Care Home: West Ham House

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What the care home does well People who use the service told us that they were "very happy here" and that staff were "very approachable and helpful". The home has produced a statement of purpose and service users guide. Potential residents are assessed prior to their moving into the home. Individualised plans that address a range of personal, social and healthcare needs are developed with people who use the service. These reflect residents abilities to make their own decisions. Plans are regularly reviewed, and potential risks are subject to a seperate assessment. Residents are encouraged to manage their own finances. Where the home does provide support with this activity appropriate records are maintained. The home encourages residents to participate in the homes day to day running. People who use the service are supported to engage in individualised community and occupational activities that reflect their interests and abilities. Residents are supported to maintain contact with their families. Residents are also supported to develop their activities of daily living and individualised menus are prepared each week that offer a range of nutritious and varied meals that reflect the preferences of people who use the service. Residents are encouraged to be independent in their personal care and to attend a range of healthcare appointments. Where appropriate, the home encourages people who use the service to manage their own medication. The home has developed a range of policies and procedures that comply with National Minimum Standards. People who use the service are listened to and protected from abuse. The home is clean and well maintained. Residents benefit from a range of shared spaces. Each resident has their own bedroom. Staff receive regular core training updates and are supported to undertake NVQ level qualifications. Staff are employed in sufficient numbers and the homes recruitment procedures safeguard people who use the service. The home carries out and records a range of health and safety tests required by regulation. What has improved since the last inspection? As this is the services first inspection since altering its registration, there are no requirements from previous inspections. What the care home could do better: The home must ensure that all medicines including PRN medication must be listed on the Medication Administration Record (MAR) sheet. Information outlining the circumstances in which PRN medication should be administered must be readily available. Some minor repairs and maintenance issues should be addressed. The home must ensure that fire alarm call point tests are carried out and recorded on a weekly basis at all times. Key inspection report Care homes for adults (18-65 years) Name: Address: West Ham House 1A Plashet Road West Ham London E13 0PZ     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: Lea Alexander     Date: 3 1 0 3 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: West Ham House 1A Plashet Road West Ham London E13 0PZ 02085481539 02085481539 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Leyton House Community Care care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 11 The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 11 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: 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: One Inspector visited the home on two occassions in March 2009. West Ham House is an established care home providing support to men with mental health care needs. Their registration was varied in 2008, and this is the homes first inspection since then. We spoke with the Responsible Individual, the Deputy Manager and a care worker. We also spoke with people who use the service and spoke privately with one resident. We also looked at a range of records maintained by the home including residents personal files, staff personnel files and health and safety records. The service completed and returned its Annual Quality Assurance Assessment within the timescales we requested. Care Homes for Adults (18-65 years) Page 5 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The home must ensure that all medicines including PRN medication must be listed on the Medication Administration Record (MAR) sheet. Information outlining the circumstances in which PRN medication should be administered must be readily Care Homes for Adults (18-65 years) Page 6 of 27 available. Some minor repairs and maintenance issues should be addressed. The home must ensure that fire alarm call point tests are carried out and recorded on a weekly basis at all times. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 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 8 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. The home has developed a statement of purpose and residents are only admitted once their needs have been fully assessed. Evidence: The home has produced a statement of purpose and service users guide. We examined these documents and found that they reflected the service provided within the home. We examined the personal files of two people who use the service. These evidenced that each was assessed by the home prior to their moving in. Care Homes for Adults (18-65 years) Page 9 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. The service involves individuals in planning their care. Individuals are encouraged to make their own decisions and choices. Plans are easy to understand and cover all areas of the individuals life. These plans are regularly reviewed with the resident, and potential risks are assessed. Evidence: Each of the residents personal files we examined contained clearly laid out individual plans that address a range of health, social and personal care needs. The plans we saw were reviewed every six months or as the residents needs changed. Sampling of residents personal files evidenced that their individual care plans were developed and reviewed with residents during regular key working sessions. For one resident their personal file contained information about their life story and significant events. However, this information was not available in a second residents personal file. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: We found residents rights to make decisions about their lives were reflected in the plans we saw. Discussion with people who use the service, the deputy manager and examination of available records evidenced that residents are encouraged to manage their finances independently. However, one resident is subject to local authority court of protection to help them with their finances. Another resident is supported by their family to manage their finances. With the residents agreement their family provide a weekly allowance that the home support the resident to manage. The money is held in a locked box with staff, and the resident can access this as required. The date, amount and nature of each transaction is recorded and signed in a log book. We saw this log book and were satisfied that all was in order. We examined the individual care plans of two residents. Potential risks were subject to a seperate risk assessment and management plan. Residents are encouraged to participate in regular household meetings where issues relating to the day to day running of the home are discussed and agreed. We looked at the minutes for residents meetings held in March and January of 2009. These evidenced that recent discussions had included maintenance, keyworking, outcomes from feedback surveys and possible new admissions to the home. Care Homes for Adults (18-65 years) Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a strong commitment to residents maintaining and developing independent living skills. People who use the service have the opportunity to develop and maintain family relationships. Residents are involved in meaningful daytime activities of their choice according to their interests and abilities. Residents take responsibility for planning and preparing their own meals. Evidence: The residents we spoke to told us that they were happy with the community and leisure activities they had been supported to engage in. We looked at two residents personal files. These evidenced that one attends a local college for arts and music classes four days per week. Their plans also detailed their needs and strengths in activities of daily living such as shopping, cooking and cleaning. The information recorded reflected the residents abilities and areas where they would require staff support. The second resident whose personal file we examined was not currently Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: involved in structured community or leisure activities. We viewed notes of their keyworking sessions and spoke with the deputy manager. This evidenced that a recent deterioration in their mental health had impacted upon their ability to engage in activities, and that the home were monitoring the situation closely. This resident was however being supported to engage in activities around the home and to visit local shops. At the time of our visit to the home four residents were in. The remainder were engaged in personalised community activities of their choice. During our visit we observed residents who were at home watching the news, engaging in discussions relating to news stories and playing pool. Our discussions with people who use the service and sampling of personal files evidenced that residents are supported to maintain contact with their families. People who use the service told us that they choose their own daily routine and that they choose when to join in or be alone. One resident commented that staff are supporting and encouraging them to develop their independent skills by encouraging them to take the lead in establishing their getting up time and meal times. Residents also told us that they feel respected by the care staff. We looked at the homes log of meals provided. This evidenced that residents are supported to devise and prepare individual menus for the week. We found the meals provided to be varied, nutritious and reflective of residents preferences. The residents we spoke to told us that they were happy with the meals provided. Care Homes for Adults (18-65 years) Page 13 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. Residents are supported to access a range of healthcare services. The home has an appropriate medication policy and a good record of compliance with the receipt, storage, administration and disposal of medication. However, the home must ensure that as required medication is listed on the Medication Administration Record (MAR) and that the circumstances in which such medication should be administered is readily available. Evidence: We spoke with people who use the service, with the deputy manager and a care worker on duty. We also sampled the individual plans of two people who use the service. This evidenced that residents are supported to be independent with their personal care, and that staff only provide prompts and reminders. We exampled the personal files of two people who use the service. We also spoke with the Deputy Manager and residents. This evidenced that people who use the service are supported to attend a range of healthcare appointments. Details of the appointment along with its outcome and any follow up are recorded in the personal file. Recent appointments attended included the GP, Psychiatric Nurse, Dentist, Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: Optician, Psychiatrist and Community Nurse. The home has developed a medication policy that complies with National Minimum Standards. The policy also includes information on the storage and administration of medicines and guidelines for residents who self medicate. Sampling of Medication Administration Records (MAR), access to the medicines cupboard and discussion with the Deputy Manager and residents evidenced that some residents are supported to self medicate. We examined the personal file for one resident who is self medicating and found that this activity was detailed in their care plan and subject to a risk assessment. At the time of this inspection no residents were prescribed controlled drugs. We examined the available medicines and MAR sheets for two residents. The MAR sheets were found to be in general good order and appropriately completed. However, one resident was found to be prescribed an as required (PRN) medication. This medication had not been listed on their MAR sheet. There was also no information in their personal file or the MAR sheet file outlining the circumstances in which the PRN medication should be administered. Care Homes for Adults (18-65 years) Page 15 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. Residents are happy with the service provided and feel safe and supported. The service has developed a complaints procedure that residents are aware of. The home has developed a safeguarding policy and procedure and the home runs periodic training in this area. Evidence: The home has developed a complaints policy. We looked at this and found that it complied with National Minimum Standards. Residents we spoke to were aware of how to make a complaint if they were unhappy with the service provided. We looked at the homes complaints log and noted that no complaints had been recieved since the last inspection. The home has developed a safeguarding policy. We looked at this and found that it made appropriate reference to local multi agency safeguarding protocols. Sampling of records and discussion with the Deputy Manager and residents evidenced that no safeguarding issues had been raised since the home was last inspected. The care worker we spoke with had joined the home in the last few weeks. At the time of this inspection they had not recieved safeguarding training. Training records did evidence that safeguarding training had recently been provided to other care staff. We Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: were told by the Responsible Individual that safeguarding training would be provided to this staff member as a priority. Care Homes for Adults (18-65 years) Page 17 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 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 and provides residents with a range of communal spaces. Each resident has their own bedroom. The home is clean, tidy and smells fresh. Evidence: The home is situated in a large detached property close to West Ham Park. Accommodation and communal areas of the home are based on the ground and first floors of the home. Staff offices and a store room are located at basement level. On the second floor there is additional office and storage space. The staff sleep in room is also located on this level. The home has a raised entrance with access from a ramp. There is an entrance hallway with a small staff office located off. Four bedrooms are located on this level. A large communal lounge with a range of comfortable seating, a TV and stereo is located on this level as are a large dining area with pool table. A kitchen with a range of fitted units and two ovens and hobs is located off of this. A laudry room, a WC with handbasin and a bathroom with tub, mixer shower, handbasin and WC are also located on the ground floor. Access to the first floor is via a staircase. A further seven bedrooms are located on this level along with a shower room with WC and handbasin and a bathroom with tub, Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: mixer shower and handbasin. The home has a paved car park to the front, and a small rear yard. Some minor repairs were identified as a result of this inspection and these are detailed in the requirements section of this report. We looked at the homes maintenance log and found that routine repairs and maintenance issues are promptly reported and attended to. During our visit to the home we found it to be well maintained, clean, hygenic and free from offensive odours. Care Homes for Adults (18-65 years) Page 19 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. Residents have confidence in the staff that care for them. Staff members undertake external NVQ qualifications. Sufficient staff are employed and rostered on duty. The home has developed a sound recruitment procedure. Evidence: The home employs twelve permanent staff. In addition staff from the organisations sister homes also provide bank cover. Discussion with the Deputy Manager and sampling of training records evidenced that over 50 of care staff have obtained NVQ level 2. We noted that one of the care staff on duty had recently joined the home. Discussion with this staff member and sampling of their personal file evidenced that they did not have previous mental health or care worker experience. Further discussions with the care worker and Responsible Individual evidenced that they are undertaking an extended induction and training period, during which time they are only rostered on with senior care workers and are not currently undertaking some duties, such as the administration of medicines. We looked at the homes staffing rota and found that this reflected the situation in the Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: home at the time of our visit. We looked at the personnel files of two care staff who were on duty at the time of our visits. We found that the home obtains two satisfactory references and a Criminal Records Bureau (CRB) check as part of their pre employment checks. Discussion with one care worker on duty and sampling of two personnel files evidenced that staff receive an induction to the home upon joining. We looked at the homes training records. These evidenced that recent training provided included safeguarding, fire safety, mental health awareness, medication, oral hygiene and first aid. Care Homes for Adults (18-65 years) Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is studying for the required qualifications. The service has developed sound policies and procedures. The home operates to a clear health and safety policy and regular random checks are carried out and recorded. Evidence: The homes manager is currently undergoing the registration process with the Commission. They are currently studying for their NVQ level 4 award. The home had surveyed residents for their feedback on the service provided in June 2008 and February 2009. We looked at these surveys and noted that the majority of residents were either very or quite satisfied with the service provided. We looked at a range of health and safety records the home is required to maintain. Fridge and freezer temperatures are recorded on a daily basis and are maintained within acceptable parameters. We looked at the homes fire alarm tests. These evidenced that the homes fire alarm is Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: usually tested on a weekly basis with the outcome of the test recorded. However, we noted that on occassions in November 2008 the tests had not occurred on a weekly basis. The home maintains detailed accident and incident reports. We examined these and found them to be in order. The homes current registration certificate was displayed in the entrance hallway. Care Homes for Adults (18-65 years) Page 23 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 24 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 1 20 13 All medicines including PRN 04/08/2009 medication must be listed on the MAR sheet. To ensure the safety and wellbeing of people who use the service. 2 20 13 Information outlining the circumstances in which PRN medication should be administered must be readily available. To ensure the safety and wellbeing of people who use the service. 04/08/2009 3 24 13 Loose floor edging batons by 04/08/2009 the ground floor fire exit must be secured. To ensure the safety of people who use the service. 4 24 13 The hole in the ceiling by the 04/08/2009 ground floor fire exit must be repaired. Care Homes for Adults (18-65 years) Page 25 of 27 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 To ensure the safety of people who use the service. 5 24 13 The missing floor tile in the 04/08/2009 first floor shower room must be replaced. To ensure the safety of people who use the service. 6 42 23 The home must ensure that 04/08/2009 fire alarm call point tests are carried out and recorded on a weekly basis at all times. To ensure the safety of people who use the service. 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. 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