Care Home: Mapleford

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What the care home does well Members of staff treated people with respect and were professional and friendly when attending to them. One person said, "They look after me well." Surveys completed by people using the service included positive comments such as, `I`m happy here.` and `They look after me.` The relative of a person using the service told us Mapleford was a good home and said, "The care and the staff are brilliant." A visiting district nurse said, "The people I see are very happy. Staff are always concerned about them." Leisure activities were routinely organised at the home. The activities manager also took people out to visit local places of interest and the cinema. One visitor said, "My dad`s really happy, there`s always something going on." It is commendable that almost all of the care workers have National Vocational Qualifications in health and social care at level 2 or above. Surveys completed by members of staff stated that they received the training they needed in order to meet the individual needs of people using the service. What has improved since the last inspection? The manager has taken appropriate action in to comply with the requirements made at the last key and subsequent random inspections. Care plans have improved to accurately identify and address the health and social care needs of each person using the service. This helps to ensure that people are cared for in the way they prefer. Risk assessments for falls, nutrition and the development of pressure sores have been completed for each person. This enables any identified risks to be managed effectively. Good arrangements for the handling of when required medicines and creams are in place that helps to make sure they are used effectively and safely. To prevent people from being injured if they mistakenly enter storerooms these are kept locked. Nurse call bells are accessible to people in their bedrooms. If necessary an extension lead is used unless, subject to a risk assessment, this would be unsafe. Procedures are in place to prevent and deal any unpleasant odours. This provides a homely and comfortable environment for people using the service. What the care home could do better: The homeowner must visit the home at least once a month and prepare a written report for the manager. This will ensure the day to day running of the home is monitored and the manager is receiving the appropriate support and supervision. Fire drills should be held regularly in order to ensure that all members of staff know the action they must take in the event of a fire. Key inspection report Care homes for older people Name: Address: Mapleford Bolton Avenue Accrington Lancs BB5 6HN     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: Susan Hargreaves     Date: 2 8 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 Older People 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 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. 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 Older People Page 3 of 28 Information about the care home Name of care home: Address: Mapleford Bolton Avenue Accrington Lancs BB5 6HN 01254871255 01254231768 mapleford@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mapleford (Nursing Home) Ltd Name of registered manager (if applicable) Ms Julie Hammond Type of registration: Number of places registered: care home 54 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following categories of service only: Care home nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disabilities or dementia - Code MD, Dementia - Code DE. Maximum number of service users who can be accommodated is: 54 Date of last inspection Brief description of the care home Mapleford is a purpose built care home set in its own grounds. It is situated in a residential area of Huncoat close to shops and a Church. It is on a bus route to the town of Accrington which is about 2 miles away. Mapleford provides 24 hour nursing and personal care for up 54 people suffering from dementia or mental health problems. Accommodation is provided in mostly single Care Homes for Older People Page 4 of 28 Over 65 54 54 54 54 0 1 1 0 2 0 0 9 Brief description of the care home rooms and 7 double rooms. Some of the bedrooms have en-suite facilities. There are 3 lounges each with with a dining area. A passenger lift facilitates access to all areas of the home. The current fess charged at Mapleford are £424 - £686.47 per week. A copy of the statement of purpose and service user guide is available to people who are considering using the service and their relatives on request. Care Homes for Older People 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A key or main unannounced inspection, which included a visit to the home, was conducted at Mapleford on 28 April 2010. As part of the inspection process we looked at all the information we have received about Mapleford since the last key which took place on 9 June 2009. This included random unannounced inspections on 1 October 2009, 7 December 2009 and 10 February 2010 to monitor how medication was being managed following issues raised about this at the key inspection of 9 June 2009. Information about the last key inspection and the random inspections can be obtained from Mapleford or www.cqc.org.uk The manager completed an annual quality assurance assessment several weeks before this visit to the home. This document is a self-assessment that focuses on how well outcomes are being met for people who use the service. It also gives us some numerical information about the service. Care Homes for Older People Page 6 of 28 Ten completed surveys were returned from people using the service and seven from members of staff. At the time of this visit thirty seven people were living at the home. A tour of the premises took place and we looked at staff files and care records. We also spoke to members of staff on duty and people who use the service. Discussions also took place with manager regarding issues raised during the inspection. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The homeowner must visit the home at least once a month and prepare a written report for the manager. This will ensure the day to day running of the home is monitored and the manager is receiving the appropriate support and supervision. Fire drills should be held regularly in order to ensure that all members of staff know the action they must take in the event of a fire. Care Homes for Older People Page 8 of 28 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 Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. A thorough admission procedure ensured the health and personal care needs of people using the service were identified and met. Evidence: A copy of the statement of purpose and service user guide is available to people who are considering using the service and their relatives on request. These supply information about the care and facilities provided at the home. The manager or a senior member of staff visited people who were considering using the service in hospital or their own home before admission. The purpose of this visit is to assess the persons health and personal care needs to ensure they can be met at the home. The manager told us in the AQAA that people were only accepted for admission if she was sure their needs could be met at Mapleford. We looked at the care records of a person recently admitted to the home. These Care Homes for Older People Page 11 of 28 Evidence: records included a detailed pre-admission assessment which provided important information for the development of their care plan. People considering using the service or their relatives received a letter of welcome confirming that their needs could be met at the home. Care Homes for Older People Page 12 of 28 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. People who use the service were cared for in a manner which promotes their privacy and dignity. Medication was managed safely. Evidence: We looked at the care plans of three people who use the service. These plans identified the health and personal care needs of each person and provided directions for staff to follow in order to ensure their individual needs were met. One care plan told staff that the person preferred to have a shower and advised them of the action to take if this person was reluctant to accept help with personal hygiene. Another care plan about privacy and dignity directed staff not to make assumptions but to listen to the person and find out their likes and dislikes. This helps to ensure that people are cared for in the way they want. Appropriate risk assessments including ones for falls, nutrition and the development of pressure sores, were in place. Guidance for staff to follow about how to manage identified risks was also included in the care plans. Care Homes for Older People Page 13 of 28 Evidence: A written report about the care given to each person using the service was written during each shift. This ensured that all staff had up to date information about the condition of each person in order to ensure continuity of their care. Care plans and risk assessments were reviewed monthly and updated when the needs of the person changed. Where possible the person using the service or their relatives were involved in care planning and had signed the care plan to indicate their agreement with the care provided. There were records of the involvement of GPs and other healthcare professionals including the chiropodist and district nurse in the care of people using the service. As part of the visit a pharmacist inspector looked at how medicines were being handled because we found some shortfalls on previous visits. Overall we found continued improvements that meant medicines were now being handled in a much safer way. Our checks of the medicines stocks and records showed they were usually given to people correctly. We found good improvements in the way external medicines such as creams were being applied and recorded that helped make sure they were being used properly. We found medicines could be easily accounted for because the records of medicines received, administered and disposed of were usually clear, accurate and complete. Any medicines that needed to be carried forward to a new monthly cycle were properly recorded and all medicines were dated on opening so they could be easily checked. Medicines were usually given to people at the right time in relation to mealtimes because they had been properly organised and people were generally given their medicines at a time that fitted into their normal daily routine. Giving medicines at the right time and dose is important because it helps make sure they work properly. We checked how controlled drugs (medicines that can be misused) were handled. The cupboards used for storage were secure and clear, accurate records were made that were properly witnessed. We found some minor recording mistakes that we discussed with the manager and gave some advice about how to prevent them happening again. Secure storage and witnessed records of controlled drugs help prevent them being mishandled and misused. Care Homes for Older People Page 14 of 28 Evidence: We checked a sample of care plans and supporting paperwork and found some good information about the use of when required medicines and detailed information about specific medicines and the health issues they were prescribed for. Medicines that were prescribed for anxiety had good information about how they were to be used and when they were given a clear record was made about when and why they had been administered. This information was regularly checked by the manager and used to help review the care people were receiving. We saw good care plans about the use of external medicines such as creams and the records of them being applied had continued to improve. Having detailed care plans about medicines helps make sure they are used properly. We looked at how medicines were checked by the managers and saw efficient recorded audits that found mistakes. When mistakes were found suitable action was usually taken to help prevent them happening again. All staff had received regular medicines training and this was repeated on a regular basis. Formal competency assessments were routinely carried out to help make sure staff were following the correct medicines handling procedures and these were repeated on a regular basis. Regular audits, good training and formal competency assessments help make sure staff have the necessary skills to handle medicines safely. Personal care was carried out in the privacy of the persons own room or the bathroom. Members of staff were observed attending to people in a polite and friendly manner. One visitor said, The care and staff are brilliant. Care Homes for Older People Page 15 of 28 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Leisure activities and meals are well managed and enable people using the service to have an interesting and fulfilling lifestyle. Evidence: An activities manager was employed to organise leisure activities for people using the service. These included dominoes, bingo, craft activities, gardening and manicures. We were told that people on the dementia unit enjoyed singing, ball games and foot massages. A designated room was available for social activities such as crafts and hairdressing. The activities manager regularly took people out to the shops, local beauty spots and amenities such as the cinema, bowling and swimming. During the afternoon of this visit she took one person for a short walk and then several people to the cinema. In addition to this outside entertainers regularly visited the home. One visitor said, Theres always something going on. One member of staff said, We have time to talk to people. This is important because it helps to promote the wellbeing of people suffering from dementia and mental health problems. Local clergy regularly visited the home and offered communion to people who wished Care Homes for Older People Page 16 of 28 Evidence: to practice their faith in that way. People using the service and members of staff said that visitors were welcomed into the home and offered refreshments and meals. The daily routine was flexible in order to meet the needs and preferences of people using the service. We asked one member of staff at what time people usually got up in the morning and she replied, Its up to them. We saw people having breakfast quite late in the morning. One person said, They bring me coffee and porridge, no matter what time I come I get a good meal. Drinks were served throughout the day in all areas of the home and people who were able went to the hatch in the dining room and asked for what they wanted and were served promptly. All the people who were asked said the meals were good. A lighter meal was served at lunch time because some people had enjoyed a cooked breakfast. The main meal which on the day of this visit was a roast chicken dinner was served at tea time. A choice of menu was offered and special diets such as vegetarian were also available. At lunch time we observed members of staff sitting down and feeding people suffering from dementia in a sensitive manner. They also chatted to them in order to make lunch time a social occasion. Care Homes for Older People Page 17 of 28 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Complaints were taken seriously and investigated. Members of staff had the training necessary to ensure people who use the service were protected from abuse. Evidence: The manager told us in the AQAA that the complaints procedure was included in the welcome pack suppled to people on admission to the home. People using the service who completed the survey indicated that they knew how to make a complaint. One visitor told us that she would complain if necessary and felt confident to do so because everyone was approachable. The manager said she had investigated four complaints in the last year. A record of these complaints, the investigation and the action taken were available for inspection. The members of staff who completed the survey all stated that they knew what to do if a person using the service or their relatives expressed any concerns to them. Policies and procedures for safeguarding vulnerable adults were in place. The procedure clearly stated the action that members of staff must take if allegations of abuse are made. Discussion with three members of staff confirmed that they had received training in safeguarding vulnerable adults. They all said they would report any concerns Care Homes for Older People Page 18 of 28 Evidence: immediately to the manager. Care Homes for Older People 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, 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. 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 premises are well maintained and provide a comfortable and homely environment for people who use the service. Evidence: A tour of the premises confirmed that the home was clean, tidy and generally well maintained. This provided a homely and comfortable environment for people using the service. Recent improvements to the home included redecoration of some communal areas and a new fireplace and wall lights in the main lounge. The handyman explained that to further improve the premises there was an ongoing programme of redecoration and refurbishment of the home. People using the service were encouraged to bring personal items for their bedrooms to make them more homely. These included, ornaments, photographs, pictures for the walls and items of furniture. The grounds and gardens were well kept and accessible to people using the service if they wished to sit outside when the weather permitted. All the laundry was done at the home. A suitably equipped laundry room ensures clothes are washed promptly and returned to people using the service. Care Homes for Older People Page 20 of 28 Evidence: Gloves and plastic aprons were available throughout the home for members of staff to use in order to protect themselves and people using the service from infection. Members of staff told us that they had received training about infection control. Care Homes for Older People 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Members of staff are encouraged to acquire the skills and knowledge necessary in order to meet the needs of people using the service. Recruitment procedures are thorough. Evidence: The duty rota provided details about the grades and number of staff on duty for each shift. Surveys completed by people using the service and members of staff indicated that there was usually enough staff on duty to meet the needs of people using the service. A visitor on the dementia unit said, Its a good home, theres always four carers on duty until 2pm. We looked at the files of two members of staff appointed since the last inspection. These files indicated that all the required information had been obtained before these members of staff had started working at the home. This included two written references and a Criminal Records Bureau check. These checks ensure people who use the service are protected from the employment of unsuitable staff. Discussion with the manager and members of staff confirmed that training was actively encouraged. This included induction training for new employees, moving and handling, basic food hygiene, first aid, challenging behaviour, infection control, fire and dementia. In addition to this most of the care workers had National Vocational Care Homes for Older People Page 22 of 28 Evidence: Qualifications at level 2, 3 or 4 in health and social care. Care Homes for Older People Page 23 of 28 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a competent manager and the views of people using the service are considered when decisions about the care and facilities provided at the home are made. Evidence: The manager is a qualified nurse with experience of caring for people suffering from dementia and mental health problems. She keeps up to date with current practice by attending relevant conferences, reading care journals and using the internet. One member of staff interviewed during this visit said the manager was approachable and supportive. The manager told us that she had received training about the deprivation of liberty safeguards legislation implemented in April 2009. She has compiled a file of relevant information and supplied all members of staff with a booklet. The manager was advised to ensure that training was also provided for other members of staff. This ensures that peoples rights and welfare are protected if they are unable make Care Homes for Older People Page 24 of 28 Evidence: important decisions for themselves. Discussion with the manager confirmed that she was committed to running the home in the best interests of the people living there and had achieved the nationally accredited Investors in People Award. People using the service had recently been asked to complete satisfaction questionnaires. Positive responses were seen on several completed questionnaires. Regular meetings were held for people using the service. Activities, staffing, meals and the premises were some of the topics discussed at these meetings. As a result of listening to the views of people using the service a lighter meal is served at lunch time because some people like to have a cooked breakfast. Several people using the service had a small amount of money kept at the home to pay for hairdressing, chiropody and other personal needs. To ensure this was managed safely records of all transactions were kept. We checked two of these during the visit and found the records to be up to date and accurate. The manager explained that although the proprietor visited the home regularly a written report was not completed every month. The purpose of these visits is to supervise and support the manager and ensure the home is being run in the best interests of people using the service. A written report provides the manager with details of any action that she needs to take in order to improve the care provided. Policies and procedures for safe working practices were in place. These help to make sure the home is a safe place to live and work. Fire alarms were tested weekly and emergency lighting monthly and an up to date fire risk assessment was in place. However, the last time a fire drill was held was in May 2009. The manager was advised to have regular fire drills in order to ensure that all members of staff knew what to do if there was a fire. We looked at the records of routine servicing of equipment. These included up to date electrical installation and gas safety certificates. Care Homes for Older People 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 Older People 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 1 37 26 The homeowner must visit 30/06/2010 the home at least once a month and prepare a written report for the manager. This will ensure the day to day running of the home is being monitored and the manager is receiving appropriate support and supervision. 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 38 It is strongly recommended that fire drills are held at regular intervals. This will ensure that all members of staff know the action they must take in the event of a fire. Care Homes for Older People 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. 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