Care Home: Laurels Nursing Home The

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Key inspection report CARE HOMES FOR OLDER PEOPLE Laurels Nursing Home The High Street Norton Doncaster South Yorkshire DN6 9EU Lead Inspector Christine Rolt Key Unannounced Inspection 22nd April 2009 09:45 DS0000015864.V374970.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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 older people 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. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 2 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 Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurels Nursing Home The Address High Street Norton Doncaster South Yorkshire DN6 9EU 01302 709691 01302 708409 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Kenneth Swales Mrs Deborah Swales, Mrs Sheila Swales, Mr Andre Swales Ms Julie Riley Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability over 65 years of age of places (20) Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st May 2007 Brief Description of the Service: The Laurels Nursing Home is in the centre of the village of Norton, which lies to the north of Doncaster. It provides accommodation and care for up to 20 older persons with nursing needs. The home is an attractive stone building in well-maintained gardens. a large car park to the side of the home. There is All bedrooms and communal rooms are on the ground floor. The majority of bedrooms have patio doors instead of windows, which make them light and airy. All bedrooms are single occupancy with en-suite facilities. Aids and adaptations are provided for easy accessibility throughout the home and the garden areas. A conservatory reception area forms a link between this home and its sister home, The Laurels Care Home, which is registered to provide care for 30 people. Each home is registered and inspected separately. The homes have strong links with the local community. The fees per week were £436 plus free nursing care. Additional charges were made for hairdressing, private chiropody, newspapers and personal toiletries (the home provided standard toiletries). The manager supplied this information during the site visit on 22nd April 2009. The statement of purpose, the service user guide and the most recent inspection report were available in the manager’s office and the main reception. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9:45 am to 5:00 pm. The registered manager had completed an Annual Quality Assurance Assessment (AQAA). This document gave her the opportunity to say what the home did well, what had improved and what they were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the manager and one of the owners, Mr. A. Swales. The majority of people living at the home were seen throughout the day, and several were asked for their opinions of various aspects of the home and the care received. A visitor was also asked for their opinion. The care provided for three people was checked against their records to determine if their individual needs were being met. All opinions and comments were considered for inclusion in this report. The inspector wishes to thank the people who live in the home, the visitor, staff, the registered manager and Mr. A. Swales, one of the owners, for their assistance and co-operation. What the service does well: People liked the home and considered that they were well looked after. The home was clean, well furnished and well maintained. Bedrooms were light and airy and met people’s needs. Staff were praised for their care and considered to be “great”. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 6 The dining facilities were good and showed that people were treated as individuals. People said the meals were good and that preferences were taken into consideration. The owners were on site most days and were well known to people living in the home and their families. When people were asked to sum up their feelings about the home they said, “The best”, “Utterly wonderful” and “Couldn’t be better in a four star hotel” What has improved since the last inspection? What they could do better: The main areas for improvement related to the home’s records. People’s files needed to show that there was consistent recording to demonstrate that people’s identified needs were met. To ensure that there was no confusion when using code letters on graphs, the key to codes needed to clearly identify what each letter meant. The inclusion of people’s social needs in their care plans and daily records of how each person spent their day would demonstrate person centred care. As part of the quality assurance monitory system, increasing the monitoring of medication would help to quickly identify discrepancies in medication that was not in the monitored dose system. Observations of staff who administer medication would show whether further training was needed. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 7 Staff recruitment files needed to include identity documentation and dates of employment. Relevant correspondence, contracts and evidence of interview would also demonstrate a robust recruitment procedure. 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. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People using the 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 using this service had full assessments of their needs. EVIDENCE: This home does not provide intermediate care therefore Standard 6 was not applicable. People said that this home was chosen because it had a good reputation and was convenient for families to visit. One person said that they had previously been on respite care so was aware of what the home had to offer. Another person said that they had waited 18 months for a place because it was “The best”. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 10 The files for three people were checked to determine if their needs had been assessed. Files provided good information of people’s needs and wishes. Information of health needs and health history was particularly good. There was no information to state that the person had been informed in writing that the home could meet their assessed needs. This was discussed with the manager and the owner during the site visit. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the 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’s personal and health needs were met but the inclusion of social needs and consistent record keeping would provide person centre care. Medication issues need improvement. People were treated with respect. EVIDENCE: People living in the home looked well cared for, clean and appropriately dressed. They said that the staff looked after them and they were satisfied with their care; they received the care and support they needed and were treated with respect. “Can’t do enough for you” “Good” Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 12 Bedroom doors were fitted with locks and keys were available for bedroom doors and the lockable facilities in each bedroom. People living in the home considered that their privacy was respected. Three care plans were checked in detail. They provided good information of people’s physical and health needs but social needs, as identified in their assessments, were not always included. The home used a chart to record various aspects of personal care e.g. bathing, washing etc. and there was a key to the codes but staff were using these codes to mean different things. The need to clarify what is meant by the codes was discussed with the manager. Daily records provided detailed information of specific incidents and issues affecting the person but sometimes the recordings were only carried out once per day. Therefore there was frequently no information of how the person had spent their day or whether their identified needs had been met. Files contained risk assessments. Inventories of personal belongings were available on each file but there was insufficient information to enable identification, e.g. make, size and model of television etc. Accidents were recorded and monthly analyses were produced to identify any common themes and determine the action that needed to be taken. The manager was advised to introduce 72-hour monitoring charts as a good practice measure. These forms record the close monitoring of people who’ve had accidents or falls where no injuries are apparent at the time of falls and ensure that injuries are quickly noted. Files contained detailed information of health care professional involvement in the home and demonstrated that people were referred for health care as needs arose. The home had a medication room and the medication trolley was secured to the wall. The trolley was clean and tidy. The medication system was checked. The manager had recently carried out an audit and improved the recording of all medication (following an inspection of the sister home, The Laurels Care Home). There were no gaps in the Medication Administration Record (MAR) charts. Medication in the Monitored Dosage System (MDS) tallied with the MAR charts. Loose medication was checked and in one instance the number of tablets exceeded the record by three tablets. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 13 A record of staff signatures was kept. This is good practice. People’s files contained information of their medications and the reasons for them being prescribed, which is good practice. Medication that required refrigeration was kept in a domestic refrigerator. The refrigerator temperature was recorded daily to ensure that medication was kept at the correct temperature. A controlled drugs cupboard was available for the storage of controlled drugs. The controlled drugs register showed that medication was recorded correctly with a diminishing total and two signatures. The teatime medication administration was observed. The nurse did not follow the correct procedure and did not consider that they had done anything wrong when informed about it. To ensure that people are protected, staff need to follow the correct procedure and demonstrate competency. The need for staff competency checks was discussed with the manager. It was also recommended that staff dealing with medication read the Royal Pharmaceutical Society guide The Handling of Medicines in Social Care and also the NMC guidance on the administration of medication. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the 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 were generally satisfied with their lifestyles in the home. EVIDENCE: People said that various group activities were held in the home including bingo, craft sessions, coffee mornings and church services, but they would like more. The manager said that an activity co-ordinator was being employed and would commence at the end of April. As well as group activities, the manager was hoping that there would be one to one sessions including sensory activities for people with deteriorating health. People said that they could spend their day as they liked. They said that they could get up and go to bed when they wanted and some people chose to spend time in their rooms. People’s files contained information of their preferred rising and retiring times, hobbies and interests and food likes and dislikes. People who visited the home said that they were made welcome. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 15 “I think this place is utterly wonderful” People living in the home said that they were satisfied with the meals. “Very good” “Fantastic” A relative also said that that the home was wonderful in meeting their parent’s dietary needs. Their parent had a very limited diet but the home had provided whatever the person wanted. The dining room was pleasant, clean and tidy. Tables were set with tablecloths, place mats, condiments, sugar, table napkins or aprons dependent on need. Cutlery and crockery was suitable to meet people’s individual needs. Silk flowers were also displayed on most tables. A menu board informed people of the lunchtime meal and there was a choice of dessert. The manager said that they could also provided a lighter alternative to the main meal e.g. omelette, jacket potato, salad. The manager was advised to include this on the menu board so that people were aware of the choices available. The lunchtime meal of steak and kidney pie, mixed vegetables, cauliflower and mashed potatoes looked and smelled appetising. Special diets such as diabetic, vegetarian and soft diets were available. Staff provided discreet help where needed. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the 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 felt they were listened to and protected. EVIDENCE: The complaints procedure was seen and this needed updating to include the new Commission’s name. The complaint book contained one complaint that was unsubstantiated. People said that they were happy living in the home and had no complaints but knew who to tell if they had a problem or were worried about anything. Staff had undertaken in house adult protection training and further external training was being supplied on a rolling rota basis. There were no allegations of abuse. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the 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 lived in a clean, pleasant and hygienic environment that had aids and adaptations to meet people’s needs. EVIDENCE: First time visitors would have difficulty finding their way around the home, as there are no signs to direct them and no means to alert staff that people had entered the building. This was discussed with the manager and one of the owners during the site visit. The home was pleasant and clean and there were no offensive odours. said that the standard of hygiene within the home was “very good”. Furniture and furnishings throughout the home were in good condition. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 18 People On the day of the site visit, it was a warm and sunny day. The lounge was sunny and there was a good range of chairs. In the conservatory extension there were fans in operation and windows were open to allow air to circulate. All bedrooms were on the ground floor, had en-suite lavatories and most had patio doors instead of windows, which made the rooms light and airy. The patio door threshold of each bedroom needed risk assessing and action taken where necessary to minimise the risk of tripping. Bedrooms had been personalised by their occupants. All had electric profile beds and lockable facilities. One of the people spoken to had brought potted plants from her garden at home and put these on the patio outside her bedroom. Corridors were well lit, were fitted with rails and had clean carpets. A bathroom with an adapted bath was checked and this was clean and tidy. The lavatories next to communal areas were checked. The lighting was dim and did not brighten sufficiently. The need for bright lighting, particularly for people with poor sight, was discussed with the manager. Hand washing facilities had liquid soap and paper towels to reduce the risk of cross contamination. This is good practice. Aids and adaptations were fitted throughout the home. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the 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 were cared for by a well trained and dedicated staff team. Record keeping of staff files could improve. EVIDENCE: There were three carers and a nurse on duty during the day and an extra carer was on duty at breakfast time. The manager said that during the night a nurse and a carer were on duty. People said that they liked the staff and thought they were good. “Staff are great” “They see to everything” “Can’t do enough for you” “Can’t want no better” The Annual Quality Assurance Assessment contained information of induction and NVQ training undertaken by staff. Staff files confirmed this. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 20 The manager said that skills training was ongoing and produced a list of training that was planned for the next six months. The recruitment files for four members of staff were checked. The files contained application forms, criminal record bureau disclosures, POVAFirst checks and references. However there were no identity documents and no dates of employment. Other documentation relating to interview and correspondence relating to job offers would have been useful. Methods of improving the recruitment procedure were discussed with the manager. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the 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 manager promoted the welfare of people living in the home, and it was run in their best interest. EVIDENCE: The registered manager was qualified and experienced. She was a Registered General Nurse, had completed NVQ 4 in management and care and had achieved the Registered Managers Award. She kept up to date with current practice. Advice given to the manager of The Laurels Care Home had been shared with the manager of this home and improvements in the Quality Assurance system Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 22 had commenced. This was to include records of checks carried out on the environment, observation of work practices and audits of systems and procedures within the home. The home held a yearly meeting with people living families, and handed out questionnaires at these people’s level of satisfaction with the home. The results were then collated and action taken to improve in the home and their meetings to determine manager said that the the service. The home did not hold any personal allowances on behalf of any people living in the home. These were looked after by either the person themselves or their families. Annual refresher courses for mandatory heath and safety training ensured that staff were up to date. This is good practice. Fire drills and instructions were held regularly. The manager was advised that using a fire drill matrix would highlight any member of staff who had not taken part in fire drills. A sample of maintenance and service certificates and records were checked and these demonstrated that systems were maintained. It was recommended that all servicing and maintenance certificates be kept in one file in the manager’s office for easy access. Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/a X X 3 Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 Standard OP3 Regulation 14 12 13 Requirement People must be informed in writing that the home can meet their assesses needs Daily records must show that people’s identified needs have been met. Medication records must be kept up to date to verify the stocks of medication held for each person, particularly medication that is not in the monitored dose system. Staff dealing with medication must be deemed competent to do so. Checks must be carried out to demonstrate that staff follow the correct procedure when administering medication The risk of tripping over the threshold of patio doors must be assessed and action taken to minimise the risk. Lighting in lavatories must be bright to avoid accidents. Staff recruitment files must include proof of identity and date of employment. Timescale for action 17/06/09 17/06/09 29/04/09 OP7 OP7 4 OP9 19 17/06/09 5 OP19 13 20/05/09 6 OP29 17 17/06/09 Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Laurels Nursing Home The DS0000015864.V374970.R01.S.doc Version 5.2 Page 26 Care Quality Commission Yorkshire and Humberside St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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). 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