Care Home: Rochell House

Similar services:

• 22 Sandown Road
• The Highlands
• Dilston College Of Further Education
• West View House
• Prince Bishop Court
• Park View (15)
• Craigmore House
• 1 Lanark Close

What the care home does well Rochell House provides the people who live there with a good fulfilling way of life with a variety of activities and outings offered. The quality of the care given is very good, staff know the service users very well and this helps to give people the care and the support they need to make decisions and choices that effect their everyday lives to make sure they have a varied social life. There is good rapport between service users and staff and healthcare needs are well met with other healthcare professionals fully involved service users gave positive comments about life in the home. The care plans contain good information such as detailed pre admission assessment details and tell staff how they can meet all of the needs of the people living in the home. What has improved since the last inspection? Some areas of the home have been redecorated and one bedroom has been fully refurbished. The ground floor bathroom has been replaced with a walk in shower that has proved popular with service users and hand towel and soap dispensers have been located throughout the building. What the care home could do better: The home need to review the care plans as they are disorganised and do not contain all the information they should about service users as individuals and monitoring of the care plans should be done to make sure information is up to date and correct. All concerns or complaints raised should be recorded so that information is recorded for future reference and details how the concerns were addressed. The Acting Manager must apply to the Care Quality Commission to be the registered manager of the service and the Acting manager and staff team should receive one to one supervision from their line manager on a regular basis that is formal and records stored in staff personal files. Key inspection report Care homes for adults (18-65 years) Name: Address: Rochell House 94 Queen Street Amble Northumberland NE65 0DQ     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: Eileen Hulse     Date: 2 3 0 6 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 Adults (18-65 years) 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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) 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 Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Rochell House 94 Queen Street Amble Northumberland NE65 0DQ 01665-710234 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: elsie@elpha.totalserve.co.uk Mrs Elsie Hazel Dixon care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Rochell House provides personal care and accommodation for 9 service users with learning disabilities. The home is located in the town centre of Amble, close to the main shopping centre and harbour. The home is near good transport links, with good access to restaurants and other local amenities. The home is a converted stone house; there are eight single bedrooms and one double room. Two of the bedrooms are located on the ground floor; the home does not have a passenger lift. The service users have access to a very attractive rear / patio area with seating. Fees for the home range from #395 to #597. 8 Over 65 1 Care Homes for Adults (18-65 years) Page 4 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was completed on 27 June 2007 This is an overview of what the inspector found during this inspection The quality rating for this service is 2 STAR. This means that people who use this service experience GOOD quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit on 27 June 2007 How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service their relatives and staff. Care Homes for Adults (18-65 years) Page 5 of 28 During the visit we observed staff practice and talked with people who use the service and looked at how well their needs are met. We looked at other records which must be kept. Checked that staff had the knowledge skills and training to meet the needs of the people they care for. We looked around the building to make sure it was safe clean and comfortable and checked if any improvements had been made. Care Homes for Adults (18-65 years) Page 6 of 28 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 Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good assessments are included within the plans of care for all service users that help to form the basis of the individual care plan, this ensures that before admission takes place the home is able to know if the care needs can be met by them. Evidence: All service users living in the house have had needs assessments carried out by a care manager and the manager of the service prior to their admission, most of the service users have lived in the home for between six and nine years. The Acting Manager was able to explain in detail the process that is followed when a vacancy occurs, a care manager would make a referral to the home and the prospective service user would then make several visits there either having a meal with the people who live there or spending some time in the house with them and accompanying them on activities to eventually being offered overnight stays. An assessment is carried out at this time to ensure the placement is suitable and the service can meet the care needs. This gives the person the time to decide if they would like to move in and ensures the correct equipment and care plans are made available prior to moving in. The organisation has comprehensive policies and procedures regarding the admission process and the most Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: recent service user to move into the home had all the documentation required within the plan of care. Copies of contracts for service users have been produced in picture format to help service users to understand what is written about them. Talking with service users about the home one person made the following comments, I love living here because I am independant and do things for myself, I like to go out everyday and usually walk around the harbour. Everybody has been kind to me Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans are easy to understand and contain information on the care required by service users, however, the care plans are bulky and disorganised and are not regularly monitored and therefore do not inform staff of any changes that may be required to the plans of care and therefore do not ensure all of the care needs are being met. Evidence: All service users living in the home have an individual plan of care. They include good assessment information on the care required but they are disorganised and bulky and difficult for staff to follow. Healthcare appointments are held for all service users within one file that does not conform to the Data Protection Act, all information regarding service users should be held on their individual files. Medical records are also held in one file and daily notes are recorded in another seperate file. No monitoring of the individual care plans is in place and therefore evaluation of the care plan is repetative and does not always give up to date information on any changes Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: that are needed to the care plans. The home is currently reviewing the care plans and devising a new format to ensure that staff have the information they need about people and the support that is needed by staff to help meet the needs on a daily basis. Risk assessments are completed and included within the care plans to make sure that any element of risk to the service user has been assessed and minimised where possible. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good range of social activities made available to all service users to fulfill lifestyles and this ensures people are able to make choices on how to spend their leisure time. The rights of people as individuals is recognised by support being given to maintain personal relationships and to maintain contact with their families and friends. Service users are offered nutritious and varied meals with good choices for everyone Evidence: All daily routines of the house are centred on the preferences of the people who live there. During the visit, one service user was writing the menu out for the day on a whiteboard in the dining room so that everyone knew what the meals were for the day and could choose something else if they did not want what was offered. It is a very busy house, one service user has been enrolled for next year to attend Ashington College. two people currently attend craft classes in Alnwick and most of the service Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: users visit a pop in social day at Lynmouth. Service users are very much part of the local community and other activities include visiting the local market in Amble followed by attending the local coffee mornings and attending regular Mencap organised events within Amble. All service users have an annual holiday of their choosing, this years forthcoming holiday has been arranged to go to Berwick. Service users were keen to discuss how they spend their leisure time, some help with the weekly food shop and everyone makes their own breakfast and helps with the preparation of meals and doing the washing up after the meal is over, service users also talked about their home in general and comments they made included, Its absolutely great here, we are going on our holidays soon We have a lovely manager here that helps us a lot The staff are all very good I like living here and I like to support Newcastle United I am looking forward to my holidays we are going in caravans to Berwick I like to sew and can really do anything I want to here Staff access information from the local village booklet on future events, local posters and information leaflets to help service users plan and choose what they want to do. The service have their own mini bus so that people can get out and about and the bus is used everyday to somewhere or other. People are encouraged to continue with relationships outside of the home. One service user spends the weekends at home with family whilst another goes home for holidays. All service users currently living in the home have contact with someone outside of the service and families visit the home on a regular basis. During the visit, a lunchtime meal was taken with service users who were at home for the day. Both staff and service users were sat around two tables discussing what they would like to do for the rest of the day. The meal consisted of a snack type meal of sandwiches, crisps and yogurt as their main meal is a hot meal in the evening when everyone has returned home. There was good rapport between service users and staff and it was evident everyone was comfortable with each other. Following the meal, service users cleared the tables and did the washing up. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A number of specialist health professionals are used by the service and good systems are in place on the safe administration of medicines and this ensures that the healthcare needs of service users are identified and met. Evidence: Within the plans of care there was evidence to suggest that the healthcare needs of service users are addressed although people currently living in the home have no moving and handling needs and need minimal help with personal care tasks such as washing and dressing. Service users are supported by key workers when attending hospital appointments or GP visits. Staff work sensitively with the service users, showing discretion when assisting with personal needs and demonstrating respect and sensitivity when interacting generally. The home has a policy and procedure on the administration of medication used in the home. A monitored Nomad dosage system is used and the policy covers areas on the recording, administration, safekeeping and disposal of unwanted or unused medicines. At this time no service users hold their own medication and during the visit, observation was made of a member of staff administering the lunchtime medications Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: in a safe and correct way. All medication is recorded on individual medication administration record sheets that are up to date and well maintained and medication is administered by support staff who have completed The Safer Handling of Medication training. Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear and easy to understand complaints policy and procedure that is accessible to service users and they representatives should they have a complaint or concern about the service and good safeguarding procedures help to protect people should and abuse situation arise or be suspected. Evidence: The complaints policy is written in a format that is suitable for the people living in the home to understand.Staff confirmed they are aware of how to deal with a complaint should one be made whilst they are on duty. However, when looking at records there were no entries made in the last twelve months and the acting manager explained that any issues are dealt with immediately. All complaints or concerns should be recorded within the complaints book and advice was given to ensure this happens. Complaints or concerns are received by the service are acted upon and service users spoken with clearly knew how to make a complaint and stated if they were unhappy it was always sorted out by the staff. Safeguarding of vulnerable adults procedures are available in the home for staff guidance that also includes whistle blowing. Staff records confirmed all staff have received training on safeguarding of people. There have been no safeguarding issues in the home since the last inspection. Care Homes for Adults (18-65 years) Page 17 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, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, homely and well maintained, however, some areas of dampness must be addressed to ensure the home is safe and comfortable for the people living there. Evidence: The bedrooms are homely and personalised to suit individual tastes and have a homely and comfortable feel to them. One of the bedrooms has been refurbished with new bedroom furniture and another recently redecorated. A handyman is employed by the homes group and spends a number of hours every week in Rochell House attending to maintainence issues and following a decoration programme and has recently completed gloss painting in most areas of the service. Since the last visit, a new bath has been installed and hand towel and soap dispensers have been located throughout the building. The ground floor bathroom has been converted into a walk in shower which has proved popular with the service users. In the main sitting room and in one of the bedrooms damp patches were evident on the walls and need to be attended to. The rear courtyard is popular with service users and was attractively set out with seating areas and many potted plants which the service users were keen to show to visitors to the home. One service user requested somewhere of his own outside and a Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: garden shed has been provided by the proprieter that is furnished to a good standard. Care Homes for Adults (18-65 years) Page 19 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, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels within the home are good and sufficient in numbers to enable the needs of service users to be addressed and this helps to ensure that service users can live the lifestyle they prefer. Evidence: There are ten support staff employed in the home and fifty per cent of the staff team now hold an NVQ qualification in care. There are always a minimum of two staff on duty but sometimes this rises to three depending on the activities of the day. The home has a low turnover of staff and most of the staff have worked in the home for over five years. The home has a recruitment policy and procedure in place when employing new staff, the acting manager was able to describe in detail the procedure that is used when the home have a staff vacancy. In February of this year two members of staff commenced employment and the reason for the vacancies was due to two members of staff retiring. Two staff personal files were looked at and showed references had been obtained, a Criminal Records Bureau check and an application form were completed and other records that are required to be kept but there were no records concerning the actual interview or how the person was selected. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The staff team all receive regular training and the staff training records showed what training had been undertaken. Five of the staff team have an NVQ qualification in levels two and three and plans are in place for other staff in the team to complete this training. All staff mandatory training records were up to date and well maintained identifying when staff training had taken place. Care Homes for Adults (18-65 years) Page 21 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently managed by an acting manager who shows leadership skills in managing the staff team and ensures risks to the health and safety of people are minimised. However, the acting manager must register with the Care Quality Commission and complete the Registered Managers Award and systems must be in place to ensure the quality of a good service. Evidence: The manager of the home left the service in December and the Acting Manager intends to make a formal registration application with the Care Quality Commission. She has worked at the home for thirteen years as both a care worker and as a senior care worker and has been acting as manager since December of last year. Qualifications include NVQ levels two and three in social care and NVQ level three in business administration and is currently attending a Management Development Project workshop. No staff in the home currently receive one to one supervision and staff meetings are not very often held, the last staff meeting was held in December. Although the acting Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: manager has frequent contact with her line manager there are no formal supervisions held and no records of any issues discussed. Quality assurance systems are being developed to allow the views of service users, relatives and others to be sought and to monitor the quality of the service provided. Observation showed that all staff throughout the day followed safe working practices at all times and records evidenced that staff receive regular training in fire safety. Care Homes for Adults (18-65 years) Page 23 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 Adults (18-65 years) Page 24 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 6 15 All personal records for service users must be held individually in their personal files This ensures confidentiality and conforms to Data Protection Act 28/08/2009 2 6 15 Care plans must be 28/08/2009 monitored on a regular basis This ensures the information recorded is correct and details if changes are necessary 3 22 22 All complaints or concerns must be recorded This ensures that complaints or concerns will be monitored and dealt with effectively 28/08/2009 4 24 16 Damp Patches on the walls of the sitting room and one bedroom must be repaired and redecorated 28/08/2009 Care Homes for Adults (18-65 years) Page 25 of 28 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 This will ensure a pleasant and safe place for people to live in 5 34 19 All personal records for staff must be kept and held on theor personal file This ensures records are in place should they be required or need to be referred to in the future 6 35 18 All staff in the home including the manager must receive one to one supervision from their line manager This identifies any issues and reviews training needs 7 37 9 The acting manager must 28/08/2009 apply to Care Quality Commission to be registered as manager of the service This provides leadership for the service on a day to day basis 8 37 8 The acting manager must complete the RMA this ensures management competancies 25/09/2009 28/08/2009 28/08/2009 Care Homes for Adults (18-65 years) Page 26 of 28 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 Adults (18-65 years) 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. 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. 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. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!