Care Home: Red House

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What the care home does well People who use the service are given good information about what is provided. This means that they know what help they will be given. People who would like to move into the home are assessed so that they and the staff team can be sure that their needs will be met. People are involved in deciding what care they need and a plan is then drawn up. This gives everyone a say in planning services they will receive. The staff showed a good understanding and knowledge of people that live at Red House. They look after them in a friendly and supportive way. People see their GP, Dentist, Optician, District Nurse, Occupational Therapist, and Chiropodist whenever they need to. This ensures that their health care needs are met. Everyone is asked what they think about the service provided so that the staff team can make changes to improve their quality of life. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Everyone living at the home enjoys their own interest and hobbies and has the opportunity for an annual holiday. The staff support people to live a fulfilling life within the home and beyond in the local and wider communities. What has improved since the last inspection? The staff are aware of confidentiality and the need to make sure that all personal documentation is held safely. Any documents held downstairs are now in a locked bureau in the hallway of the home. The home has a permanent manager who is to apply for registration and will manage this and one other St. Anne`s home, "Jenkin Lodge," based in Ingleton. What the care home could do better: The manager must make sure that all the required staff information is held on the premises; this includes staff recruitment and staff training information. Health and Safety was generally well audited but water temperatures needed closer monitoring and details of action taken must also be recorded. Key inspection report CARE HOME ADULTS 18-65 Red House Gas House Lane Main Street High Bentham North Yorkshire LA2 7HQ Lead Inspector Linda Trenouth Key Unannounced Inspection 8th June 2009 09:00 Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red House Address Gas House Lane Main Street High Bentham North Yorkshire LA2 7HQ 01524 262694 F/P01524 262694 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.st-annes.org.uk St Anne`s Community Services Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for 5 service users with learning disabilities, some of whom may have physical disabilities, all of whom may also be aged 65 years or older The home may not admit any service user within the service user category (LD(E)). This category applies to those service users currently in receipt of services. Date of last inspection Brief Description of the Service: Red House is a care home registered by St. Annes Community Services to provide personal care and accommodation for up to five adults with learning disabilities some of whom may have physical disabilities and all of whom may be aged 65 years or older. The home consists of a two storey detached house situated on a quiet lane in the market town of High Bentham. The town centre is within easy walking distance of the home and has numerous and varied facilities including shops, cafes, churches and pubs. All five bedrooms are for single accommodation, none of which has en-suite facilities. Shared areas consist of a kitchen, dining room, and lounge. The home has a large, landscaped garden that is well maintained. There is hard standing for parking to the rear of the home. There is level and ramped access to the home. The current weekly fee for the home is £252.96 extras that are charged for are hairdressing, chiropody, toiletries, aromatherapy and holidays and the leasing of cars. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a unannouced visit to the home. The inspection also included gathering information and facts before and after the visit to decide the overall judgement. The home now has a permanent manager who will be applying for registration. The manager was not at the home during the inspection but the deputy manager was available throughout the visit. During the visit the records were reviewed and we watched staff working, and talked to people who live at the home. We also looked around the building. The main purpose of this inspection is to make sure that the home continues to provide a good standard of care. Comment cards were sent to people who use the service, staff and Health and Social Care Professionals, to give them the opportunity to comment on how well they thought the home had done. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as commendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Feedback was given to the deputy manager at the end of the visit. The requirements made during this visit can be found at the end of the report. What the service does well: People who use the service are given good information about what is provided. This means that they know what help they will be given. People who would like to move into the home are assessed so that they and the staff team can be sure that their needs will be met. People are involved in deciding what care they need and a plan is then drawn up. This gives everyone a say in planning services they will receive. The staff showed a good understanding and knowledge of people that live at Red House. They look after them in a friendly and supportive way. People see their GP, Dentist, Optician, District Nurse, Occupational Therapist, and Chiropodist whenever they need to. This ensures that their health care needs are met. Everyone is asked what they think about the service provided so that the staff team can make changes to improve their quality of life. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 6 Everyone living at the home enjoys their own interest and hobbies and has the opportunity for an annual holiday. The staff support people to live a fulfilling life within the home and beyond in the local and wider communities. 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. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. . People using this service experience good quality outcomes in this area. People are assessed and given good information before they move into the home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There has been one new admission to the home since the last inspection. This individual had an assessment and the support of an independent advocate to help them decide if the home was right for them. The service user guide is available for everyone and tells people what they can expect when they live at the home. Staff tell us that individuals are encouraged to visit and stay at the home to help them decide if the home is right for them. They also say it is very important in such a small home that everyone is happy with the move and people living at the home get the opportunity to see if they are happy too. The Care Manager will arrange a Care plan review meeting within a week of the person moving in and a further review at six weeks. The opinions of the Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 9 person, their relatives, and carers are important as well as the views of other people living in the house. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. People using the service experience good quality outcomes in this area. People are able to make their own choices about how they live their lives both in the home and the wider community. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Assessments and care plans were complete and reviews regularly undertaken. This makes sure that the changing needs of people living at the home are continually met. Staff were able to give good examples of how they support individuals. Staff say, Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 11 We try to make sure they do a lot of different and interesting things, they like to be out a lot and enjoying coffee mornings and days out. Staff discussed how they encouraged people to make their own decisions they help them choose clothing, items for their room and presents for their friends and families. People living at the home tell us that they make their own decisions about what they do from day to day. The care plans recorded examples of how staff enabled people with their personal care, detailing how people should be supported to do as much as possible for themselves. This is important to make sure people maintain their independence and dignity. Staff also have good communication and understanding of how to meet the communication needs of individuals. There is a section in the care plan about preferred communication and additional guidance is available for staff to help them improve and help people make day-to-day decisions. Other staff said that they encourage everyone to be involved with the menu planning and shop for food. Each individual has a special worker called a “key worker”, who includes them in their care planning and there are regular house meetings where people were able to further express their views. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16, and 17. People using the service experience excellent quality outcomes in this area. The people who live at the home have excellent opportunities to experience and enjoy fulfilling lives both within and outside the home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There are many varied activities happening throughout the week, which are appropriate to the needs, age and abilities of the people living at the home. One individual was leaving for his holiday and others spoke about their holidays to the seaside. Everyone enjoys a holiday from the home and one individual prefers to have day trips rather than a long break from his normal routines. The staff at the Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 13 home encourage people to choose where they would like to go and recently one holiday trip had included an outing to the races. In addition to this there are regular outings to places of interest and lunches, meals out. Staff tell us that peoples birthdays are always celebrated with special birthdays being a big event. One individual has just celebrated his 90th birthday. Other individuals attend age concern’s lunch club and enjoy dominoes. A diary of all their activities for the month are in the kitchen, this allowed for some planning but staff said that there are also spontaneous activities on the day depending on the weather. The survey cards returned confirmed that people felt there are lots of activities on offer. Health and Social care Professionals say; The home tries very hard to provide the 5 gentlemen with individual opportunities/ activities outside the home, in the local community and further field. No mean achievement given their age and disabilities. People are supported to develop and maintain relationships with families and friends. They are assisted to visit their families and can meet their visitors in private. The mealtime is not rushed or hurried, people were observed having breakfast, which was clearly relaxed. People were supported to enjoy their food at their own pace. Where necessary staff help people with their food in a sensitive and supportive manner. Most main meals are eaten together at the home and staff told me that individuals also eat out regularly at pubs, cafes, and restaurants. They also sometimes have takeaways and fish and chips. One person commented, We always have roast on Sundays and the food is good There was a positive comfortable atmosphere and friendly banter between the staff and people living at the home. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. People using the service experience good quality outcomes in this area. People were well supported with all their health needs by caring staff. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Everyone has care plan, which details how they will be supported with their health and care needs. These care plans look at areas such as general health, Optical, and Dental needs. One individual recently had a fall, the care plans provided good detail about how they would be supported with their mobility and made comfortable. They also received additional help from the Occupation Therapist to support them with their rehabilitation and physical needs. People visit their GP regularly and their medication is reviewed. Where Health Professionals make recommendations these are included into the care plans. Everyone has their medication administered by staff. The medication was reviewed and found to be safely stored. The staff administer and record Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 15 medication safely and make sure any used medicines are appropriately returned to the chemist. Where any errors are made the staff follow the correct procedures to make sure that people are kept safe. The medication provided to the home is in a monitored dosage system supplied by the local Chemist in Bentham. Staff said that the pharmacist is very supportive and collects the returned medication weekly. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. People can be confident that their concerns will be taken seriously. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The complaints procedure is available in the service user guide in an easy read style and staff have access to grievance and complaints procedures in their own policies and procedures. Staff have a good understanding of the communication needs of people living at the home and therefore interpret when individuals may have concerns. There are also regular house meetings and people are supported to talk about issues in the home. Staff tell us that they have completed training in adult protection and understanding their responsibilities when they have concerns for a persons welfare. There is an adult protection procedure in place which everyone has access to. I confirmed with the staff that there have been no complaints sent to the home; the complaints book did not have any complaints or concerns recorded and no complaints have been received by CQC since the last inspection. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People using the service experience good quality outcomes in this area. People live in a comfortable and safe home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: This was an unexpected visit and the home was welcoming, clean, and well maintained. Staff tell us that everything in the building is working well and that that they are receiving a new hoist to support people on the first floor to be moved safely. There has also been new flooring added to the kitchen. The bedrooms were individualised and furniture is chosen and bought by the individuals themselves. The bedrooms reflected peoples individual personalities and tastes. They also had their own TV’s and CD players. Communal areas were comfortable and homely and provide a safe environment for everyone. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 18 The gardens were well maintained and people have a good outdoor area to sit out in or walk around if they wish. There is gazebo and garden furniture so that they can enjoy the garden throughout the year. One individual has his own area of patio to keep his own plants, and miniature greenhouse. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, and 35. People using the service experience good quality outcomes in this area. The people at the home benefit from a well-supported and trained staff team who are competent and understand their needs and work in the best interests of each individual. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff rotas showed that there was always a minimum of two staff on at any one time. This is increased to three at busy times. The people living at the home were also supported by an organisation called, Avalon, who provide activities for people on an individual basis. The support people need has increased as their needs have increased, one individual now requires two members of staff for all his care needs. Staff commented that staff shortages hindered the service at times and that agency staff often supported the home. The deputy manager said that one of the homes staff was presently supporting Jenkin Lodge. It is hoped that with further recruitment the staffing shortage will be resolved. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 20 The recruitment records were reviewed and found to be incomplete with important information omitted. Some information was emailed to the home later in the day. The deputy manager explained that this information was with the personnel department and confirmed that no one was employed at the home until all the required checks were in place. All recruitment information must be held at the home to confirm that people are recruited safely. Staff tell us that they have had training in areas such as manual handling, food hygiene, health and safety and adult protection but the records could not confirm this. One staff commented, The training is good and the organisation encourages you to go on a range of training courses. There was however no apparent auditing of staff training and no evidence in some cases of courses completed. This information must be in place to make sure that staff are always trained and no updates are missed. New staff undertake LDIA (Learning Disabilities Induction Award), which includes their induction training within the home. Staff say that the organisation is very supportive of people taking additional training in areas such as Bi Polar disorders or other mental health conditions for staff to expand their knowledge. The percentage of staff now trained to NVQ level 3 is less than 50 of staff working at the home and has fallen since last year. The AQAA tell us that the home is aware of this short fall and is working on training more staff in the NVQ in the next year. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42. People using the service experience good quality outcomes in this area. People are supported by good management. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has appointed a manager who is applying for registration to the CQC. This manager is also presently managing Jenkin Lodge in Ingleton. Staff said that they had regular staff team meetings and supervision and felt that the home is well managed. Staff commented, Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 22 We are well supported by the management I had supervision last month, we do have regular support Monthly Health and Safety checks are completed with staff at the home being given delegated responsibilities for specific areas. The following areas were reviewed at the visit and were satisfactory, Electrical, Gas, and Fire safety systems. Water Temperatures were recorded, some were found to be higher than is considered safe and there appears to have been no action taken to remedy this problem. The staff must alert the manager when water temperatures are too high. Further Health and Safety records show that COSHH risk assessments are in place. The home has notified us when there has been any occurrence affecting the well being of people living at the home. The service manager says that monthly audits of the service have taken place but there have been no reports issued to the manager of the home. These should be in place to support everyone in the home and make sure that the quality of care is maintained. People living at the home, relatives, staff, and visitors have been asked to complete quality questionnaires. The views of people living at the home are also sought, making sure that everyone has a say in running the home. Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x 3 x 3 x x 2 x Version 5.2 Page 24 Red House DS0000007899.V375932.R01.S.doc No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA34 Regulation 19 Requirement Staff recruitment records must be available and complete. This is important to make sure that everyone is recruited safely. A staff training and development audit must be completed for all staff within the home to make sure that training needs are not overlooked. Water temperatures must be audited and any Health and Safety concerns dealt with promptly. The Responsible Individual must visit the home regularly and make available a monthly report on the conduct of the home. This is to make sure they monitor the quality of care that people receive and that the manager is well supported. Timescale for action 10/08/09 2 YA35 18 10/08/09 3 YA42 13 10/08/09 4 YA39 26 10/08/09 Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Red House DS0000007899.V375932.R01.S.doc Version 5.2 Page 26 Care Quality Commission Yorkshire & Humberside Citygate, Gallowgate NEWCASTLE UPON TYNE NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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