have their own large TVs in their rooms and all of the permanently occupied rooms were individualised to reflect the tastes and personality of the resident. There are several lounges and communal spaces. The main lounge has a large TV screen and one smaller room has projection equipment for group movie shows, though this is less used nowadays with so many high quality TVs in the home. There is a handyman at the home and the building is generally well cared for. However, most of the toilets and bathrooms need to be redecorated and one of the toilets needed a seat to be fitted. Several bedroom carpets need to be replaced or thoroughly cleaned. The carpet in one of the main corridors was badly rumpled and needs to be refitted or stretched. Some of the damage to carpets is caused by heavy wheelchair use and cannot be avoided Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: but this does not mean that the carpets should not be replaced when they are irreparably worn or marked. The conservatory overlooking the internal courtyard/patio is used as a smoking lounge and is not used by non smoking residents. Girtrell Court has a huge garden at the back and it is well used for barbecues in warm weather, when we have any. The large grassed area is kept cut but the garden area is not well kept. The internal courtyard is a pleasant area in which to sit out but is not well cared for. it needs to be weeded, cleaned and some new garden furniture bought. Care Homes for Adults (18-65 years) Page 18 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, 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 who live at Girtrell Court are supported by well trained, well motivated, experienced staff. Evidence: The home employs enough staff to meet the needs of the people who live there. It is normally staffed by the manager, his deputy, one or two senior care staff (some of whom are also called support workers), five or six care workers plus catering and domestic staff as well as a handyperson and a part time administrator. There are three waking care staff on duty overnight. In the last year over 100 shifts have been covered by agency or temporary staff as not all vacancies are filled permanently. It would provide more consistency for the residents if all shifts were covered by permanent staff. Additional hours are provided for several people by agency staff. The agency staff are provided consistently and we spoke to one who worked regularly with one particular resident. This type of arrangement helps the individual concerned to lead a far more independent lifestyle. The agency workers we saw and spoke to fitted in very well with the homes permanent staff and other residents. There is a full training programme in place and recent courses have included issues such Managing challenging behaviour, Personalisation, Communication awareness, Equality and diversity as well as statutory training in Safeguarding, Moving and handling and Health and safety. All but one of the care staff now have NVQ2 (the relevant qualification), a Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: huge increase on the last time we visited. This ensures that people are cared for by staff with the appropriate skills to do so. Staff meetings are held but there is no regular programme of one to one staff supervision in place. Staff should receive one to one supervision six times a year. It is impractical for the manager to do all of this and senior staff should be trained in supervision techniques. Supervision is needed to make sure that staff get the right support, advice and training. Staff are properly checked before they are allowed to start work, though there have been very few new staff in recent months. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home are protected by living in a well managed home with effective health and safety measures. Evidence: The current manager has been in post since November last year yet no application has been made for him to be registered by the Care Quality Commission. An application should be submitted without delay. He is an experienced manager and has previously been registered at another home. Staff appeared to be enthusiastic and committed, working well as a team. Agency staff employed to work with individuals fit in well with the staff team. There is no formal quality assurance programme but senior management visit the home regularly. Senior management are required to complete reports on these visits every month but the records were not up to date. Staff are trained in health and safety issues and basic food hygiene and risk assessments were in place on the files we looked at. Fire safety and other safety records were up to date. The home does not use the Food Standards Agency food safety programme Safer Food, Better Business and should discuss this with the Environmental Health Officer. An Environmental Health Officer visited in November 2008 and required that a Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: record should be kept of cooked meat temperatures. This has not been done and should be done without delay. Other checks, such as fridge temperature checks were kept properly. Care Homes for Adults (18-65 years) Page 22 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 Adults (18-65 years) Page 23 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 1 2 14 No one must be admitted to the home until the registered person has confirmed that the home is suitable for meeting their needs. Service users need to be sure that the home can meet all of their needs. 01/10/2009 2 6 15 The registered person shall, after consultation with the service user, prepare a care plan setting out how their needs are to be met and must keep the plan under review. Staff need an accurate guide as to how to provide care so that people get the care they require. The plans should be reviewed regularly to make sure they remain up to date and effective. 01/10/2009 Care Homes for Adults (18-65 years) Page 24 of 26 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 3 24 23 All parts of the home must be kept reasonably decorated. The carpets in identified bedrooms must be thoroughly cleaned or replaced and the corridor carpet made safe; all toilets and bathrooms need to be redecorated, in whole or in part; the open areas must be properly maintained. 01/12/2009 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 14 The appointment of a dedicated activities organiser would help to extend further the range of of activities that people take part in. The outcome of safeguarding issues should be recorded and kept on file. Staff should receive one to one supervision at least six times a year. A representative of the registered provider, Wirral Borough Council, should visit the home every month and make a written report of the visit. The manager needs to make sure that the requirements made by the environmental health officer in respect of meat temperatures are implemented. 2 3 4 23 36 39 5 42 Care Homes for Adults (18-65 years) 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. 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. 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