Care Home: Maple House

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What the care home does well The care home finds out what people need and writing this down. Staff read these reports so that they can help people to keep healthy and as active as possible.People were helped to have interesting lives. Staff gave them individual attention and they were treated with respect.The home’s policies and procedures kept people safe. Policies are rules about how to do things. Procedures tell people how to follow the rules.People were living in a comfortable, homely and safe environment.The care home finds out information about new staff before they start work there. They have training so they understand how to meet people’s needs.The care home was well managed. People were safe and their rights were recognised. What has improved since the last inspection? Records were better at this inspection and people were safer.The Manager was looking at ways of improving the quality of the Service. What the care home could do better: Staff must be trained in fire safety. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Maple House 51 Peveril Road Tibshelf Alfreton Derbyshire DE55 5LR two star good service The quality rating for this care home is: 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: Anthony Barker Date: 0 5 0 5 2 0 0 9 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 Audience Further copies from Copyright Inspection report CSCI 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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Maple House 51 Peveril Road Tibshelf Alfreton Derbyshire DE55 5LR (01773)872720 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : maplehouse51@hotmail.co.uk Mr Peter South care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: Date of last inspection 1 1 0 4 2 0 0 8 A bit about the care home Maple House is a care home situated in Tibshelf village near Alfreton. The Service is based in a semi-detached house on an estate at the edge of the village. It had an increase in registered service users from 3 to 5 in 2006, following an extension to the premises. The people living at the Service receive day services for five days of the week and are supported at other times to undertake activities within the local community. 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 How we did our inspection: This is what the inspector did when they were at the care home The inspector visited at short notice. The last key inspection at this care home was on 14th April 2008. We had asked the Manager to complete a questionnaire about the home, before this inspection. We had asked other people to tell us what they think about the home. Six people sent us their views. We looked at what staff had written about one persons life. We also looked around the care home and at two bedrooms. We talked to the people who live in the care home and to staff. We saw how staff treated people. The weekly fees at the time of this Inspection were from £380 to £484. What the care home does well The care home finds out what people need and writing this down. Staff read these reports so that they can help people to keep healthy and as active as possible. People were helped to have interesting lives. Staff gave them individual attention and they were treated with respect. The home’s policies and procedures kept people safe. Policies are rules about how to do things. Procedures tell people how to follow the rules. People were living in a comfortable, homely and safe environment. The care home finds out information about new staff before they start work there. They have training so they understand how to meet people’s needs. The care home was well managed. People were safe and their rights were recognised. What has got better from the last inspection Records were better at this inspection and people were safer. The Manager was looking at ways of improving the quality of the Service. What the care home could do better 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 Tony Barker CSCI CPC1, Capital Business Park Fulbourn Cambridge CB21 5XE Tel: 01223 771300 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 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 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 . Individual written needs assessments were in place before people were admitted to the Service so that their diverse needs were identified and planned for. Evidence: An assessment of needs, of the person most recently admitted, was made prior to their admission, as confirmed by examination of care records at the last inspection. 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 who use the Service had individual plans of care which demonstrated that their health, personal and social care needs were being met and they were enabled to make decisions about their lives. Evidence: There was a set of brief, holistic care plans and risk assessments relating to the people living at the Service. Each care plan had an associated Implementation Sheet and Evaluation Sheet - the latter showing evidence of brief monthly in-house review notes. Formal care plan review meetings were being initiated, for each of the people living at the Service, by the placing agency Derbyshire County Council (DCC). The Service was taking a person centred approach to the people living here, although this was still not reflected in the Services own care planning documents. Two care plans mentioned limitations on the unsupervised movements of two people living at the Service, outside the premises, with associated risk assessments. The limitation on one of these two people had been re-assessed recently by a psychologist following discussions at the persons care plan review meeting. The Manager said that full discussion with, and agreement by, external professionals had taken place with regard to this policy and there was a record, with signatures, to support this. One person living at the Service chooses to visit their mother and to shop in Mansfield, using public transport independently, the Manager explained. The Manager and Assistant Manager also stated that peoples preferences are taken account of when it comes to which local pub to go to and discussion with the people concerned supported this statement. People living at the Service also choose which activities they get involved in and their going to bed times and rising times at weekends. The case Evidence: tracked person told us that, I get up at 7...and at 12 on Saturday. Only on weekday mornings is there an expectation to rise in sufficient time to catch the transport to peoples respective day services. Examples of the people living at the Service taking responsible risks were given by the Manager. Risk assessments were in place to reflect the fact that all but one person use the facilities of the kitchen - as well as reflecting potential scalding from radiators. Risk assessments were also in place regarding unsupervised access to the community, as required at the last inspection. Additionally, a policy had been written to address the use of alcohol by people living at the Service. 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 . The Service provided activities and services that were age-appropriate and valued by the people who live here, and promoted their independence. Evidence: The people living at the Service were all attending day services for five days a week. The Manager provided evidence of people being involved in valued and fulfilling activities. He was listing, in their files, all their social activities in order to maintain an overview. He said he had asked each of the people about what changes they would like to see to their social life. This had led to some small changes, he said, and gave examples of person centred activities being carried out, such as football matches and Speedway at Sheffield. There had been a recent day out at Derby Garden Centre, including a meal there. The Manager said that he was giving some thought to whether one of more of the people living at the Service would benefit from voluntary work at a local animal rescue centre. Two people living at the Service were attending a local social club for people with learning disabilities once a week and all the people enjoy Karaoke held at a local pub, the Manager said. He added that three of the people living at the Service play in a local Pool League every Wednesday in the pubs in local villages. The two people spoken with both said they enjoyed going to the pub. One said, I play darts there...watch big screen TV. The other spoke of enjoying, playing pool with friends and also enjoyed, cycling on Wednesdays - this related to a weekly cycling club. Evidence: One person living at the Service has a particular friend seen every day at day services. This person has no family contact but the others were all having good to reasonable levels of contact, the Manager said. The three people most established at the Service are well known to local people, the Manager commented, and the other person is becoming known. This person visits their parents every Saturday and one evening a week. The Manager spoke of good friendships having been developed between the people living at the Service, and this was confirmed in discussions with them. They made comments such as, I get on well with all the people here. One person said, I have friends at the pub and the (Day) Centre. The people living at the Service were involved, to varying extents, in domestic activities. They had full access to all parts of the premises other than to the private accommodation belonging to the Manager and his wife and to each others bedrooms, unless invited. This showed they were encouraged to be independent within the Service. Further evidence of this lay in two people having a key to their bedroom door and one of these two people told us, I have a key to my door. The other two people had chosen not to hold a key. The case tracked person catches a bus each week to visit their parent or goes to a football match. This person also arranges their own appointments with a hairdresser. The Manager explained that the people living at the Service were also independent regarding their personal hygiene, apart from one person needing help from staff with shaving. This meant that they had full privacy while using the bathroom and toilet. Staff knock on bedroom doors before entering, the Manager said. A good range of meals were described on the Services six-week rolling menu and this was reviewed periodically, the Manager stated. Foodstocks in the larder, freezer and refrigerator were good and included fresh fruit and vegetables. Most food was bought on line but one person who lives at the Service may accompany the Deputy Manager to buy top up shopping at a local store. The case tracked person uses a local store to buy personal drinks. The Manager and Deputy Manager showed awareness of peoples food preferences. Mealtimes were very flexible and reflected the activities being carried out at the time. The people living at the Service are not involved in preparation of a main meal but are involved in preparing drinks and snacks. The case tracked person said, of the food provided, Nice food. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The Service was providing people with personal support in the way they preferred and required and was meeting their physical, emotional and health needs. Evidence: The Manager explained that the people living at the Service were generally independent regarding day to day routines except, on occasions, two people do need prompting with regard to personal hygiene matters. Two bath rails had been provided to improve one persons independence when using one of the Services two baths. An additional step, outside the front door, also addressed this persons mobility needs. People choose their own clothes each day, although guidance was needed when out clothes shopping. They were each able to make their needs known verbally and one person uses some Makaton sign language as well. Two people living at the Service were involved in Self Advocacy meetings and annual conferences. One staff questionnaire returned to the Commission stated that people living at the Service are, treated as they would be if they lived in a normal home situation. There was documentary evidence, albeit rather brief, of the way that peoples health needs are being met - through health notes and care plan progress notes, including records of appointments with appropriate health professionals. One persons health condition was well controlled by diet and was on no medication. Two people living at the Service were in receipt of prescribed medication. This was being securely stored. The Medication Administration Record (MAR) sheets of these two people were examined and were satisfactory. The Deputy Manager and care assistant had both undertaken a training course in the safe use of medication. 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 . Procedures for handling complaints and abuse were in place ensuring that people were protected. Evidence: The Services complaints procedure was kept outside a cabinet in the entrance hall - in a prominent position for visitors to see. The Manager said he had sent a copy of the complaints procedure to relatives and other stakeholders in July 2008. He stated in the pre-inspection questionnaire that the Service had received no formal complaints within the last 12 months. He added that there had never been any formal complaints made about the Service. An informal complaint about the Service, made by a local person, was recorded on the case tracked persons Implementation Sheet. A satisfactory record of formal complaints received had been developed and the Manager was recommended to use this to record informal complaints made by neighbours and the people who live at the Service - so that the quality of the service provided could be clearly monitored. The Manager accepted that the people who live at the Service do grumble, from time to time, about matters that affect them. He was able to evidence how they are able to voice their unhappiness over an issue and how the complaints procedure had been explained to them. We asked one of the people living at the Service who they would speak to if they were unhappy. They told us, Id talk to (the Manager) or (the Assistant Manager). The completed pre-inspection questionnaire had confirmed there had been one safeguarding adults referral and investigation since the last inspection. There was evidence that the Service had taken the matter seriously and had fully co-operated with Social Services in their investigations. The Manager and Assistant Manager had attended a training course on Safeguarding Adults. There was also a DCC Policy and Procedures document and a training CD Rom from Derbyshire County Council. A policy on Sexuality and Relationships had been drawn up. However, no individual risk assessment, in relation to the person most recently admitted - to address the change in gender balance within the Service - was in place. A policy of staff receiving gifts had been written. The Services whistle blowing policy was satisfactory. The two people Evidence: spoken with confirmed that staff treated them well and that they felt safe living at the Service. One reported, Im not frightened of being hurt. There was reference on one persons file to assessment and implementation under the Mental Capacity Act Deprivation of Liberty Safeguards. This indicates that the Service has started to consider vulnerable peoples right not to be deprived of their liberty without full consideration. The case tracked persons financial records were examined and were cross-referenced to monies held. They were satisfactory and there was recorded evidence of regular audits. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People were living in a comfortable, homely and safe environment. Evidence: The premises were well decorated and furnished and homely. Each of the five bedrooms had appropriate lockable doors. The two bedrooms viewed were found to be well-personalised and providing evidence of the interests held by the people accommodated there. The rear garden had been cleared and was tidy and mainly laid to lawn. The Manager stated in his pre-inspection questionnaire that, We plan to have a more structured yearly maintenance plan. He added, at the inspection, that this was one of 93 items on the Services Quality Assurance Action Plan. The premises were clean and hygienic, with no unpleasant odours. The Control of Infection policy was satisfactory - indicating that the health of people living at the Service was being well considered. There was a dedicated sink in the utility room that could be used for pre-washing any items of soiled clothing. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The Service was sufficiently staffed to ensure that people living here were safe and their needs were met. Evidence: The staff at the Service comprised the Manager, Assistant Manager and one full time care assistant. The Manager and Assistant Manager displayed appropriate commitment to the people living at the Service and had a comfortable relationship with them. The care assistant was not on duty at the time of this inspection. The Service did not meet the National Minimum Standard to maintain a staff group with at least 50 qualified staff. The care assistant was working full time at the Service. Her hours were being recorded on a formal rota, as recommended at the last inspection. There was also a risk assessment in place that addresses the potential risks associated with lone working. The file of the care assistant, appointed in March 2008, were examined at the last inspection. At that time there had been no written references that would provide a view of the persons suitability and fitness for this post. These were in place at this inspection. An employment contract and written policies on staff recruitment, grievance and disciplinary matters were in place - to give staff information about these aspects of their employment. The Manager had provided an induction to the care assistant but not to nationally recognised Learning Disability Award Framework (LDAF) standards. Following a recommendation at the last two inspections, the Manager had approached the British Institute for Learning Disabilities (BILD), for advice on providing such induction should further staff be appointed in future. The Manager and Assistant Manager had, three years ago, attended training courses on Fire Safety, Basic Food Hygiene and First Aid in order to ensure the safety of the people living at the Service. The care assistant Evidence: had attended Basic Food Hygiene, First Aid and Fire Safety training. 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 was well managed so that people living here were protected and their best interests were promoted by the systems in place. Evidence: The Manager is a nurse qualified in work with adults with a learning disability and with 19 years experience with this client group. He said he had enrolled on the Leadership & Management for Care Services (LMC) course, which is the training course for Registered Managers at NVQ at level 4, and was due to commence the course soon. The Manager had become a paid-up member of the British Institute for Learning Disabilities (BILD), which keeps him up to date with current practice and policy issues regarding services for people with learning disabilities. The Manager stated that a house meeting, with the people who live at the Service, was held in November 2008. His notes from this meeting indicate that people were asked about the activities provided by the Service. The Manager had also held a staff meeting in late 2008. He said he had sent out quality assurance questionnaires to external professionals, as recommended at the last inspection, but none had been returned. No questionnaires had been sent to relatives though. One relative did return our pre-inspection questionnaire and stated, I am very pleased with all aspects of the service Maple House provides, it is first class. The Manager had developed a National Minimum Standard (NMS) based check-list of the services he provides. A score for each of the eight outcome areas had been created and he said these appeared to reflect the ratings given by the Commission in the report of the last inspection. This showed that the Manager was seeking to measure success in achieving the aims of the Service. A Quality Assurance Action Plan, containing 93 items, had been developed from this exercise; 15 had been completed, the Manager said. An Annual Development Evidence: Plan had also been developed since the last inspection. The Managers pre-inspection questionnaire indicated that several key policies and procedures were not in place. However, on examination of the Services Policies and Procedures folder it was clear that a good range of written policies and procedures were in place. Two areas were not covered, though - these were, Death of a Service User and First Aid. There was evidence of good food hygiene practices in the kitchen. The Service was using a Food Standards Agency record each day to record food temperatures, menu sheets and any problems occurring. Cleaning materials were being stored in a locked cupboard. Product Data sheets, as required by the Control Of Substances Hazardous to Health (COSHH) Regulations, were in place. There was documentary evidence of Portable Appliance Tests (PAT) being undertaken annually. Records of regular fire alarm tests and fire drills were being kept. Environmental risks were reflected in risk assessments relating to the individual people living at the Service and these had been expanded since the last inspection. However, an overview of potential environmental risks within the Service had not been undertaken although the Manager said this was on his Quality Assurance Action Plan. 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 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 1 35 23 23(4)(d) The Manager and staff must be provided with fire safety training at least annually. 01/07/2009 This will ensure that the safety of people who live at the Service is not compromised. 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 2 3 6 22 23 Recorded care plans and risk assessments should reflect a person centred approach. Informal complaints should be recorded on a complaints record. An individual risk assessment, in relation to the person most recently admitted - to address the change in gender balance within the Service - should be developed. 50 of care staff should be trained to at least NVQ 2 standards. 4 32 5 35 Those staff, including the Manager, whose mandatory training was undertaken more than three years ago, should attend refresher courses Quality assurance questionnaires should be sent to the relatives of people who live at the Service. Policies and procedures should be written on the topics of Death of a Service User and First Aid. An overview of potential environmental risks within the Service should be recorded as risk assessments. 6 7 8 39 40 42 Helpline: Telephone: 03000 616161 or Textphone : or 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. 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