Care Home: St Edmund's House

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What the care home does well The service provides well planned and well managed support to the people living in the home. an experienced and well trained staff team are on hand to support the people living in the home, and ensure that identified needs are being met. Comments that were made in quality assurance surveys included `i am very happy at St Edmund`s, the staff are like a family to me` `my stay has been very comfortable and beneficial` `the care is excellent` People living in the home are supported in making views known about the service, and how they wish to be supported, and assist in decisions made affecting their day to day lives. A range of activities and events are provided and the people living in the home are also able to join in local community events. Staff receive a variety of training, including training specific to the needs of people they are supporting. What has improved since the last inspection? This is the first inspection of a recently registered service, but as indicated was previously registered with the commission as a charitable trust. There have been no significant changes since the previously registered service was last inspected, although some new furniture has been purchased, with residents helping make the choice. More volunteers have been recruited to assist the people living in the home in taking part in activities and events arranged within the home and in the local community. Staff have received more specialist training in the past few months, in areas including eating disorders, spinal injuries and acquired brain injury, all to assist the in supporting residents with specific needs. A new sensory garden has been created, with input from people living in the home, and further improvements to the gardens are planned. What the care home could do better: No major areas of improvement were noted as a result of our visit. The AQAA showed plans to improve family contact and assist the activities co-ordinator with more training, to refurbish their treatment room, and to improve the service`s website Key inspection report Care homes for adults (18-65 years) Name: Address: St Edmunds House Station Road Ditchingham Suffolk NR35 2QL     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: Alan Buttery     Date: 2 7 1 0 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: St Edmunds House Station Road Ditchingham Suffolk NR35 2QL Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) All Hallows Healthcare Trust Limited Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia physical disability Additional conditions: The maximum number of people who can be accommodated is 8 The registered person may provide the following categories of service: Care home with Nursing - Code N to people of the following gender: either whose primary care needs on admission to the home are within the following categories: Physical disability - Code PD Mental Disorder - Code MD Date of last inspection Brief description of the care home The service is based in a wing of a community hospital in the village of Ditchingham, and close to the market town of Bungay. The service provides support fro up to eight younger adults with a range of complex Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 8 8 Brief description of the care home physical disabilities and aslo on occasions provides support to a people with an eating disorder. Facilities including maintainance and catering are shared with the main hospital site, and the extensive gardens are available to people living in the home. The service aslo has its own garden areas including a sensory garden and water feature. Support is commissioned by the local health services, both in Norfolk and Suffolk, and fees range between 1100 and 1800GBP depending on need. Care Homes for Adults (18-65 years) Page 5 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: This was an unannounced visit, which was carried out at the service. Prior to the inspection, the service submitted the required Annual Quality assurance Assessment, and surveys were sent to people living in the home. The following report contains information from the AQAA and surveys as well as information provided during the course of the inspection by the matron of the service. As part of the inspection, we looked at records held in the home including resident and staff files, and spoke to management, staff and two of the people living in the home. Although this was the first inspection of a recently registered service, the change in registration was made following a change to the organisational running of this and other services operated by the provider. 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. Care Homes for Adults (18-65 years) Page 7 of 28 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 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 9 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. Procedures are in place to ensure that anyone moving into the home knows what facilities are on offer, and have their needs fully assessed to ensure that the service will meet those needs, and in a way suited to them as individuals. Evidence: Although this is the first inspection of a newly registered service, the service was previously operated and registered with the Commission. It was run by a charitable trust, but is now run as a health care trust. Procedures remain the same as those that were in existence under the previous arrangements, but have been reviewed, and a new Statement of Purpose, Service User Guide and staff/volunteer handbook produced to reflect the new arrangements. Copies of this documentation has been given to all residents, families and staff, and were given to the inspector on the day of the inspection. During our visit, we discussed the procedure of admitting anyone to the home with the matron and a staff member. We also spoke with two people living in the home about the process that was followed when they were admitted to the service, and about the Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: information that were given. In addition, we examined the individual files and care plans for these two people as well as a resident who was admitted recently. The residents that we spoke with told us that they were given full details about the service and the facilities available, and were able to tell the home of their individual likes and dislikes. Details of the assessment information gathered was seen on the three files that were examined during our visit. The information obtained provided sufficient detail for the service to identify the individual needs, and ensure they were able to meet those needs. We discussed the process in some detail with the matron and a staff member, who told us that their assessment work also takes into account people already living in the home to ensure that any new person would be compatible with current residents. On some occasions, members of the homes care staff have worked alongside people supporting a potential new resident in another home, ensuring that they are able to gather as much information about the prospective resident, their needs and likes and dislikes. Wherever possible, prospective residents would also visit the home and spend the day there giving them the chance to see first hand what is on offer and the opportunity to meet and get to know the people already living in the home. Care Homes for Adults (18-65 years) Page 11 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. Individual care plans are in place and under regular review, and these ensure that the identified needs of the individual resident are met in a way suited to them. Evidence: As indicated earlier, we discussed the admissions procedure that is in place within this service with the matron of the service, and once the assessments referred to earlier have been completed, and the service is happy they are able to meet the individuals needs, arrangements are made for the person to move into the home. At this stage initial care plans are prepared, showing the basic needs of the person concerned and how those needs should be met. These are reviewed with the resident concerned in the first few days in the first few days of heir stay, and extended to include all the persons health and social care needs. We looked at the individual plans in place for three of the people living in the home, and talked to two them about their plans and how the support detailed in the plans is Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: provided. The care plans that are in place showed how the individuals receiving support chose to have their care delivered, and the intended outcomes of the support, as well as risk assessments. These ensure that the care and support is provided safely to the people living in the home. At the present time the home has one resident with more complex needs, and a multi disciplinary team has agreed the care plan for this person, with more formal boundaries in place and weekly reviews. The care plans all contain an expected outcome, and endeavour to show the personal development that is planned, and this was in evidence in the three files that we examined. A number of volunteers are recruited to assist staff in supporting the people living in the home, particular when undertaking activities, and the service ensures that advocacy support is available through the commissioning bodies to promote the rights of the individuals. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are supported in this home are able to take part in a variety of activities suited to their likes and dislikes, and feel part of their local community. Evidence: During our visit, we discussed with the matron of the service and the staff team the activities that were available to the residents of the home. A variety of different activities are provided, and these appear suited to individuals living in the home. We also spoke to two of the residents about the activities they are able to do, their likes and dislikes and how the service meets those needs. On the day prior to our visit, all the residents of the home had joined staff in preparing pumpkins for Halloween, and these were seen around the home. The two people we spoke to told us they had enjoyed this activity. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: One of the residents we spoke to is very interested in computers and the Internet. Internet access is provided in their room, and they are able to use the Internet to pursue their own interests, and assist the other residents, for example when looking at holidays. They also told us how they had helped the service to source a new table with a rise and fall mechanism, suited to residents of the home who use a wheelchair. The resident showed us their room, which has a specially adapted computer desk, which the resident is able to operate without the need for assistance, and which he happily demonstrated on the day of our visit, and this allows them to maintain some independent living skills. They also use special equipment to enable them to maintain communication at all times. We also observed the residents and staff in the lounge area of the home, and staff were seen asking people what television or radio programmes they wanted to watch or listen to, and taking into account the views of other residents in the room at the time. One person has access to the gardens from their room, and whilst we were in the home, spent a lot of their time in the gardens, walking around and using their own mobile telephone. The service has good community access, and local school children have helped with a garden feature, and visit the home, for example at Christmas. People who live in the home are supported to visit local amenities including shops and restaurants and the theatre. The AQAA gave details of external activities that have been arranged recently which included trips to a local air show, a wildlife park, a horse sanctuary and a an airfield museum, and other community activities enjoyed by residents living in the home included quiz nights and a local community pantomime. Although food is supplied from the main hospital kitchens, staff and residents told us that they are always offered a choice of main meal, and can have snacks and drinks when they wish. Support is provided by dietitians to ensure that a balanced and healthy diet is provided, and additional support is given to the needs of any resident with more specific needs. Care Homes for Adults (18-65 years) Page 15 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. Detailed plans show how the health care needs of the individuals living in the home are met, and how the care and support is provided to suit the preferences of the person concerned. Evidence: The service supports a number of younger adults, many with a physical disability, but with other complex health care issues, including Motor neurone disease and eating disorders. Everyone living in the home has a detailed health care support plan, and examples of these were seen during our inspection visit, and we were able to discuss the support received with two of the residents of the home, who both felt the care and support they receive was excellent. These health care plans are reviewed regularly, and again this was seen in the files we examined, and where issues are more complex, a muliti disciplinary team would be responsible for the review, with the involvement where possible of the person concerned. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Qualified nursing staff are available to ensure that all health needs are met, and that medication is administered safely, and the wider hospital unit provides the benefit of more specialist staff where required. Although we did not observe medication being administered, medication records were examined and had been completed satisfactorily. Care staff administer personal care, and again the two people we spoke to felt the support was done in a way suited to their needs. Care Homes for Adults (18-65 years) Page 17 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. Procedures are in place to ensure that any concerns, com[plaints or allegations are dealt with, and people supported in the home know how they can make any concerns known. Evidence: During our visit, we discussed the complaints procedures with the manager of the service. This procedure has transferred across from the previously registered service along with all other documentation, and at the time of our visit, no major issues had been reported since the new registration began. The matron told us of two concerns that had been raised, which had both been addressed to the satisfaction of the resident who had raised the issue. We spoke at length with two people living in the home, who both told us that although they had no reason to make any concerns known, they knew who they should speak to, and the procedure that would be followed. One of the residents also told us how management were always prepared to listen to any comments that they may have, and to act on them. For example, when the new sensory garden was finished, the resident suggested a switch be installed so that people entering the garden could turn the water feature on and off, allowing them to enjoy the feature but not wasting money running it Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: unnecessarily. All staff receive safeguarding training as part of their initial induction training as well as annual updates, and during our visit, staff members we spoke to were aware of the procedures, and the actions they should follow in the event of a safeguarding issue occurring. No safeguarding issues have been reported since the service began. Care Homes for Adults (18-65 years) Page 19 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 service provides comfortable and clean facilities for the residents, and they are able to enjoy well maintained gardens. Evidence: During our inspection visit, we were shown around the home by the manager of the service. The home is based in a wing of a privately run hospital, with its own private gardens people living in the home re able to access the garden without going through the main part of the building, but visitors enter through the min hospital entrance. Seven of the eight bedrooms are en-suite, the remaining room next to a bathroom and the manager of the home told us of planned changes to the facilities which include the refurbishment of one of the bathrooms. In spite of being based in a hospital, all rooms are individual and suited to the needs of the people receiving support, and communal facilities are clean and comfortable and have equipment appropriate to the people living in the home including a large television and computer games console, DVD player, music system, and a kitchen/dining room with adjustable table and comfortable seating for those not in a wheelchair. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: As indicated earlier, we spoke to two of the residents, who also showed us their rooms. These were equipped with the aids and adaptations needed by the individuals, but also personal in decor and facilities. The individual who has his own computer has all the equipment needed including a rise and fall desk that they can operate themselves, ensuring that they can maintain some independence. In recent months, a new sensory garden area has been created together with a water feature and seating, and people living in the home also have access to the larger grounds of the main site, and the private chapel. Maintenance of the premises and gardens is managed through the main hospital as well as the cleaning of the home, and on the day of our visit, the home was clean and bright, with no unpleasant odours. Staff were seen wearing protective clothing and using alcohol gels to prevent the spread of infection. Care Homes for Adults (18-65 years) Page 21 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. Recruitment policies and procedures are in place which together with a range of training ensure that people receiving support within this service can be confident staff can meet their needs. Evidence: As indicated earlier within this report, the service is set within part of a private hospital, and shares some staffing with the hospital establishment including catering and domestic staff, and maintenance staff. The service as its own team of carers and management, and can call on staff from the hospital in the event of staff shortages. In addition to the staff employed by the service there are also a number of volunteers, who assist with supporting the residents of the home in activities and trips out. All staff and volunteers are subject to a detailed recruitment process which includes enhanced CRB and POVA checks, interviews, 2 references and a detailed application process. During our visit, we looked at the recruitment records for 3 staff members and one of Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: the volunteers, and these records indicated that the process described above was being followed, and the required information available. As a nursing home, qualified nursing staff are also employed., and they assist with the training needs of the volunteers and care staff in addition to the variety of training provided to all staff. Records examined showed that recent training has included moving and handling, Safeguarding, Fire safety, Food hygiene, Health and safety, Palliative care and First aid. Staff are all paid to attend at least 21 hours training per annum, and the service now holds an Investors in People award. Care Homes for Adults (18-65 years) Page 23 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 service is well managed, and the views of people living in the home reflected in the procedures followed. people living in the home are given regular opportunities to make any vies or suggestions known. Evidence: During our inspection visit, we discussed the way the service is run with the senior matron and matron, as well as spending some time with the Chief executive of the trust that now runs the home. We also sent time talking to two of the residents and to staff working on the day of our inspection. The home is well run, and all the required information was readily available. It was also clear from observations made during our visit that the staff all take into account the wishes of the people they support, for example in making sure that they could watch television programmes of their choosing, or listen to the type of music they enjoy. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The AQAA indicated that all the required checks on equipment were up to date, and that all policies and procedures were reviewed at the time the new registration of the service took place. The AQAA also indicated that regular meetings take p;lace for all staff to ensure they are kept informed of changes, and able to contribute to discussions about future plans. It also informed us that the service has achieved the Investors in People award. The Chief executive of the new hospital trust takes a keen interest in the service, and the interests of those living there. The AQAA also informed us that the service has a strategic plan for the future including a business plan and training plan. Staff receive training in all aspects of health and safety, and records of this were seen on the files examined. Care Homes for Adults (18-65 years) Page 25 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 26 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 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. 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