Care Home: Imola

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What the care home does well The Service makes sure the right people come to live at the home, and that the Manager and staff can give them the care that they need. The manager finds out allot of information when they complete an assessment. Both the assessment and `Service User guide’, which tells you all about, the home, is good. The three care plans completed tells staff what Service Users like, and how they would like to be supported. A key worker is allocated to talk about the care plan and make sure that it is up-to-date. A range of activities are offered to service users who live at the home. Staff work hard to try to meet individual requests. All activities are risk assessed, and possible concerns noted to ensure the person receives the support they need in certain situations. Lots of different types of food are available at the home to eat, and staff will help Service users chose what they would like. The Manager stated that the kitchen policy is that, it is `open`, and that people at the home just ask staff if they would like a drink or snack. The complaints procedure is clear and accessible, and if Service Users are unhappy or concerned, then staff want people to tell them. They will listen and try to help. If you feel that your key worker cannot help, you then the Manageris also available. What has improved since the last inspection? This is the first inspection of the service since it registered with the Commission for Social Care Inspection. What the care home could do better: The Manager and staff team seen on the day of the inspection seemed approachable, and enthusiastic about working at the home, and there are only a few improvements that have been recommended. The complaints procedure would benefit from being written in a more `easy read` format, or possibly an audio version may be more helpful. The home is very clean and hygienic throughout but again would benefit form being a little more homely without Service Users safety being compromised. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Imola Imola Lanham Green Cressing Braintree Essex CM77 8DT The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: June Humphreys Date: 1 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 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 Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Imola Imola Lanham Green Cressing Braintree Essex CM77 8DT 01376584352 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Zero Three Care Homes LLP Name of registered manager (if applicable) Hayley Mumford Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 Learning disability Additional conditions: The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is 6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Imola is part of the Zero Three group of homes which provides a range of Services to Adults with a Learning disability. The home is currently registered for six people. The home is a detached property situated on the outskirts of Braintree, in the village of Langham Green. Regular community access is provided to Service Users by the use of two vehicles based at the home. The accommodation is on two levels with bedrooms provided on both floors. All the bedrooms are singles, and the home has a variety of communal spaces decorated and furnished in domestic styles. The fenced rear garden is large, well maintained and accessible to Service Users. The home is staffed twenty-four hours a day and aims to support the service users to lead the lifestyles they choose in a safe environment. Information from the home confirmed that weekly fees vary according to the care package agreed with the placing agency. Care Homes for Adults (18-65 years) Page 5 of 30 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 Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. One Inspector June humphreys visited the home unannounced on Monday 13th October 2008. This was the first time the home had been inspected by the Commission for Social care Inspection. The Inspector looked around the home, and observed staff and Service Users working together. A sample of records kept in the home was looked at to ensure the health and safety of service users is taken into consideration at all times. This included three care plans, supervision records, and staff rotas, complaints, medication and accident records. The manager Hayley Manford completed the Annual Quality assurance Assessment form (AQAA) which is a self assessment which indicates how the home considers it is meeting the National Minimum standards, and what improvements they will make in the next 12 months. Information from this document is used within this report. Comments received about the home were positive and Service Users value the opportunities and support that is offered. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well The Service makes sure the right people come to live at the home, and that the Manager and staff can give them the care that they need. The manager finds out allot of information when they complete an assessment. Both the assessment and Service User guide’, which tells you all about, the home, is good. The three care plans completed tells staff what Service Users like, and how they would like to be supported. A key worker is allocated to talk about the care plan and make sure that it is up-to-date. A range of activities are offered to service users who live at the home. Staff work hard to try to meet individual requests. All activities are risk assessed, and possible concerns noted to ensure the person receives the support they need in certain situations. Lots of different types of food are available at the home to eat, and staff will help Service users chose what they would like. The Manager stated that the kitchen policy is that, it is open, and that people at the home just ask staff if they would like a drink or snack. The complaints procedure is clear and accessible, and if Service Users are unhappy or concerned, then staff want people to tell them. They will listen and try to help. If you feel that your key worker cannot help, you then the Manager Care Homes for Adults (18-65 years) Page 8 of 30 is also available. What has got better from the last inspection What the care home could do better The Manager and staff team seen on the day of the inspection seemed approachable, and enthusiastic about working at the home, and there are only a few improvements that have been recommended. The complaints procedure would benefit from being written in a more easy read format, or possibly an audio version may be more helpful. The home is very clean and hygienic throughout but again would benefit form being a little more homely without Service Users safety being compromised. Care Homes for Adults (18-65 years) Page 9 of 30 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact June Humphreys Regulation Inspector CSCI CPC 1 Capital park Fulbourn Cambridgeshire CB21 5XE 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 10 of 30 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 11 of 30 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 . Service Users moving to Imola can be confident that the home will only admit people whose needs can be fully met. Evidence: A detailed Statement of Purpose is held within the home and all current and prospective service users are provided with a copy. The Statement contains information for the service user to make an informed choice about if they would like to live at the home. The service user guide is written in a basic format, appropriate to the service user group, however most of the Service users admitted to the home have high complex needs and would require assistance in understanding what the service is able to offer. The service ensures that detailed assessments are carried out with new service users prior to their admission to the home, and this extends to a trial period staying within the home. Two initial assessments were looked at as part of the inspection and were of a high standard. The trial period within the home ensures that the service can meet the individuals needs, and also enables and empowers the service user to make an Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: active choice about if this the right home for them. Care Homes for Adults (18-65 years) Page 13 of 30 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 promotes 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 benefit from personalised care plans that enable them to undertake activities, both personal and social in the way they chose. Evidence: Three care plans were looked at as part of the inspection process. The information is stored in an easily accessible format. The individual files held a range of significant information, clearly identifying individuals needs. The format listed aspects of care such as personal care, safety, environment, physical health, communication, sleep, leisure and religion. Identified special care actions were then shown, and clearly written to ensure staff consistency when working with people. The daily plans of care had the goal or need, the outcome, how to achieve this and who was responsible along with planned timescales for meeting the need. A key worker was allocated to each person and regular reviews of care had been recorded on the files looked at. The staff are clearly committed to providing a high standard of service and those spoken to were aware of how to work with each person, and what was written in the Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: care plan. A range of activities are offered to service users, and staff work extensively to try to meet individual requests. All activities are risk assessed, and possible concerns noted and how the person should be supported should a certain situation occur. Care Homes for Adults (18-65 years) Page 15 of 30 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 . Staff recognize and support individual rights and responsibilities, and involve service Users where ever possible. Evidence: The provision of activities within the home appears to be high with positive feedback being sought by Service Users regularly talking to their key worker, who had recorded the contact and discussion. Care plans provided evidence of the use of a range of community facilities such as libraries, the post office and cafes. Each person had an up-to-date activity plan which staff continually reviewed, to ensure Service users enjoy, and gain a positive experience from the things they are involved in. Staff help Service Users to make choices, for example in relation to clothes, menu planning, room colour schemes, leisure and social activities. As a result of listening to people who use the service the manager advised that there is now two cars, a seven seater and also a five seater, to increase the amount of community access. Sky T.V as also Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: been introduced due to a request made by a family member prior to the service Users admission. Service Users are also encouraged to take part in some household tasks such as laying the dining table and doing their laundry with staff support, which assists in improving people’s independence. Visitors are welcomed into the home. Information regarding family and friends is noted on file, and also when they have visited in the daily notes. The service users present were observed following their own pursuits on the afternoon of the inspection, spending time in their bedrooms, watching television in the lounge and talking with the support workers on duty. There was a relaxed atmosphere within the home, despite staff at times managing difficult and challenging behaviour. Staff were available in sufficient numbers to work with service users when needed. Service users have a sensible, well balanced diet. They discuss menus with staff and are involved to varying degrees in choosing the food on the menus. The Manager stated in the AQAA that service users choose where they eat and some have an individual meal time plan. We have an open kitchen policy and one of our Service Users does his own food shopping with support as he generally doesnt like to eat the same food as our other service users. Care Homes for Adults (18-65 years) Page 17 of 30 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 . Staff have excellent knowledge of service Users needs and preferences, which ensures that peoples health and emotional needs, can be met. Evidence: The care plans examined contained a good level of detail regarding the personal and health care needs of the Service Users. Service users are supported with all aspects of their physical and emotional health and receive adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dietitians. Information and advice is provided to all services users regarding general health issues. Individual care is tailored to each persons needs with service users choices and preferences being promoted. Assessments and reviews are continuously completed to try to ensure that the service provided is person centred, and this is achieved by the support workers on duty, which demonstrated excellent knowledge of the Service Users individual circumstances and the actions agreed to meet their needs. Very positive relationships were observed between them and the Service users. The support workers were observed to treat Service users respectfully, and discouraged Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: inappropriate behaviour in a measured and constructive way, that corresponded to the behaviour management guidelines noted in the care plans. A comprehensive policy and procedure is in place to support the safe administration, storage and receipt of medicines. Evidence was seen to confirm that all staff receive training prior to administering medication. Medication records were viewed for two Service users. The majority of medication is stored in blister packs, and there is sufficient space for records to be located within where medication is stored. One person is currently being perceived a schedule 4 drug, and whilst this is not considered to be a controlled drug it is recommended due to the complex needs of people living at the home that a secure storage cabinet is made available for use when and if needed. Care Homes for Adults (18-65 years) Page 19 of 30 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 can be assured that the appropriate practices and procedures in place within the home will protect them from possible abuse, and that any complaints will be acted on. Evidence: A robust complaints procedure is in place that contains the required elements to meet the standard. There is a copy of the complaints procedure on display in several communal areas of the building. Service users have limited ability to communicate effectively their concerns, and therefore rather then making a complaint this maybe displayed in their behaviour. All service users have allocated key workers who they talk regularly with, and any concerns are recorded and monitored carefully. Evidence of this was available, and changes had been made to activities, and care plans if something had been picked up as part of the dialogue with the Service User. A complaints book is kept in the office and is monitored through the regulation 26 visits, which the company Zero, three undertake at regular intervals. The current complaints procedure is not available in pictorial format or audio. This is considered good practice to make all documentation available in this format with service users with such high complex needs, and the manager stated in the completed AQAA that this is a development that the service intends to do. Safe guarding procedures and protection of Service Users is covered during the induction of new staff. A relatively new member of staff was spoken to as part of the Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: inspection and had a fair grasp of the basic principles involved and understood her responsibilities as a member of staff in responding to allegations or suspicions of abuse. Staff training files confirmed that priority has been given to ensuring staff undertake safeguarding training and as all Service users are Essex funded a copy of Essex booklet is issued at the time staff undertake training. Care Homes for Adults (18-65 years) Page 21 of 30 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 safe, comfortable and well-maintained environment, which suits the service users needs. Evidence: The home is well maintained, with good quality domestic style furnishings, fittings and decor. The lounge, kitchen and dining room are smart and comfortable. There is also a second lounge and conservatory. Service Users bedrooms seen were nicely decorated, but in some cases lacked a homely feel. The manager stated in the AQAA that we want to look into alternative ways to make the environment more homely. Currently this is difficult with the current service user group as they tend to rip down pictures and curtains and sometimes struggle with complex decoration. The garden is spacious and there is a trampoline for service users to enjoy. The home employs both a maintenance person and also a gardener. All areas of the home seen were clean, tidy and hygienic. Staff spoken to were aware of good infection control procedures. The large kitchen is modern and well equipped with suitable domestic appliances, with all food stored appropriately and good hygiene practice observed. The bedrooms seen appeared comfortable and Service Users appear at ease in their surroundings. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Care Homes for Adults (18-65 years) Page 23 of 30 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 . Staff understand and support the homes aims and their roles in delivering the service promised in the statement of purpose, which means that service users receive the support that is needed. Evidence: The homes rota demonstrated that there was sufficient staff on duty to meet the needs of the current Service user group. The staff team working at Imola is a young enthusiastic team of staff that appear to work well together. Supervision records showed that a system of all staff receiving one to one sessions was in place. The staff have a short handover meeting, lasting 15 minutes three times each day. This is recorded in a communication book. This ensure a high level of consistency and cohesiveness when working with service users. Two members of staff spoken with said they were very well supported both by senior staff and the manager. A relatively new member of staff discussed the induction process in the home has informative, and felt that the overall support provided was very good. Staff training profiles seen as part of the inspection were up-to-date. The information verified that a range of training was offered to staff including Mandatory courses. The service prioritizes Staff having the opportunity to complete had been provided with the opportunity to complete N.V.Q 2/3, and high proportion of staff were qualified or in the Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: process of completing, or starting their award. Two staff files seen for new employees included an application form, an application assessment, interview notes, proof of ID including a photograph, a minimum of two references (one file seen had three references), a Criminal Record check and terms of employment. Care Homes for Adults (18-65 years) Page 25 of 30 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 provides a safe, comfortable and well-maintained environment, which suits the service users needs. Evidence: The manager is registered with the Commission and has a good awareness of the processes set out in the National Minimum Standards. All records kept in the home relating to the protection and welfare of Service Users is of a good standard, including care plans, risk assessments, specialists involved in the Service Users care, and complaint records. Staff records completed were up-to-date, and the manager works with staff to regularly review/audit documentation such as daily notes and care plans, this is integral to ensuring service Users receive consistency of care at all times. Staff spoken with said that the Manager was approachable and supportive, and good in providing guidance when necessary in matters of care practice. Professionals and relatives spoke highly of the manager of the home, and felt there Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: was good communication. The manager demonstrated a good awareness of the needs of people with learning difficulties, and a positive approach to promoting independence and fulfilment for the people living in the home. All of the records required by regulation are kept correctly. The home had a clear health and safety policy statement, and additional information and guidance on various aspects of health and safety. Staff interviewed was aware of policies and procedures and felt confident that the manager would update them when necessary. The homes training summary record showed that the majority of staff had current moving and handling and fire safety training, and that staff had attended other relevant health and safety training (e.g. COSHH, food hygiene, first aid, health and safety). New staff had dates scheduled for training. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  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 28 of 30 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 Description 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 Description 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 22 Service User would benefit from the complaints procedure being produced in a user-friendly format for people with Learning difficulties. Either written form or audio. The service should look at possible ways of making the house more homely whilst not compromising Service Users safety. 2 24 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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. 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