Care Home: Self Unlimited

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What the care home does well The home provides individualised person centred support so that those people that can move into a supported living environment are encouraged and will be supported to do so. There are extensive opportunities available on-site for leisure, training and work activities. Residents are continually consulted on how the service runs and are able to influence key decisions in the service whatever their communication style. They are fully involved in decisions about the areas such as staff selection, the day-to-day life of the homes, and its future development. Residents benefit from living in the homes of a service that is run by a competent and experienced registered manager and their rights and best interests are safeguarded. What has improved since the last inspection? More members of the public are visiting the on-site Bistro and horticultural shop and interacting with people who live in the services homes. Two service users have their own vehicles through the mobility scheme enabling a greater degree of independence. More service users have been supported in managing their own medication. The service is developing supported living accommodation on-site for people who have developed the skills to live more independently. There are plans to relocate the main reception area to be staffed by service users using assistive technology. What the care home could do better: There are no requirements arising from this inspection and we are of the opinion that the service is providing excellent quality outcomes for people who use the service. Key inspection report Care homes for adults (18-65 years) Name: Address: Self Unlimited 1 Phillippines Close Off Hever Road Edenbridge Kent TN8 5GN     The quality rating for this care home is:   three star excellent 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: Paul Stibbons     Date: 2 1 0 9 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 27 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 27 Information about the care home Name of care home: Address: Self Unlimited 1 Phillippines Close Off Hever Road Edenbridge Kent TN8 5GN 01732782700 01732782701 martin.sleigh@selfunlimited.co.uk www.selfunlimited.co.uk Self Unlimited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 34 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 34. 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 Disabilities (LD) Date of last inspection Brief description of the care home Self Unlimited is a registered charity supporting people with learning disabilities throughout their daily lives. The service provides a range of supported accommodation, training and work opportunities tailored to individual need. The administration building for the companys regional activities is located at Philippines Close. The Oak Tree Bistro (a catering facility open to the public), Acorns (an ecoCare Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 34 Brief description of the care home friendly horticulture centre providing gardening skills training as well as sales of plants, gardening services and handicrafts to the wider community), day service facilities, four residential premises and a further building (currently used as staff accommodation) are on the site. The Acorns Horticulture Training Centres eco-design includes 2 wind turbines, ground source heat pump, solar panels, grey-water recycling and exports power to other parts of the service including residential premises. Facilities for residents and day care visitors include workshop rooms for crafts, skills development and computer work for training and leisure. Each of the four residential premises has individual accommodation for residents and communal catering facilities. Residents may also have meals in the centres dining room attached to the public bistro that is used by staff, day service visitors and residents from Self Unlimiteds other residential homes at Longfield, Sevenoaks and Biggin Hill. Weekly fees are £685 for Houses 2, 3 and 4 and £890 per week for House 5. The latter is designed around the needs of people who are older or who have complex needs including dementia. Other charges (eg. for hairdressing, private chiropody, holiday costs, entry fees, transport expenses and contributions to staff expenses) are applicable. Care Homes for Adults (18-65 years) Page 5 of 27 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: three star excellent 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 on this service was completed on the 21st September 2007. This unannounced inspection was conducted over a period of 4 hours from 1250 to 1650 on the 21st September 2009. A completed AQAA (Annual Quality Assurance Assessment) was submitted to the commission when we asked for it and it contained excellent information supported by a variety of evidence. The Registered manager was present during the inspection and several residents were spoken with before the conclusion of the visit as were a number of staff. Discussions were held with those present and a variety of documents and records that included Statement of purpose, Service user guide, care plans, health action plans, risk assessments, activity records, training records, medication records and health and safety records were examined. Care Homes for Adults (18-65 years) Page 6 of 27 The interactions between staff, management and residents were observed and noted. Care Homes for Adults (18-65 years) Page 7 of 27 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 8 of 27 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 9 of 27 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. Prospective residents have sufficient information on which to base an informed decision as to whether the home can meet their needs. A comprehensive assessment of needs is carried out prior to admission to ensure the home can meet prospective residents needs. People living in the home have the security of an individual written contract of terms and conditions attached to the placement. Evidence: We wanted to know whether the service provided sufficient information to prospective residents to enable them to make an informed choice as to whether the service could meet their needs. One new service user has been admitted in the last 12 months and the initial assessments viewed evidenced that significant time and effort is spent planning to make admission to the home personal and well managed. Prospective residents and Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: their families are treated as individuals and with dignity and respect for the lifechanging decisions they need to make and there is a high value on responding to individual needs for information, reassurance and support. The home has developed a comprehensive statement of purpose and service users guide, which is very specific to the resident group and in a suitable format for the individual giving all the information about the service that prospective residents would want to know. All new residents receive a comprehensive needs assessment before admission. Where the assessment identifies a need for aids and adaptions these are acquired. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the service meet the ethnic and diversity needs of the individual. Before agreeing admission the service carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Prospective residents are given the opportunity to spend time in the home. All residents receive a contract to which they have agreed. It gives clear information about fees and extra charges which is reviewed and kept up to date. Intermediate support (short-term recuperative care) is not provided. Care Homes for Adults (18-65 years) Page 11 of 27 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 living in the home benefit from having an individual plan of care that reflects their assessed and changing needs. People living in the home are consulted and supported in taking risks as part of an independent lifestyle. People living in the home can be confident that information held about them is handled appropriately and their right to confidentiality is upheld. Evidence: We looked at three care plans because we wanted to know whether residents personal and health care needs are being met and that people using the service make their own informed decisions and have the right to take risks in their daily lives. The care plans are developed with the person using the service and is based on a full and up to date holistic assessment. The plans are person centred and focus on the Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: individuals strengths and personal preferences, for example, choice of carer gender for personal care and bedtimes. The essential lifestyle plan includes a range of information that is important to the individual such as who and what is important to them (circle of support), how they keep safe, their goals and aspirations, their skills and abilities, and how they make choices in their life. The care plans also include a Health Action Plan that details health care needs for each resident, evidence was seen of support in attending health care appointments. The care plans include comprehensive risk assessments which are regularly reviewed. The service has a can do attitude and risks are managed positively to help people using the service lead the life they want. The service works creatively and actively with other services and organisations to ensure that the persons whole life needs are met, and goals addressed. Residents are continually consulted on how the service runs and are able to influence key decisions in the homes whatever their communication style. The service is currently developing supported living flats on site and one resident spoken with was very excited about moving into one. The privacy of people living in the homes is safeguarded through a confidentiality policy that staff and other health care professionals adhere to. Care Homes for Adults (18-65 years) Page 13 of 27 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 living in the home have a range of opportunities that will meet their social, leisure and educational needs and their own personal development. People living in the home are supported in maintaining appropriate relationships with friends and family. People living in the home enjoy a healthy and varied diet that is of their choosing. Evidence: We wanted to know if people living in the homes were supported to lead a lifestyle according to their individual preferences. We looked at the care plans and activity records of three residents and it was evident that central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life in both the home and the community in a way that is directed by the person using Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: the service. Residents are supported to develop their independent living skills and take responsibility for the cleaning of their own room and bathroom and to do their laundry and ironing. Residents plan their own weekly food menu and are supported by staff to make varied and healthy choices. Menus viewed indicated a balanced and nutritious diet. There are a range of activities that residents can participate in including, craft, music, learning office skills, horticulture centre. There are also opportunities to work in the kitchen and bistro that is open to the public. Residents are encouraged and supported in accessing the local amenities that are all within walking distance. The supported employment coordinator has enabled 13 people to find suitable voluntary or paid employment and all residents have the opportunity to attend daytime and evening adult education classes. Care Homes for Adults (18-65 years) Page 15 of 27 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 living in the home receive personal support in the manner they prefer and require and their physical and emotional needs are met. People living in the home are protected by the homes policies and procedures for dealing with medication. Evidence: We wanted to see if peoples physical and emotional health needs were being met safely and in a manner acceptable to them. We looked at three Health action plans and the homes procedures for dealing with medication. The records viewed indicated that staff and management are highly aware that the way in which support is given is a key issue for people living in the homes and individual Health action plans clearly record peoples personal and healthcare needs and detail how they will be delivered. The staff group is balanced to enable choice of male, female and age related preferences when delivering personal care and personal preferences are recorded in individual plans. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Residents are supported and encouraged to manage their own healthcare and have access to all NHS healthcare facilities in the local community. There is evidence that regular appointments are seen as important and there are records of attendances to GP and other healthcare professionals. Staff members are very alert to changes in mood, behaviour and general wellbeing and are fully trained in how they should respond and take action. The service has developed efficient medication policy, procedure and practice guidance. Staff all have access to this written information and understand their role and responsibilities. We examined the procedures for managing medication and the storage and administration is in accordance with current guidelines and legislation. Medication records are seen as key to the efficient management of health care matters and the homes consistently keep them up to date. All members of staff with responsibility for medication complete the NCFE Safe handling of medicines certificate. Care Homes for Adults (18-65 years) Page 17 of 27 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 living in the home can be confident that their views will be listened to and acted on and they are protected from abuse and neglect. Evidence: Observations of interactions between staff and residents indicated that the service has an open culture that allows residents to express their views and concerns in a safe and understanding environment. The service has a complaints procedure that is clearly written and easy to understand. The AQAA states that it is available in a number of formats to help anyone living at, or involved with, the service to complain or make suggestions for improvement. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Discussions with staff members on duty demonstrated that they know when incidents need external input and who to refer the incident to. Records viewed evidenced that the training of staff in safeguarding is regularly arranged by the service and other training around dealing with physical and verbal aggression is also made available to staff as needed. Care Homes for Adults (18-65 years) Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a homely, safe and comfortable environment with sufficient personal and communal space to meet their needs. Evidence: We wanted to see the environment in which people who use the service live in and as to whether the facilities promoted their independence. There are four homes on the site and we looked at two of them and spoke with residents and staff in each one. The homes provide excellent facilities for residential living and conforms to the Disability Discrimination Act regulations. There is a selection of communal areas both inside and outside of the homes, this means that people using the service have a choice of place to sit quietly, meet with family and friends or be actively engaged with other people who use the service. The kitchens and laundrys are designed to enable and promote the involvement of people in domestic tasks and as part of developing or maintaining independence. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Three bedrooms viewed promoted high levels of privacy and have locks and the AQAA states that all residents have a key to their own room. They also have a key to the front or outer door where this has been agreed in their plan. The bedrooms viewed had a number of personal possessions on display that reflected family, hobbies and interests. The homes are very well lit, clean and tidy and smell fresh. There is good outdoor space where residents can relax and are encouraged by staff to be active in maintaining their garden areas. Some grassed areas would be of benefit to residents from more frequent mowing. Care Homes for Adults (18-65 years) Page 20 of 27 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. People living in the home are supported by a competent and qualified staff team in sufficient numbers to meet their needs. People living in the home are protected by the services robust recruitment procedures for new employees. Residents individual and joint needs are met by an appropriately trained and supervised staff team. Evidence: The AQAA states that all new staff have enhanced CRB checks, health checks and three references, previous inspections have confirmed this practice. Training records were viewed and they evidence that the service ensures that all staff within its organisation receives relevant training that is targeted and focused on improving outcomes for residents. The service uses external providers to deliver this training if they have not got the appropriate skills within the organisation and over 90 of staff members have achieved an NVQ qualification in care. The content of the induction and probationary periods are seen to be very robust, Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: detailed and service specific. Induction training exceeds Skills for Care requirements and includes person centred planning and thinking. All staff are expected to complete the Learning Disabilities qualification. Evidence was seen that staff meetings and Supervision sessions are regular and staff said they find them helpful with a focus on improving outcomes for people using the service. Notes and action points are taken of meetings and sessions, and progress is regularly reviewed. Care Homes for Adults (18-65 years) Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home that is run by a competent and qualified manager and where their rights and best interests are safeguarded. Residents benefit from living in a home where their views underpin all self-monitoring and development of the home and their health, safety and welfare is promoted and protected. Evidence: The registration certificate for the service is displayed and correct in its detail. The registered manager in charge of day to day running of the homes is qualified and has over 11 years experience and a clear understanding of the key principles and focus of the service, based on organisational values and priorities and they are working to continuously improve services. There is a focus on person centred thinking, with residents shaping service delivery and a strong ethos of being open and transparent in all areas of the running of the homes. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The Registered manager leads and supports a stable staff team who have been recruited and trained to a high standard. The AQAA was returned to the commission when we asked for it and contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. The service has sound policies and procedures that are reviewed and updated in line with current thinking and practice. The home works to a clear health and safety policy and all staff are fully aware of the policy and are trained to put theory into practice. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. The service conducts annual surveys of residents, family and friends, key professionals and staff, the last surveys received positive responses. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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