Care Home: Langdale Court Care Home

What the care home does well Langdale Court provides a safe and homely environment for a small group of people with varying needs. People feel confident that their needs are met in accordance with their wishes and that the staff team and manager are competent to meet these needs. People are treated with respect and dignity and are enabled to make choices about their daily living and well-being. The small staff group benefits from a wide variety of training relevant to the needs of the people who live at the service. What has improved since the last inspection? Since the last inspection visit took place, the content of people`s care plans has been reviewed and up-dated. These now contain comprehensive information enabling staff to provide support to people in a person centred manner. Care plans reflect each persons individual goals and aspirations and Respect and Dignity is considered throughout. There has been some further re-furbishment including some replacement windows, new floor coverings and re-decoration of some bedrooms. Records we saw were more easily accessible and the format had improved. What the care home could do better: Although some re-furbishment has taken place there continues a need to make improvements to the environment. The bathroom would benefit from being re-fitted with modern appliances and the addition of a shower. Key inspection report Care homes for adults (18-65 years) Name: Address: Langdale Court Care Home 1 Colville Street Nottingham NG1 4HQ     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: Angela Starr     Date: 1 2 0 4 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Langdale Court Care Home 1 Colville Street Nottingham NG1 4HQ 01159472167 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Bernard Okenwa Ogbakaeko,Mrs Cordelia Nwafor Ogbakaeko care home 7 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Langdale Court, opened in 1987, is a converted Victorian style three-storey house with a small front and side garden, registered to provide personal care and accommodation for up to seven males with mental health needs. Situated near the city centre it is close to shops, pubs, the post office and other amenities. Car parking is street parking and a residents permit is required from the home. There are five single bedrooms and one double bedroom; none with ensuite facilities. The staircase to upper floors is steep, with handrails, but there is no lift to provide independent access and consequently the home is not suitable for wheelchair users, or, people with mobility difficulties. The fees for this home are in line with the fees paid by Nottingham City Council. The Care Homes for Adults (18-65 years) Page 4 of 28 2 7 0 4 2 0 0 9 7 Over 65 0 Brief description of the care home homes service user guide and statement of purpose are available on request to the provider, together with a copy of the latest Inspection Report. The Registration Certificate is displayed on the wall, and is up to date. A copy of the latest inspection report can be seen at www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star good service. This means that the people who use this service experience good quality outcomes. The focus of Inspections undertaken by the Care Quality Commission is upon outcomes for people who use the services and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We ask managers to fill in a questionnaire called an Annual Quality Assurance Assessment, which tells us about how well their service provides for the needs of the people who use it and how they intend to improve their service. We received this back from the manager within the required timescale and the form was completed in a satisfactory manner, providing us with information to assist in planning our visit and deciding what areas to look at. Care Homes for Adults (18-65 years) Page 6 of 28 We also reviewed all the information we have received about the service since we last visited and we considered this in planning the visit and deciding what areas to look at. The main method of Inspection we use is called case tracking which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking with them, observation, reading their records and asking staff about their needs. We also sent Have Your Say questionnaires to a random selection of people who use the service and some staff members. The information provided in the replies we received, was also a contributory factor in the focus of our inspection visit. We spoke with one member of staff and two people who use the service to form an opinion about the quality of the service being provided. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who use the service. Care Homes for Adults (18-65 years) Page 7 of 28 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to live at the service have a full pre-admission assessment completed to ensure that their needs can be met. People are given accurate information about the service that is provided. Evidence: The manager told us in the written information she provided We provide good quality information to people who consider moving to Langdale Court. Each person is given a copy of our statement of purpose and service user guide and these are also displayed in the entrance of the home. We carry out full pre-admission assessments of need for each person to ensure their needs can be met and this is confirmed in writing to the person before they move to the home. People are always invited to visit and look around. All placements are reveiwed after three months to ensure that people are happy and their needs are being met. On the day of the inspection we discussed this with the manager and she told us that anyone considering moving to the service would be visited at home, or wherever they were, for a full assessment to be undertaken. They would also consider the people Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: already living at the service to ensure compatibility as far as possible. We looked at the aims, objectives and philosophy of the home as well as the service user guide. These were specific to the people living at the service and were available in a suitable format. Some people we spoke with who live at the service told us that they had visited before they moved to the home and they thought had been given all the information they needed to help them make a choice, but added that this was a long time ago and they couldnt remember exactly. The surveys that were returned to us also confirmed this. As part of our case tracking process, we looked at files for three people who live at the service. All three files contained pre-admission assessments and copies of letters sent to people confirming that their needs could be met and offering them a place at the home. The files also contained signed contracts. A person we spoke with who lives at the service told us I like it here. It suits me and is what I want. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service have their personal and health care needs and any identified risks, assessed and met. Evidence: As part of our case tracking process we looked at files for three people who live at the service. The care plans we looked at all contained evidence that people had been involved in the development and continued to be actively involved in the reviews. Peoples likes and dislikes were clearly identified with statements made by the person. Throughout, there was reference to peoples respect and dignity and to people being consulted and offered choice. The plans contained detailed and comprehensive information enabling staff to provide support in a person centred manner. Risk assessments were also present in files and were clear about the identified risk and any actions to be taken. These were signed by the person they related to. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: People we spoke with were very clear about making choices and said they would tell the staff what they want and how they expect to receive any help and support. People also told us that they see their Doctor, Dentist and Optician as necessary and have easy access to any necessary health support. Records of professional visits were recorded in peoples files. On the day of the inspection visit we spoke with one member of staff who told us that people are always offered choice and are supported in a manner of their choosing. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People mostly experience a flexible lifestyle which is in accordance with their needs, abilities and preferences. Evidence: The written information provided to us by the manager tells us that Langdale Court promotes personal development, support to access the community and community facilities. People are encouraged to maintain relationships with family and friends. We looked at care files for three people who currently live at Langdale Court. These showed us that people have opportunities to access college courses and to undertake learning and activities of their choice. People are supported to identify their goals and aspirations and measures are put in place, wherever practicable to support them to achieve these. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: On the day of this inspection visit one person was at college and another person told us that they had completed college courses. Files we saw contained the certificates awarded to people on completion of a variety of different courses. People we spoke with also told us that they see family and friends whenever they wish or speak to them on the telephone. One person said he likes to go into town with other people who live at the service and another person stays with family most weekends. Staff we spoke with told us that outings are arranged whenever possible and these are decided by the people living at Langdal Court. They vary from visiting the local parks to spending a day at the seaside. People told us that they enjoy going out on occasions but like to spend time just watching television and relaxing. Activities within the home environment are limited but people appear to be satisfied with this. On the day we visited, the menu was displayed in the dining room. People told us that the food is very good and they have choices about what they eat. They also said that there is plenty of food and drinks are available whenever they want one. The menu is varied and fresh fruit and vegetables are provided. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples physical and emotional needs are mostly identified and met. The principles of respect, dignity and privacy are put into practice. Evidence: The written information provided to us by the manager tells us that staff are trained to administer medication. People are involved with making decisions about how they wish to be supported with health and personal care needs. They are involved with choosing their Doctor and any necessary help and support is provided to people to enable them to access whatever services they require. We looked at files for three people living at the service. Each plan made reference to respect and dignity and peoples emotional needs were assessed and addressed. Staff we spoke with were very knowledgable about considering peoples choices and dignity when providing support. There was evidence that people had accessed Community Health Care services and one person told us that they had seen the Optician recently. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: No one living at Langdale Court at the time of this inspection was responsible for administering their own medication but we saw evidence that told us people had been assessed to do this. We looked at the system for ordering, storage and administration of medicines and found it to be appropriate with the records completed correctly. Training records we looked at confirmed that staff have received training to administer medication. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and have confidence that any concerns would be acted upon and responded to. People living at the service are safeguarded from harm and abuse. Evidence: The written information provided to us by the manager tells us that people living at Langdale Court have a copy of the Complaints and comments procedure on admission. Complaints and comments are addressed by the relevant person, with speed and efficiency and the outcomes are communicated with the person making the complaint. Staff have received training in Safeguarding Adults and managing Challenging behaviour. We looked at records of complaints received since we completed our last Key Inspection and saw that none had been recorded. We discussed this with the manager and she told us that no complaints have been made and if anyone has raised anything of concern, it has been dealt with at the time. People we spoke with confirmed that they have not made any complaints but would not hesitate to do so if they had anything to complain about. We have not received any complaints. The staff member we spoke with told us that she would encourage anyone to make a complaint if they were unhappy about anything. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: We looked at three staff files and saw that they have all received training in Safeguarding Adults. (Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals at risk.) The staff member we spoke with demonstrated a good level of understanding of this process and assured us that she would report anything of concern. People we spoke with told us that they feel safe living at Langdale Court and that the staff listen to them and act on what they say. Informal meetings take place with people on a regular basis as well as more formal meetings. People told us that they are given opportunities to voice their opinions about the service they receive. We saw evidence that annual surveys are completed to capture feedback about the service. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, safe, comfortable and reasonably well maintained environment which meets their needs. Evidence: We undertook a partial tour of the service and saw that some re-decoration and refurbishemnt has taken place since the last Key Inspection took place. The lounge carpet has been replaced and the kitchen has had new floor covering. Some bedrooms have been decorated. Some windows have been replaced. The written information provided to us by the manager tells us that there are plans to install a shower and provide digital television in the coming year. We discussed this with the manager and she told us that the budget set aside for the coming year includes money to improve the bathing facilities. The areas we saw were clean and reasonably well maintained. The environment was clean and tidy. Maintenance records are kept and show us that the handyman responds quickly to any problems that are identified and recorded by staff. The handyman attends the home whenever required. There is a cleaning schedule in place to ensure that all domestic Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: tasks are completed by staff. Staff are responsible for doing peoples laundry and people we spoke with told us that this is done to their satisfaction and they always have clean clothes. People we spoke with told us that the home is always clean and tidy and that they are warm and comfortable. One person told us I have a lovely bedroom. I have everything I need. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by experienced and competent staff in sufficient numbers to meet their needs. Evidence: The written information provided to us by the manager tells us that sufficient staff are on duty at all times to meet the assessed needs of the people living at the service. The recruitment processes are robust, references are sought and checked. Criminal Record Bureau and Protection of Vulnerable Adults checks are always carried out. A comprehensive Induction system supports new employees. Staff have supervision and appraisal and high standards of training. As part of our case tracking process we looked at three staff files. All three contained evidence of the required checks having taken place when they commenced employment. Each staff member had provided a minimum of two written references and files contained application forms, information about induction, job description and a copy of their contract of employment as well as proof of identity. The files also contained supervsion records and appraisal. We saw evidence of training that staff had received, including challenging behaviour and administration of medication. Staff we spoke with confirmed that they had Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: received this training as well as a number of other courses including Safeguarding Adults. Staff also said they had regular supervision with the manager which they found to be useful and supportive. Supervision records were seen and showed us that this takes place on a regular basis. Staff told us that they feel supported by the manager and that they feel part of a good staff team. No new staff have been recruited since the last Key Inspection took place and evidence we saw tells us that the staff turnover is very low, with the majority of them having worked at Langdale Court for several years. People we spoke with told us that the staff are very good and understanding and there is always someone there to help. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and is being run in the best interests of the people who live there. Evidence: The Annual Quality Assurance Assessment completed for us by the manager was returned within the required timescale and it contained some useful information about the service. The manager has been in post at the service for many years and has achieved the necessary qualifications to enable her to undertake the post. Since the last key inspection the service has achieved some of the goals that were identified in the homes annual development plan. These include some refurbishment and re-decoration of rooms. However, there is more maintenance work required to improve the overall condition of the home. People living at the service meet regularly with staff and are encouraged to discuss anything of concern or interest to them. The information gained at these meetings is Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: used in the planning and development of the service. People we spoke with told us that they use the meetings to discuss any issues they may have. The service does complete quality monitoring and we looked at the questionnaires that people had completed. We discussed with staff how the information is used to inform any improvements. We were informed that individual issues that may be raised are dealt with at the time of the survey being completed. Two people we spoke with commented that the manager is lovely and easy to talk to. Staff we spoke with said that they feel very well supported by the manager who is available whenever they need her. They told us that she is approachable and is dedicated to the home. Staff files showed us that staff receive supervision two or three monthly and an annual appraisal. Staff told us that they find this useful to look at career development and progression but reinforced that the manager is always around if they have a problem. We found that the Health and Saftey testing and sevicing has been undertaken as required and staff told us that they consider their Health and Safety is well protected as well as the people living at Langdale Court. They told us they are up to date with all statutory courses and this was confirmed by training records. Records we saw showed us that eight accidents have occurred since the last key inspection. These records contained relevant details of the accident and subsequent actions. The Care Quality Commission have received one regulation 37 notice. (This is a regulatory process which informs us of any reportable incidents that occur at a service.) Discussion took place with the manager and one staff member about this process and the nature of accidents/incidents that should be reported within this to ensure that the process is fully understood. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The service will benefit from further investment in improving the environment. The provision of a new bathroom and shower is recommended to provide people with improved bathing facilities. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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