Care Home: Seaview

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What the care home does well The staff and management of the home are stable. The same manager is in post as at the last inspection. The manager has several years experience and knows service users and staff well. Each person has a person centred support plan. This means that peoples needs and aspirations for the future are recorded and supported. Risks are assessed and managed so as not to restrict people but enable them. There are opportunities for people to take part in a range of activities including supported employment and life long learning. Hobbies are supported. Bedrooms are all single and very personalised so people can make their room feel like home. The staff work with health professionals to ensure peoples needs are supported. People said staff are there when they need them especially if they need to talk when feeling down or stressed. People have the support they need to keep in touch with family and friends. People have had support to plan and book their holidays individually. What has improved since the last inspection? People are having support to take more control of their medication and health. Each person has a person centred support plan and positive behaviour support plan to ensure people get the support they need and want. Service users, staff and the manager said that the home is calmer and a nicer place to live since some people have moved out. Staff said now there is a cleaner they will have more time to spend with service users. E learning has been introduced for staff as a flexible learning tool that staff can complete at work or at home. What the care home could do better: The manager agreed that communication could be better supported in that people have to ask what is for dinner or who is on duty rather than having a way to find out for themselves. To make it more homely some improvements are needed to the environment. The manager is well aware of this and has plans to improve the home for people. Key inspection report Care homes for adults (18-65 years) Name: Address: Seaview 23 Old Dover Road Capel-le-ferne Folkestone Kent CT18 7HW     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: Kim Rogers     Date: 2 0 0 7 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 29 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 29 Information about the care home Name of care home: Address: Seaview 23 Old Dover Road Capel-le-ferne Folkestone Kent CT18 7HW 01303246404 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Robinia Care Group Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Seaview is part of the larger Company of Robinia Support Solutions. Seaview is a home for eight people providing personal care and support to people with learning disabilities. Seaview is a large detached house with a garden at the rear of the property. All rooms are of single accommodation and there are two en suite bedrooms on the ground floor and the remaining of the bedrooms are situated on the first and second floor of the home. There is easy access to the main bus route and the home has transport for the use of the residents. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 Brief description of the care home The home is staffed 24 hours a day and is supported by two staff during the night. The range of fees per week is approximately 1,555.00 to 1,773.00 pounds. For more information about the fees and services please contact the provider. Care Homes for Adults (18-65 years) Page 5 of 29 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: This was a key inspection of the service which included an unannounced site visit to the home. We inspected all of the key National Minimum Standards. The last key inspection of this service was carried out on 31/07/07. We carried out an Annual Service Review on 27/05/08. These reports are available from the Provider or can be accessed on our website. We spoke to service users, staff and the manager, had a look around, made observations and sampled records. We looked at information we have received since the last inspection. This includes notifications from the home about incidents and accidents and what people have told us about the service. We looked at the Annual Quality Assurance Assessment. The manager completes this Care Homes for Adults (18-65 years) Page 6 of 29 every year. It has information about service users and staff and tells us how they intend to improve outcomes for the people who use the service. The AQAA is well completed and has detailed information about how they have improved and how they intend to improve further. We sent surveys to staff and service users. We received three surveys back from staff and three from service users. All of the surveys were positive and some comments include, I would like more one to one time. The AQAA shows that the home has addressed this by employing a cleaner. Staff said they can spend more time on a one to one basis with service users rather than cleaning. When I get upset staff give me the support I need. I chose my key worker. Staff said, We benefit from regular supervisions and appraisals Communication at Seaview is very important and valued Extra training is regularly provided which is useful and relevant. Care Homes for Adults (18-65 years) Page 7 of 29 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 Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 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 10 of 29 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. There is information available about the service. Person centred assessments are carried out and trial stays offered before a person moves in. Evidence: There is some information about the home produced in large text with symbols and pictures. The AQAA says they plan to improve this to make it more meaningful to people. This means that prospective and current service users will have some information to help them decide about moving in. We found that each person has a copy of the service user guide so they have some information about the service provided. We talked to the manager about the assessment process. That is, how assessments are carried out before someone moves in so the home knows it can meet a persons needs. The manager said she meets prospective service users and carries out an assessment with them. Trial stays and visits are offered. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: We looked at the assessment of the last person to move in. We found that a detailed assessment was carried out with the person. This means that the home has the information they need to decide if they can meet a persons needs. There has been a placement breakdown recently. The manager said this happened even though an assessment was carried out and a trial stay and two trial visits organised. The manager said it has been a difficult time for service users and staff but they have made some changes to ensure that this does not happen again. Three service users sent surveys back to us. All of them said that they had enough information when they moved in and that they were asked if they wanted to move in. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the support they need to achieve their goals. Risks are supported and managed so that people are not unnecessarily restricted. People have the support they need with communication. Evidence: We found that each person has an individual support plan which is person centred. This means that the person and their friends and family have been involved in developing the plan. Plans show peoples needs and goals for the future so staff know what support people want and need. We looked at three support plans. The plans tell you about the persons background and about the life they have had and about the life they would like to have in the future. The support needed is also recorded so staff know what to do to support peoples needs and goals. We found that support plans are regularly reviewed with service users so staff can Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: check that people are getting the right support. We found that potential risks are identified and assessed. This is done with the person and usually the manager and the persons key worker. We found that risk assessments do not restrict people but enable them to take part. We found that risk assessments are regularly reviewed with the service user by the manager and key worker. This means that any change in need or new risks can be identified more quickly. We found that the way people prefer to communicate is recorded in individual plans. This is detailed and clear so staff know how to communicate effectively with people. This means that people have support to make choices and decisions. We observed staff communicating effectively with service users. We observed staff offering choices to people including what they would like for breakfast, what they would like to drink and how they would like to spend their day. The surveys we received told us that people can choose how to spend their days and evenings. Service users said that staff listen to them. We heard one person asking who was on duty this week and another person asking about what was for dinner. The manager agreed that there could be a system so service users can find things out for themselves without having to ask staff. This means service users would have more control. Care Homes for Adults (18-65 years) Page 14 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to take part in a range of activities including employment and learning. People have support to keep in touch with their family and friends and are involved in planning and preparing meals. Evidence: We found that there are opportunities for people to take part in various activities, in house and in the community. Each person has an activity planner which covers Monday to Friday. The manager said that some activities and outings are planned on an ad hoc basis. A trip to a rare breeds centre was organised on the day of the visit and two people chose to go. Others chose to go shopping by bus or stay at home. People said that they have enough to do and especially enjoy trips out and their work placements. People enjoy fishing locally and going to local pubs and restaurants. Some people enjoy college although this has now stopped for the summer holidays. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Service users said they are looking forward to their holidays. Holidays are arranged individually so people can choose where to go and who they go with. People said they have had support to plan and save for their holidays. We found that people have support to develop their skills and learn new ones. One person said they enjoy cooking and will have support to plan a meal, buy the ingredients and cook for themselves. One person said they do their own ironing and have support with cleaning their room and laundry. We found that everyone takes part in the household tasks. The support people need to take part is recorded in individual plans. We found that relationships are supported. People have the support they need to keep in touch with and visit family and friends. Visitors are welcome at the home. We found that hobbies are supported. One person is going to see his favourite singer in concert in London soon. He said he is really looking forward to it. One person has support to look after his pet hamster. We found that service users are involved in planning and preparing meals. We observed people being given a choice of what to eat and drink and being given the time they need to eat. People said they go food shopping and can choose what they have. People take turns to cook with support. We found that food likes and dislikes are recorded in individual plans. We found that special diets are supported and nutrition and weight is monitored. Care Homes for Adults (18-65 years) Page 16 of 29 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. People have the support they need with personal and health care. Medication practice is safe protecting service users. Evidence: We found that the support people need with their personal care is recorded in detail in individual plans. This means that staff know how people prefer to be supported. We observed support with personal care being offered in a sensitive and discreet way by staff. We found that the support people need with their health is recorded in individual plans. Each person has a health action plan that shows staff what they need to do to support people to remain healthy and well. We found that the home has worked closely with health professionals to make sure people have the support they need. Staff have training in areas related to health so they can give people the support they need. People have the support they need to attend health related appointments. One person said that staff have supported them to go to the doctor. Records of the outcomes of appointments are kept and changes made to service user plans when Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: needed. There are monitoring records completed by staff that highlight any changes so staff can act quickly when necessary. We found that medication practice and storage is safe. We found that medication administration records had no gaps and showed a record of receipt and administration. The manager regularly checks the records to ensure safe practice continues. People are having support to take more control of their medication. We found that staff have training before they are allowed to administer medication. We found that regular competency assessments are carried out by the manager to make sure staff are still safe to administer medication to people. Care Homes for Adults (18-65 years) Page 18 of 29 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. People know their complaints will be listened to and acted on. People are protected from harm and abuse. Evidence: We found that there is a complaints procedure. This has large text and some symbols to make it user friendly. All three surveys from service users said they know who to complain to. People said they would speak to staff if they had a complaint. People said they are sure that staff would try to sort out any complaint. Neither the home nor the Commission has had any complaints about the home since the last inspection. We found that there are policies about how to safeguard people from harm and abuse. Staff and the manager have training in how to recognise and respond to abuse. The AQAA says they are planning appropriate training for service users about abuse. There have been three safeguarding alerts since the last inspection. This means that harm or abuse was suspected and reported to the safeguarding coordinator at social services by the home or us. The safeguarding coordinator investigates allegations of harm or abuse. The home has worked with social services and taken steps to ensure that people are properly protected and that they are safe. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: We found that staff have training in how to support problem behavior. We found that people have positive behavior support plans showing things like triggers and distraction techniques. Guidelines are clear, easy to follow and up to date. Service users have been involved in developing these guidelines. This means that staff have the guidance they need to support people in a positive way. The home has reported incidents to us and other agencies appropriately. After an unsettled period, people said it is calmer at the home and they feel safe living at Seaview. Care Homes for Adults (18-65 years) Page 20 of 29 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 adequate 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 but requires improvements to make it homely and a nicer place to live. Evidence: We found that the home is clean and smells fresh. Service users confirmed this in the surveys we received saying the home is always clean. We found that each person has their own room which are personalised so look individual. Two bedrooms have en suite shower rooms. People said they are happy with their rooms. Bathrooms and toilets are close to bedrooms. There is a large lounge diner, separate lounge and kitchen. There has been some decorating work since the last inspection and the AQAA says lots more is planned. This means that the home will be more homely and welcoming as currently some areas are stark and unattractive. Service users said they are supported to take part in the housework including the laundry and cleaning. This means that people have the support they need to be involved. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The home was clean on the day of the visit. A cleaner is employed and staff said they welcome this as it means they spend more time with service users and less time cleaning. Care Homes for Adults (18-65 years) Page 22 of 29 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. There are enough trained staff to meet peoples needs. Recruitment checks are robust protecting service users. Evidence: We found that there is enough staff to meet peoples needs. Extra staff can be called on when needed. The staff team is stable and there are no vacancies. Some staff have worked at the home for some time so know service users well. The manager said that all staff are up to date with the required mandatory training and some of the staff have an National Vocational Qualification in care. Staff also have training related to peoples needs. The company has introduced e learning for staff. This requires staff to use a computer to read about a topic and answer some questions about it to check they understand. The manager said that she gives staff time while at work to complete modules or staff can work on this at home. The manager said she can keep track on which staff might need refresher training or more support. New staff complete an induction based on learning disabilities. This means they cover the underpinning knowledge they need. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: We found that staff have one to one meetings regularly with a line manager. There is opportunity for staff to attend staff meetings. The manager said she plans to hold more regular staff meetings. This means that staff can have discussions about the service and have some coaching and mentoring. We found that recruitment checks are carried out before a person starts work at the home. The AQAA says that service users are getting more involved in recruiting staff. This means that they can have a say about who may potentially support them. Service users said that staff are good listeners and have time to talk. Service users said that staff treat them well. Staff said that they feel supported and have the training they need to do a good job. Staff said they benefit from regular supervision and yearly appraisals and that they feel communication between staff is good and valued. Staff said they like working at Seaview. We observed staff supporting people respectfully and appropriately, giving people the time they need and offering people choices. Care Homes for Adults (18-65 years) Page 24 of 29 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 well managed and peoples health and safety is protected. People know that their views and opinions will be listened to and acted on. Evidence: We found that the management of the home is stable as the same manager is in post. The manager has several years experience and has been managing the home for several years. The manager has the experience and qualifications required by the Minimum Standards. The manager spoke with understanding and knowledge of peoples needs. The three staff surveys we received said that the manager is supportive. A service user said the manager is good. The manager completed the Annual Quality Assurance Assessment, AQAA. The AQAA is well completed and gives detailed information about how the home has improved, what could be better and how they intend to improve further. The AQAA gives good information about how they promote and support issues relating to equality and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: diversity and how the home is good value for money. The AQAA shows that the manager has identified barriers to improvement and has plans of how to overcome these barriers so that the service still improves. The AQAA shows that the required health and safety checks are carried out on the premises and equipment. Staff have training in areas relating to health and safety which protects service users. The AQAA shows that they use of range of ways to seek peoples views about the service. There are systems in place to check the quality of service including monthly visits by an area manager. Changes have been made based on peoples views including changes to the menu, changes to daily activities, involving service users in recruiting staff and redecorating of the home. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 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 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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