Care Home: Orchard Avenue 10

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What the care home does well There is a high standard of care provided to the people who live in the home. The resident who was spoken to, said that they thoroughly enjoyed living in the home and there is a very good relationship between the manager, residents and the staff. There is a relaxed and friendly atmosphere and the premises are well maintained, safe and attractive. The people who live in the home are very appreciative of the meals provided and that they are always asked about what they would like to eat. There are good records of the meals actually taken, which shows that the residents have a varied and nutritious diet. Residents have comfortable, well-decorated rooms and are able to bring their personal furniture and other possessions with them when they move in to the home. What has improved since the last inspection? A member of staff has commenced their National Vocational Qualification training, which will enhance the care they provide to residents. The manager has provided a written format that enables her to carry out a full needs assessment of people who are referred to ensure that the home is suitable for them. Authorisation has been obtained for the covert administration of medicines if necessary. This protects the rights of this individual. The home has developed a new questionnaire for residents, their representatives and other stakeholders so they are able to have a say about whether the home is run in their best interests. A Criminal Records Bureau check has been obtained for the volunteer who works in the home, which protects residents` best interests. What the care home could do better: Two requirements from the last inspection are repeated in this report. The manager must ensure that all staff attend training in food hygiene to protect residents from harm. Subsequent to this inspection, the manager has informed us that she has obtained a training course in food hygiene for the staff at Southgate College. The Commission will seek evidence of compliance with this requirement at the next inspection. At the busiest times of the day, a minimum of two staff must be on duty to ensure that the needs of the residents are being met safely and residents` care plans must be reviewed on a monthly basis to ensure that any changes in their needs are addressed. The hot water supply to the bathrooms must be fitted with thermostatic valves to minimise the risk of scalding. A bath thermometer must also be provided and risk assessments need to be included in the residents` care plans to warn staff to check the temperature before supporting them to have a bath. Key inspection report Care homes for older people Name: Address: Orchard Avenue 10 10 Orchard Avenue Whetstone London N20 0JA     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: Ffion Simmons     Date: 2 9 0 1 2 0 0 9 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 26 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 26 Information about the care home Name of care home: Address: Orchard Avenue 10 10 Orchard Avenue Whetstone London N20 0JA 02084452014 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Mabel Blanche Watkins Name of registered manager (if applicable) Mrs Mabel Blanche Watkins Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who may be accommodated is: 4 The registered person may provide the following category of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the Care Home are within the following categories: Old Age, not falling within any other category. Date of last inspection Brief description of the care home 10 Orchard Avenue is a privately owned care home, which is registered to provide personal care for a maximum of three older people. The provider/manager lives on site at the home and occupies a first floor bedroom. The home s stated aims are to provide a safe, secure, homely environment for older people, where they will be free from physical, sexual and emotional abuse. The home consists of a detached two-storey property, located in a cul-de-sac / private road, in a quiet residential area of Care Homes for Older People Page 4 of 26 Over 65 4 0 Brief description of the care home Whetstone, Barnet. There are three single bedrooms, one on the ground floor, and two on the first floor.There is a toilet on the ground floor, and a bathroom with toilet on the first floor. Also on the ground floor, there is a kitchen, leading to a conservatory, where the laundry equipment is located. There is also another small toilet downstairs. A small garden fronts the property and there is a large garden at the rear. There are good public transport links to the area.The fees for the service range from GBP700 to GBP800 per week.Following Inspecting for Better Lives , the provider must make information available about the service, including inspection reports, to people living in the home, and other stakeholders. Care Homes for Older People Page 5 of 26 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: The quality rating for this service is 2 Stars. This means the people who use this service experience good quality outcomes This unannounced inspection, which took place over a period of four hours, was carried out as part of the Commissions inspection programme and to check compliance with the key standards. In May 2008, the Commission received the homes Annual Quality Assurance Audit, (AQAA), which is a self-assessment of the service by the manager. This document is required to be completed annually to provide information about how well outcomes are being met for people who live in the home. It also gives some numerical information about the service. The manager and two members of staff were present during the inspection. There were two people living in the home and there was one vacancy. As part of the inspection process, we discussed specific issues with the proprietor Care Homes for Older People Page 6 of 26 regarding any new developments and how the requirements made at the last inspection were being complied with. A full tour of the premises was carried out and both residents were visited in their rooms. Both residents are very elderly and it was not possible to converse with one person who was very frail, but we spoke to the other resident about their experiences of living in the home, and we interviewed one member of staff about their work. We examined the residents files, the staff records and other documents that related to the running of the home. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including looking at residents records. Residents are given a statement of purpose/service user guide, which provides appropriate information to enable them to decide if the home will meet their needs. An appropriate format has been produced to ensure that people will be thoroughly assessed before admission to the home. The people living in the home are well cared for and say they are happy with the service they receive. Evidence: There is an up to date Statement of Purpose/Service User Guide that describe the service and the fees charged. A named copy is provided in each residents room. Since the last inspection, a resident died which leaves one vacancy in the home. One person is funded by the Primary Care Trust and there was a record of a monitoring officer from the Trust visiting the home to monitor the placement. The Care Homes for Older People Page 10 of 26 Evidence: other resident funds her care privately. There is a contract in place for the latter resident, which at the time of the inspection, was with their relatives for them to sign. The manager has complied with a requirement from the last inspection and has produced an appropriate assessment form to ensure that residents needs will be assessed before being admitted to the home. Through observation and discussion with one of the residents and reading both case files, we were satisfied that they were happy in the home and their needs were being met. One person said that she was very happy to have found this home and was very contented. She said the staff looked after her very well. Care Homes for Older People Page 11 of 26 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 this service experience good outcomes in this area. This judgement has been made using available evidence, including observation of the residents and looking at their care plans. There are good care plans that document each residents needs, but these plans must be reviewed on a monthly basis to ensure that staff are aware of any changes in these needs. There is a good system for safely administering and recording medicines. Staff treat the residents with dignity, and their wishes in relation to their funeral arrangements are respected. Evidence: Both residents have a written care plan that includes an assessment of their needs and which provide guidance for staff about the care to be provided. However, the last recorded review of the care plans was October 08 which indicates they were not being reviewed regularly. A requirement is made to address this. One person is mostly bed-bound but in the daily records there was evidence of her being supported to sit out for periods during the week. Pressure-relieving equipment Care Homes for Older People Page 12 of 26 Evidence: was provided. At the time of the inspection, this resident did not have any pressure ulcers. The other person living in the home has some mobility with staff supporting her to walk. Recently, the resident had been successfully treated for a small facial ulcer. Another had been treated by a chiropodist and records showed that both residents were seen frequently by the G.P. and district nurse. Both residents also have appropriate equipment to minimise the risk of pressure ulcers developing and risk assessments had been carried out regarding pressure ulcers and of falling. The residents weights were monitored monthly. We observed that the residents were clean, appropriately dressed and looked well cared for. Both residents receive medication. The records for ordering, storage and administration of medicines were checked and found to be satisfactory. A resident spoke highly of the care they received, and said that she was always treated with great dignity and respect. Staff were observed knocking on the residents doors before entering. We noted that there was a record in both case files of residents wishes in relation to their funeral arrangements. Care Homes for Older People Page 13 of 26 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 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 this service experience good outcomes in this area. This judgement has been made using available evidence including observing how staff interacted with residents and looking at daily records. Residents can be confident that their wishes about how they want to spend their time in the home will be supported and respected. They can also expect to have the meals they like and to be supported sensitively by staff if they need assistance to eat. Evidence: One resident is ninety-eight years old and the other is over one hundred. Because of their advanced age and disabilities, the residents are not very active. The person who lives on the ground floor, is mainly confined to bed, due to her disability and frailty, but her daily records showed that she is sat out in her armchair several times during the week. There is a television and radio in her room, and the staff said that she likes watching religious programmes on Sunday. It was stated in this persons care plan that she likes to have her hands stroked. The other resident said that she likes to spend her time in her room and does not wish to have a television or radio. The visitors book showed that both residents have regular visits from their relatives. One person said that staff always respected her wishes regarding when to get up or Care Homes for Older People Page 14 of 26 Evidence: go to bed, what to wear and what they wished to eat. Preferences are recorded in residents care plans, for example; does not like fish. To have a cup of tea any time of day. None of the residents require specific ethnic meals. We observed staff supporting a resident who needed assistance with eating. The food was finely chopped for this person to prevent choking, which was identified as a risk in the care plan. The member of staff engaged the resident in conversation while supporting her at mealtime. There isnt a daily menu in the home, but residents are asked each day what meals they would like to have. A record is kept of what each person has eaten. This showed that meals were individually prepared with a good variety of wholesome food according to the persons taste. Fresh fruit was available. A check of the larder and fridge showed that there was ample food in the home. Care Homes for Older People Page 15 of 26 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including observation and speaking to a resident and staff. A resident said that they feel safe in the home and are confident that any concerns would be properly addressed. The staff have been trained in, and are able to demonstrate, awareness about adult protection issues. Evidence: The complaints procedure is attached to the residents contracts and there is a book for recording any complaints. There is space in the complaints book for recording the response time and the outcome of any investigations. No complaints were logged in the complaints book and the manager stated that no complaints were pending. A resident told us; I am very contented living here and I feel safe. The staff are wonderful and very attentive. The local authoritys adult protection procedure is available in the home, and the staff have attended training in adult protection procedures. We spoke to a member of staff on duty who was able to describe the protection from abuse procedures and demonstrated a good awareness about their responsibilities to protect residents. The staff were observed interacting with the residents. They showed a friendly, respectful and caring attitude. Care Homes for Older People Page 16 of 26 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including visiting all areas in the home. Residents live in a well maintained, clean and comfortable home and their bedrooms meet their needs. There is good standard of decor throughout the home and there is an attractive garden for the residents to enjoy. People are at risk of scalding as there are no thermostatic valves on the hot water system. Evidence: All internal and external areas of the home were visited. Both residents have single rooms, one downstairs and one on the first floor, both of which were attractively decorated. There was evidence of personal possessions and mementoes in the bedrooms, which residents had brought with them when they came to the home. One person had a television and radio; the other resident stated that she preferred not to have these. Each room had a wardrobe, bedside table and comfortable armchair. There is a downstairs room that can be used as a communal lounge/dining room for the people who live in the home. This provides somewhere for the residents to meet and socialise if they want to, but at the time of this inspection, the two residents did not use the room. Care Homes for Older People Page 17 of 26 Evidence: The gardens, flowerbeds and hanging baskets were well maintained and they enhance the overall appearance of the home. There is also a large summerhouse in the garden. There is a washing machine and drier in the conservatory. The care staff are also responsible for cleaning all areas of the home, which were very clean and tidy and smelled fresh. There were certificates of safety for gas, fire and electric systems. However, the water in the bathrooms was running very hot. The water supply to the bathrooms does not have thermostatic valves and a requirement is made to have these fitted to minimise the risk of scalding. A requirement is also made for a bath thermometer to be provided and risk assessments to be included in the residents care plans to warn staff to check the temperature before supporting them to have a bath. Care Homes for Older People Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including looking at staff rotas and consideration of the dependency of the residents. There is not always sufficient staff available to meet the needs of the people who live in the home. The staff have attended some training courses. However, none of the staff have been trained in food hygiene, which could pose a risk to the health and safety of the residents. Evidence: There are three part-time members of staff who work at Orchard Avenue at various times during the week. The staff have been together for a number of years, know the residents well, and are experienced at caring for older people. No new staff have been employed since the last inspection. A volunteer works at the home who maintains the gardens and talks to the residents. A Criminal Records Bureau check has been obtained for this person. A new format showing the staff rota has been provided. However, at the inspection, this rota did not accurately reflect who was on duty that day, which was updated later. It was evident from the rota, and in discussion with the manager that there are several periods of time during the week when she is the only person on duty. The manager stated that because of the limited income from only two residents, this Care Homes for Older People Page 19 of 26 Evidence: affected the cost of staffing. However, given the frailty and high dependence of the current residents, this level of staffing is not sufficient to meet their needs safely, particularly from 8am to 8pm when peoples needs are highest. After discussion, the manager agreed to review the staffing levels and provide sufficient staff to cover these hours. One member of staff has started training to attain the National Vocational Qualification Level 2, which was a requirement from the last inspection. However, no one has yet been trained in food hygiene, which was also a requirement at the last inspection. The manager said that she was having difficulty accessing a training agency to provide this course. This is not a satisfactory response and we advised the manager to contact the National Care Homes Association, (of which she is a member), or the Skills for Care Council for advice about trainers in this subject. In the meantime, this requirement is restated, and the Commission is also considering what further action to take regarding this failure to comply. Care Homes for Older People Page 20 of 26 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including discussion with the manager and staff and looking at records. People who live in the home can be confident that the manager is experienced and runs the home in their best interests. Residents and their representatives are consulted about the quality of the service. There are good systems in place to safeguard the health and safety of the residents, staff and visitors to the home. Evidence: The registered provider/manager has very many years experience of running the home. She has no formal qualifications, for example, the National Vocational Qualification, level 4, or its equivalent. However, the manager has engaged a person to provide administrative support to help with the management of the home. This has resulted in the development of a needs assessment form, a quality assurance questionnaire and a staff rota. However, as stated elsewhere in this report, the staff rota is not always up to date and Care Homes for Older People Page 21 of 26 Evidence: mandatory training for staff in food hygiene has not yet been provided. During the inspection, there was a relaxed and friendly atmosphere in the home and the staff confirmed that the manager was very approachable and sensitive in her dealings with them and the residents. The manger meets with the staff once a month and discusses day to day issues, including staffs performance. We saw records of these meetings. The manager said she was about to send out a quality assurance questionnaire for this year to the relatives and other stakeholders, using the new forms. The residents either manage their own financial affairs or their relatives do so, and no money is held in the home on their behalf. Certificates of safety for the gas central heating system, fire equipment and the water system were seen. Portable electrical appliances had been tested recently and there was a record of the fire alarms being tested weekly. The home has a contract for the disposal of clinical waste and the employers liability insurance was up to date. Care Homes for Older People Page 22 of 26 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 23 of 26 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 7 15 Care plans must be reviewed 28/02/2009 on a monthly basis to ensure that any changes in residents needs are addressed. . 2 25 13 A bath thermometer must be provided and risk assessments must be included in the residents care plans to warn staff to check the temperature before supporting them to have a bath. . 28/02/2009 3 25 14 The hot water supply to the bathrooms must be fitted with thermostatic valves to minimise the risk of scalding. . 31/03/2010 4 27 18 There must be at least two staff on duty from 8am to 28/02/2009 Care Homes for Older People Page 24 of 26 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 8pm to ensure that the needs of the residents are being met safely. This requirement is amended and restated from the last inspection. The previous timescale was 31/08/08. . 5 30 18 All staff who work at the 30/04/2009 home must attend training in food hygiene to protect residents from harm. This requirement is restated from the last inspection. The previous timescale was 31/08/08. . 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 Care Homes for Older People Page 25 of 26 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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