Care Home: The Lady Verdin Trust Ltd - Stewart Street

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What the care home does well The personal development plans (person centred plans) for the people who live in the home are continually improved, updated and accurately reflect their changing care needs. There is a comprehensive range of information about each person kept in the home and this is readily available to staff so they are able to keep up to date with, and record any changes to, the person`s care needs. There is clear guidance for staff so they know what they must do to met the needs of each person. Information about people`s healthcare needs is up to date and shows how these needs are being met by the staff at the home. There is a staff training programme in place to ensure staff have the necessary skills to support the people in their daily lives. Staff have received training on safeguarding vulnerable adults, moving and handling, fire safety, infection control and the administration of medication. This will make sure staff know how to provide safe care, in line with up to date best practice for the people who live in the home. The in house training programme developed by the Lady Verdin Trust ensures there is continuous professional development for staff who support the people who live in the home. The way the home is staffed ensures there enough staff available to meet the needs and choices of the people who live there. The complaints procedure in place within the home ensures people are able to raise issues of concern and worry, that their complaints will be listened to and acted upon. The general decor and appearance of the home, both inside and outside, is of a high standard and provides a safe and comfortable for the people who live there. The changes to the way the home is managed will make sure the care needs of the people living there will continue to be met in a way they prefer. What has improved since the last inspection? The personal development plans that show how the care needs of the people who live in the home are to be met are continually updated and improved. The support staff continue to develop methods that ensure the quality of life for the people who live in the home is improved. What the care home could do better: The statement of purpose should show the changes to the management and staffing structure within the Trust. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Lady Verdin Trust Ltd - Stewart Street 136 Stewart Street Crewe Cheshire CW2 8LY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Val Flannery     Date: 2 2 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: The Lady Verdin Trust Ltd - Stewart Street 136 Stewart Street Crewe Cheshire CW2 8LY 01270666972 01270256900 mellorp@ladyverdintrust.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Lady Verdin Trust Limited care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The registered person may provide the following category of service only: Care home only - Code 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 - Code LD. The maximum number of service users who can be accommodated is: 3. Date of last inspection Brief description of the care home 136 Stewart Street is a care home for three adults with a learning disability. It is run by the Lady Verdin Trust that operates a number of homes and other services for adults with a learning disability in Crewe and Nantwich. This home is a semi-detached house in a residential area of Crewe, close to shops and other local services. The house has two floors with access between them via a staircase. All three bedrooms are single rooms and are on the first floor. Each has a hand wash basin. There are sufficient toilet and bathing facilities. There is a large communal lounge/dining area and a smaller lounge for the the people who live in the home on the ground floor. There is a large well-maintained, secure garden to the rear of the home. A wheelchair is provided for one of the people who has with mobility problems. The home has a people carrier that is used to transport the people who live there. Staff are on duty twenty-four hours a day to provide care for the people who live in the home. Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home 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: 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 overall quality rating for the home is three stars. This means that the people who live in the home experience excellent quality outcomes. This visit took place on the 22 July 2009. It was carried out by one inspector and took 7 hours. The report will say we when referring to what we did and what we found because it is written on behalf of the Care Quality Commission. During our visit we spoke with the people who live in the home, the manager and staff. We looked around the premises and looked at various records held by the home. The visit was just one part of the inspection. The home manager had completed a questionnaire before our visit to provide up to date information about the home. CQC Care Homes for Adults (18-65 years) Page 6 of 28 questionnaires were made available to the people who live in the home and staff so they could tell us what they think about it. The last inspection of the home was completed the 17 July 2007. 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 set out 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 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. The Lady Verdin Trust has information about its services available and thorough procedures for introducing new people to the home that include checking what their needs are to make sure these can be met at Stewart Street. This helps to make sure that the home is the right place for the person to live. Evidence: The Lady Verdin Trust, the organisation that runs the home, has a process and appropriate documentation to be used when new people may wish to move into the home. This includes visits to meet the person and to find out what their needs are to see whether these can be met at the home. We saw copies of the assessment documentation that included Initial assessment, Initial Assessment Planner and Needs Assessment Planner. The person would also visit the home to meet the other people who live there and the staff, including having their meals and overnight stays. This would help them get to know more about the home to see if it would be a suitable place for them to live. However, as the three people currently living in the home have lived there for a number of years, these procedures have not been used by the home. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: During our visit to the offices for the Trust, we saw copies of the information about how the home works and who it is for. These are called the statement of purpose and service user guide to the home. The manager said they are in the process of further updating the statement of purpose and service user guide to show the changes to the management and staffing structure and the correct details for contacting the Care Quality Commission. 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. The plans of care we saw were up to date and showed how the persons need were to be met, which means that people living in the home are receiving the care they need in such a way as to ensure their safety and well being. Evidence: During our visit to the home, we looked at the files of one of the people who lives at Stewart Street, to see what care they received. The file included a personal development plan with important information about the person such as their likes and dislikes, the important people in their lives, their wishes and daily routines. On the day of our visit there were plans of care available to show how the needs of the person were to be met by staff at the home. Staff spoken with were aware of how the needs of the people were to be met and how they were to be supported. They also said they are kept up to date with the persons changing needs. The files we saw showed that the person centred plans were reviewed and that the person and their family were involved in this process so they could have a say in how the care was being provided. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: We saw risk assessments that showed how the person was to be supported in the home and when using the local community so as to ensure their health and safety. One of the people living in the home has has specific mobility difficulties when using the stairs to get to their bedroom and the bathroom which are on the on the first floor. We were told that following discussion with the person and their representatives they have been offered the opportunity to move to a bungalow which is owned by the Trust. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are available to support people with their daily routines so the people living in the home are able to take part in their chosen activities. Evidence: On the day of our visit, we saw two of the people who live in the home leave the home to attend a community based day centre. We saw another person who lives in the home being supported by staff from the Trusts daily option scheme to go to work on the homes allotment. We also saw staff helping people with their breakfast, household chores and moving about the home. The personal development plans that we looked at included a weekly activity programme. This showed that the person attended a day centre, visited local places of interest as well as the local shops and other facilities. We saw a record in the personal Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: development folders that showed staff help people living in the home to keep in touch with their families. This could be by visiting them, by telephone or by letter. Relatives are able to visit at any time and they are kept informed of events that may effect the lives of their relatives living in the home. During our visit we also saw staff sitting and chatting with the people who live in the home. Staff told us that they are aware of the likes and dislikes of the people, which included food and how they wish to be supported. The personal development folders seen for one of the people who lives in the home showed us that they are updated about the changing needs of the person and also show how these needs are to be met. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal development plans of the people who live at Stewart Street are kept up to date with information about their care and health needs and how these should be met. This means that staff are aware of how the healthcare needs of the people living in the home are to be met so they are able to ensure safe and appropriate care is provided to keep the person well and healthy. Evidence: During our visit we looked at the personal development plans of one person who lives at Stewart Street. The plans, and other detailed information about the person, are kept in four separate folders. The folders we saw contained the person centred plans about the persons care needs and how these were to be met by the staff, support plans on daily living and risk assessments as well as records of reviews carried out, medical information and details about the healthcare needs of the person and a record of the finances, benefits and personal possessions of the person. The plans we saw showed how the person wished to be cared for and the level of support they needed with tasks such as dressing, using the bathroom, their daily Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: routines and with their mobility. The plans showed the persons likes and dislikes, personal details about their background and included an analysis to support the person to prepare their own breakfast. We saw copies of reviews carried out by staff in the home and by the local authority at which the person and their family were present so they could tell staff and the social worker what they wanted. We saw risk assessments that identified risks to the person when using public transport, visiting the local community, cooking and with their personal safety. Support plans have being put in place to minimise the risk to the safety and well being of the person whilst encouraging them to be as independent as possible. We saw staff support the people who live in the home with personal care tasks such as getting ready for their daily activities, using the bathroom and moving about the home. The support offered was carried out in a respectful and calm manner which ensured the privacy and dignity of the people was maintained. Staff we spoke with during the inspection said they have worked in the home for sometime and know how the people who live in the home very well. The personal development plans showed the healthcare needs of the person were being monitored and action taken by staff to address any concerns. This included doctors and hospital appointments and visit to chiropodists and dentists. We saw a record of how a specific health care need for one of the people who live in the home was being managed with advice and guidance being sought from appropriate healthcare professionals. Staff we spoke with told us they are kept up to date with any changes to the health and personal care needs of the people who live in the home. We saw a record of the in-house staff training programme (Support Assisted General) that showed staff receive training on health and safety and on the administration of medication. This is to help to make sure that they know how to give people their medicines safely, without errors, so that people receive their medicines correctly. 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. There are procedures for making complaints or raising concerns about the home so the people living there can be confident their concerns will be listened to and acted upon. The staff have received training on safeguarding adults so they know what to do to make sure that the people living in 136 Stewart Street are protected from harm and abuse. Evidence: The record of complaints made to the home was in the organisations office and there were none recorded for the Stewart Street home. We spoke with the Community Service Director, who is applying to be the registered manager for the home, and she said they have not received any complaints about the home. We saw a copy of the complaints procedure called The Lady Verdin Trust Compliments and Complaints Procedure. It included details on how to contact the Care Quality Commission. There were also some photo images in the complaints procedure to assist the people with communication difficulties if they wished to raise issues of concern or worry. We were told that the home has made referrals under the local safeguarding adults protection procedure; these were because of a number of incidents between two of the people who live in the home. The Trust have dealt with the issues with the people involved and their families. There was a copy of the guidelines on safeguarding, No Secrets in the home. We spoke with staff who told us that they received training on Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: safeguarding adults and were aware of the complaints procedure. We saw a copy of the staff training records that showed staff have received up to date training on safeguarding vulnerable adults. This helps to make sure that they know what to do the protect the people living in the home from harm or abuse. 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 home is well maintained which ensures that the people are living in a safe and comfortable environment. Evidence: The home is a semi detached, three bedroom house in a residential area of Crewe and is in keeping with the local community. It is close to shops, bus route and other local facilities. On the day we visited the home it was clean, tidy, well maintained and provided a safe environment for the people who live there. We saw domestic type furniture and fittings in the two communal lounges and the kitchen which are on the ground floor. The three bedrooms and bathroom are on the first floor which are be accessed by the stairs. The area at the front of the home is used as a car park for the homes vehicle. The garden to the rear of the home provides a safe, secure area which is easily accessed by the people who live there. We saw the people who live in the home move freely between the communal areas and their bedrooms. We were told by staff that any maintenance issues are promptly dealt with by the Trust. The Lady Verdin Trust have provided policies and procedures on infection control and provide staff training on food hygiene. These provide guidance for staff on how to keep people living in the home safe. Care Homes for Adults (18-65 years) Page 20 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home are supported by staff who have the skills and have received the training to care for them so ensuring they are safe from possible harm or poor practice. Evidence: During our visit to the home we saw staff talking with and supporting the people who live in the home with personal care such as helping them to the bathroom, preparing to go to their daily activities and moving about the home. The people who live in the home were seen communicating with staff and were relaxed in their company. The staffing rota we saw during our visit showed that there are normally two support staff on duty up to 10am when two of the people who live at the home go out to a local day centre. The remaining person is then supported by staff from the Trusts daily option scheme from 10am with activities in the home and in the community. During the afternoons and evenings there are normally two support on duty when the people who live in the home have returned from their daily activities. One of the support staff provides sleep in cover during the night. We looked at the personnel file of a member of staff who had started working at the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: home not long before our visit. The file contained evidence that all the necessary checks, including obtaining references and a Criminal Records Bureau disclosure, had been done before the person started working with the people living at the home. These checks help to make sure that the member of staff is suitable to work with the people who live at the home. We were told that the five permanent staff who work in the home have completed induction training and that three have achieved an NVQ level 2 or above. These are nationally recognised qualifications for staff working in social care and show they are competent to provide good quality support and care. We saw the staff training records which showed that staff have received training including safeguarding adults, moving and handling, the safe administration of medication, infection control, fire safety, first aid and food hygiene. We saw a copy of the Trusts in house training programme for support staff, called Supported Assistant General Training (SAG), which all staff must complete during their probationary period. The SAG training is also used as part of the refresher training for support staff. This sets out the aims of the training being offered to staff on caring for the people who receive a service from the Trust. We also saw a copy of The Lady Verdin Trust Continuous Professional Development Progress Log 1, which is a record of training completed by staff and which states We ensure you will receive the training required to develop your role as a worker in an organisation that fully believes its staff are its greatest resource. Staff said in the surveys they returned to us that they are being given the training relevant to their role and this helps them to meet the individual needs of the people living in the home. We spoke with staff during the visit who told us that they receive monthly supervision from the manager and that they also receive lots of support from senior staff in the Trust. 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 home is well managed and staff receive training to make sure that the health, well being and safety of the people living in the home is maintained and it is being run in their best interests. Evidence: We were told that following a change to the management structure in the Trust and the development of a new post of Community Support Director (CSD) that the person appointed to this post has applied to be the registered manager for the home. We spoke with the CSD who told us that she has achieved an NVQ Level 4 and has completed the Registered Managers Award. She has undertaken training in order to update her knowledge and skills in caring for people with a learning disability. She was previously registered as the manager for another service within the Trust. We were told that feedback on the quality of service offered is obtained from the people who live in the home, their families and carers and from health and social care professionals. They also have annual reviews at which people can comment on the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: care they receive from the home. During our visit we saw a copy of the Gas Safety Certificate and British Gas Safety Certificate for the home, both dated 2009. We also saw a copy of a safety audit which had been carried out by senior staff in the Trust in 2009. The fire safety record showed that checks are carried out on fire alarms and emergency lights, also that fire drills are held with the staff and the people who live in the home. We saw the staff training records which showed that staff receive regular training in fire safety, infection control, food hygiene and first aid. These measures all help to make sure that the home is well managed and safe for people to live and work in. 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!