Care Home: Hamilton House

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well The home is evidenced to be providing a pleasant and homely environment, with a commitment to providing a good quality of care and support. There is close monitoring of residents health, social and developmental needs, with individuals being encouraged to develop their independent skills and lifestyles. There is evidence of good interaction and consultation between staff, residents and their relatives, with regular residents meetings being held. The home has a good record on complaints, not having received any since the last inspection. What has improved since the last inspection? There has been a general improvement since the last inspection, with a number of requirements and recommendations having been met. The supervision and training of staff has improved since the last inspection. What the care home could do better: There are two requirements from this inspection, for all staff to receive accredited medication training, and for fire alarm tests to be completed on a regular weekly basis. Key inspection report Care homes for adults (18-65 years) Name: Address: Hamilton House 10 Crescent Road Bromley Kent BR1 3PN     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 stanley     Date: 1 1 0 3 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 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: Hamilton House 10 Crescent Road Bromley Kent BR1 3PN 02084609046 02084608898 hamiltonhsobrien@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Bromley Autistic Trust care home 5 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: 5 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Hamilton House is a detached residence located in Bromley North. It is close to the shopping area and is well served by public transport including main line rail services. Although Hyde Housing Association owns the building the 24-hour care and support is provided by Bromley Autistic Trust. The home provides care and support in a homelike environment for five people; Each person has their own bedroom and there are a number of communal areas. The home is for people who have autism. The home is generally staffed for 24 hours a day there are also sleeping in staff. People who use the service are assisted to develop daily living skills within a home-like environment. Integration into the community, attending day centres and adult learning facilities are Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 5 Brief description of the care home all incorporated into daily routines. Maintaining family contact and open visiting is encouraged. 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: We visited the home and completed a site inspection. We met with one service user and a staff member, and looked at feedback from previous surveys. Other service users were attending a local day centre at the time of inspection. We examined a number of staff and service user files, and inspected supervision records, health and safety documentation and other records relating to the day to day management of the home. We met with the manager and discussed issues relating to the day to day running and management of the home, and regarding the relevant regulations and standards that apply. 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. The home is providing the necessary information with which to enable prospective service users to make an informed choice about the suitability of the home. There is an appropriate assessment process, with the opportunity for any prospective service user to first visit and stay overnight at the home, before a decision is made. Evidence: The home has a Statement of Purpose and a Service User Guide. These are produced in both written/pictorial and audio formats and include all relevant information. These are being reviewed and updated on an annual basis. The home currently has 4 residents, in their 50s, the most recent of whom was admitted in 2008. The process for admission is that once there is a possible admission, information is gathered about the person, followed by an invite to look around, and overnight stays, then a review meeting is held before a decision is made as to the suitability of the placement. The assessment completed by the home translates into a care plan, and includes all Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: relevant information about the person, including their health history, behaviours and triggers, their routines, interests, and relationships. The staff within the home have a range of skills and experience, and include the manager, deputy manager and 5 permanent care staff. From the information received during this inspection, and from previous surveys, residents seem generally settled and happy living in the home, and are having their needs well met. Care Homes for Adults (18-65 years) Page 10 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. Service users are having their needs and goals reflected in their individual care plans. Individuals are being risk assessed, and supported to make decisions and to participate fully in all aspects of their lives. Evidence: A sample of care plans were inspected. These were very detailed and person-centred, and included a lot of information about the persons personal background and history, their family and social networks, their likes and dislikes, interests, aspirations and routines. The care plans are compiled in consultation with the person concerned, and identify goals and aims for the future. Inspection of the care plans evidenced that these are being reviewed on a regular basis, and updated to note any changes that may apply. Review meetings are held in consultation with the person and their family member or representative. Inspection of files evidenced the completion of risk assessments, relating both to their Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: environment and to their daily activities and personal development of independent skills. There was indication that residents are being well supported and encouraged to develop their independent living skills, and to make decisions for themselves in their day-to-day living and activties. The home holds house meetings on a regular basis. At these meetings, residents are encouraged to have their say, any issues raised being discussed at staff meetings. Care Homes for Adults (18-65 years) Page 12 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. Service users are being offered varied opportunities for participating in activities, and for being part of the local community. Individuals are encouraged to maintain contact with their family and friends, and are having their rights respected and upheld. Evidence: Residents are being offered varied opportunities for participating in activities, and for being part of the local community. 2 of the 4 residents attend a local day centre 5 days a week. This is run by the Bromley Autistic Trust where a range of activities is offered. Another resident attends an occupational centre in Penge, delivering a local paper, while another resident has 1 to 1 contact 3 days a week with an independent life-style coordinator. Individuals are encouraged to participate in the community. Trips to the library, cinema, restaurant and theatre are arranged, while individuals are encouraged to go Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: out for a pub night or, in one case, to attend a football match at Crystal Palace. Residents can attend the Gateway social club on a weekday evening, or attend art therapy and keep fit classes at a local centre. One resident within the home attends church on a regular basis. Maintaining contact with familiyand friends is encouraged, with individuals being supported to visit and to stay over for a day, or overnight, on alternate weekends. Organised events such as barbeques and parties are held, to which relatives and friends are invited, and from the information available, visitors are made to feel welcome when visiting the home. Residents are offered a varied range of meals, these reflecting their choices and preferences. Meal times are flexible to fit in with individuals needs and commitments. There is a pleasant dining area for taking meals. Care Homes for Adults (18-65 years) Page 14 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. The home is providing service users with the support they need with their personal support and health care. Updated medication training does, however, need to be undertaken by all staff. Evidence: Care plans and individual person-centred plans are detailed and set out how residents wish to be supported with their personal care in their day-to-day lives. And sets out how residents are to be supported with their health needs. Staff at the home have a good understanding of the needs of people with autism, receiving specific training in this area. Staff are trained to know how each individual, with autism, likes to receive support in accordance with his or her needs, expectations and preferences. Residents files evidence regular contact with health professionals including their GP, dentist and optician, the outcome of these visits being recorded. All residents receive an annual OK health check. The home has been in the process of developing a personal health profile for each resident. The home has a medication policy and procedures in place. Staff have in the past Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: received medication training from Boots Pharmacists, with staff being required to pass an assessment before they can administer medication. It was, however, found, on the previous inspection, that there had not been any recent refresher training, and that not all staff who had been administering medication had received the necessary training. An assurance was given by the manager that, since the last inspection,, only staff who have received this training are administering medication. An outstanding requirement, for all staff at the home to receive appropriate training, has yet to be fully met. This must be prioritised. Medication storage arrangements were inspected and found to be satisfactory. A requirement, for the medication cabinet to be secured to the wall, has been met. A sample of medication records were inspected and found to be satisfactory.Each person had a photograph on their medication profile and a list of all their allergies. The home has recently suffered a bereavement with the unexpected death of a longstanding resident. This was a difficult period, not least for the residents keyworker who had developed a very close bond with the person concerned. Dealing with this situation was helped by the fact that the Trust had previously developed a policy on ageing and death. This covers all aspects of care that a person who is ageing, ill or dying will need to have considered. It also clearly maps out what to do in each eventuality and how support should be offered to everyone involved including the other residents and staff. Care Homes for Adults (18-65 years) Page 16 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. Service users and their relatives can be assured that there is a process in place for dealing with any concerns or complaints that may arise. Policies and procedures are in place to minimise risks and protect people from abuse. Evidence: The home has a complaints policy and procedure, which is made available to residents and their relatives. The maintains a complaints log. No complaints have been recorded since the last inspection, and the home has a good record in this regard. The home also maintains a record of any compliments it receives. The home has a policy and procedures for protecting vulnerable adults and whistleblowing. Recruitment policies are in place, ensuring that staff are thoroughly vetted before being employed to work in the home. Since the last inspection all staff have received updated safeguarding training, meeting a requirement from the previous inspection. No safeguarding allegations have been received. There is a system in place for monitoring the payment of any monies on behalf of residents. Receipts are kept and transactions are recorded and signed for by the person responsible for the transaction. There is a tag system in place for checking the balance every time money is taken out or returned. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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. Service users are living in a homely and comfortable environment, with sufficient personal and shared communal living space and facilities. The home presents as being a safe and clean environment, with sufficient bathroom and toilet facilties. Evidence: The home is located within easy walking distance of Bromley Town Centre, and is easily accessed by local bus and rail services. The home comprises of 3 floors, the communal areas being based on the ground floor. These comprise of a small front lounge and a rear through dining area and kitchen. French doors open onto a small rear garden. Redecoration and refurbishment has been ongoing since the last inspection. Carpeting in the lounge. Carpeting in the lounge has been replaced, and all of the homes bathrooms have been redecorated. A bathroom panel in one of the bathrooms has been replaced. Generally, the home presents as being a pleasant place to live, and is generally well equipped and furnished. There are bedrooms on on both the first and second floor, and an extension has been built to the rear of the property to create a further bedroom and bathroom area. A number of residents rooms were viewed. These presented as being reasonably well-decorated and furnished, and, with photos and personal possessions, they reflected individuals identities and interests. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: There is a separate laundry room, the problem of an odour of dampness having been resolved, as identified in the last inspection report. The home was found, generally, to be clean, pleasant and hygienic. At the present time, all the residents are reasonably mobile, hence the home is suited to their needs. However, should problems of physical disability arise as residents become older, the home may no longer be suitable in accomodating their needs. As mentioned in the last report, serious consideration will need to be given to the medium to longer-term suitability of the home in meeting any changing needs as people become older. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, 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 home has sufficient numbers of staff with which to meet the support needs of service users. Staff have relevant qualifications and competencies, and are being better supported through training and supervision to provide quality care and to meet users needs Evidence: The home has 6 permanent care staff, 5 of whom are full-time and 1 part-time. Staff records include the persons application form, evidence of their identity, two references and an up-to-date CRB check.No new staff have been recruited since the last inspection. The staff complement is supplemented by members of the the Trusts bank staff as and when they are required. No agency staff are used. The duty rota was examined. This indicates that, on each weekday, there are 2 staff on from 7 until 10am and from 3 until 11pm, with 2 staff on duty at weekends, and 2 sleep-in staff on duty overnight. The manager or duty manager are on-call overnight and at weekends. Residents attend day centres and activities throughout the day between 10am and 3pm, so that staffing is adjusted to one within these hours. The manager advised that 2 staff currently have an NVQ Level 2, that 1 (the deputy manager) has an NVQ Level 3, anthat 2 other staff are presently studying for their Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: NVQ. Level 2. The manager is currently studying for his NVQ Level 4. There is a programme of training in place, with a training matrix having been developed so as to indicate what training has been planned and completed for each staff member. The manager advised that all staff complete an LDQ induction programme and complete their mandatory training within their first six weeks. Also, that all staff have, within the last 12 months, completed updated mandatory training in health and safety, food hygiene and manual handling. The home accesses a varied range of courses from the LB Bromley and Bromley PCT Training Programme for Learning Disabilities. The manager advised that all staff have completed training in Epilepsy Awareness and regarding Practical Approaches to Autism Spectrum Disorder. Other training accessed by staff has included Positive Approaches to Challenging Behaviour and Mental Health in LD. A sample of staff supervision records were examined. These evidenced that staff have been receiving regular 2-monthly supervision. Whilst the requirement from the last inspection has been met, this improvement needs to be sustained. The manager confirmed that each staff member also receives an annual appraisal, this being evidenced on staff files. Care Homes for Adults (18-65 years) Page 21 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. The home presents as being managed competently and in the best interests of the residents. The health, safety and welfare of residents are generally being promoted and protected. Evidence: The Registered Manager, Stephen OBrian, has 12 years experience of working with this client group, and is working towards gaining his Registered Managers Award. He is assisted by a deputy manager who is also experienced in working with this client group, and is a trained risk assessor. There were a number of requirements from the last inspection, one of which remains outstanding. The home presents as being generally well run. The home has a homely and pleasant atmosphere, and staff are supported in developing the relevant skills and competencies for working with this client group. There are regular residents meetings and there is an ethos of enablement and encouraging independence amongst the residents. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: From the evidence of this inspection, the home is maintaining good record-keeping, all documentation being in order. Policies and procedures are being reviewed and updated, and those sampled presented as being in order. The home presents as being a safe environment. Health and safety checks were completed, these being generally satisfactory. There were two caveats. Fire alarm tests should be completed on a regular weekly basis, the frequency of checks having slipped in recent months. The homes Fire Risk Assessment also needs to be updated, the last review having taken place on 29 January 2009. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 All staff at the home must complete accredited medication training. No untrained staff should administer any medication. To ensure the safety of service users. 30/06/2010 2 42 13 Fire alarm tests must be completed on a regular weekly basis. To ensure the safety of service users. 30/03/2010 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 42 The homes Fire Risk Assessment needs to be updated. 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. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!