Care Home: Whitby Scheme

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What the care home does well This home provides an excellent level of care, based on a thorough knowledge of each person, excellent assessments and plans of care which are regularly reviewed. Good risk assessments help people to be as independent as possible. A relative wrote: `We are very satisfied with the care provided for our relative and especially with his keyworker. Our relative seems more happy and contented than at any time in all his years in care.` People are assisted with their health care, and medicines are safely handled. Complaints are quickly dealt with and people are protected from harm by well trained staff. The home is clean and well maintained. There is a good ratio of staff to people, and staff are well recruited. The home consults people about practice and has a good system to ensure suggestions are acted upon. What has improved since the last inspection? The manager and staff have improved the delivery of service following their own quality assurance system. This means that improvements are identified and acted upon from within the organisation. More documents have been produced in easy read formats and people living at the home are more involved in planning how to spend their time and making decisions about their lifes. People are enabled to be as independent as possible through good support from keyworkers and extensive consultation. What the care home could do better: This inspection has generated no requirements or recommendations. The manager of the home is good at recognising where improvements need to be made and the quality assurance system supports this process. Key inspection report Care homes for adults (18-65 years) Name: Address: Whitby Scheme 14/15 Crescent Avenue and 2/5 North Promenade Whitby North Yorkshire YO21 3ED     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Karen Ritson     Date: 0 4 0 8 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 25 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 25 Information about the care home Name of care home: Address: Whitby Scheme 14/15 Crescent Avenue and 2/5 North Promenade Whitby North Yorkshire YO21 3ED 01947603145 01947825654 anchor.house@craegmoor.co.uk www.craegmoor.co.uk J C Care Ltd care home 32 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) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Registered for 32 residents with a Mental Disorder and/or a Learning Disability of whom 2 may be over the age of 65 Date of last inspection Brief description of the care home The Whitby Scheme is registered to provide care an accommodation to people who have a learning disability and/or a mental health problem under the age of 65. They can admit up to 32 people. The registered provider is J C Care a subsidiary of Craegmoor Healthcare. The registered manager is Miss Nicola Craig. The Whitby Scheme consists of three properties. Anchor and Haven House are adjacent to each other with the third house, Endeavour, being approximately a half a mile away. The properties are not suitable for people who have profound physical disabilities or Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 0 32 32 Brief description of the care home mobility problems. The people who live in the Whitby Scheme generally have mental health problems combined with a learning disability. Several people display challenging behaviour and some may be the subject of supervision orders. The primary aim of the Scheme is to promote independence and to treat people as individuals with individual needs. The Scheme also endeavours to provide an element of rehabilitation by developing individuals life and social skills. Where appropriate people are assisted to relocate independently within the community. The properties are within walking distance of all main community facilities including shops and banks and are convenient for the public transport services. Anchor and Haven House have a private parking area; Endeavour House relies on available onstreet parking. None of the properties has large gardens but the staff have maximised the use of rear yards/patio areas. The properties are, however, adjacent to public parks and beaches, which people often use. Information about the home is provided in a Service User Guide, this is available on request. The Care Quality Commission produces a report and this is available from the manager. Care Homes for Adults (18-65 years) Page 5 of 25 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 inspection for this service took twelve hours. This includes time spent gathering information and examining documentation before and after a site visit and in writing the report. The site visit took place on 4th August 2009 between 9.30 and 15.30. Information for this inspection was gathered from the following. A tour of the premises, observations of care throughout the day of the site visit, speaking with people, speaking with staff, case tracking people on the day of the site visit, notifications sent to the Commission from the home since the last inspection, examining policies, procedures and records kept at the home, examining information regarding the home on the file kept by CQC, considering comments made by relatives, health care and social services staff. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations -but only when it is considered that people who use services are not being put at significant risk of harm. Care Homes for Adults (18-65 years) Page 6 of 25 In future, if a requirement is repeated, it is likely that enforcement action will be taken. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. Care Homes for Adults (18-65 years) Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 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 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their care needs well assessed. They are involved in assessing their own needs. Evidence: People have good opportunities to visit the service before deciding about admission. The manager arranges for at least two visits or as many as the person requires to feel comfortable. Each person is given a copy of the statement of purpose and service users guide. These documents are in an easy read format and have been devised with the assistance of people already living at the home. This ensures that people have the best opportunity to understand what the home has to offer. The assessment takes local authority care plans into consideration and any information from the current provider. Health care professionals are also consulted wherever necessary to ensure peoples needs are holistically considered. A key worker is assigned to help the person settle in, to begin to identify goals and desired positive outcomes. Any restrictions on choice are based on specialist needs and risk assessments and these are discussed with the person during the assessment. Such restrictions take into account the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards. Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: Rehabilitative and therapeutic needs are assessed, including a living skills assessment. In this way, the home emphasises capacity and builds the development of independence into each assessment and care plan. Plans for college and work placements are discussed at this point and an assessment of each persons potential involvement in the running of the home. The needs of service users who are already living at the home are considered to ensure that the home only admits those people who it believes will be suitable and not detract from the quality of life of other residents. Assessments cover all required areas of needs and risk assessments are thorough, detailed and specific. Three assessments were examined. These clearly showed that people had been heavily involved in their own assessments and included life stories and aspects of each persons life which were considered of particular importance, this included examples such as likes, dislikes, important connections with other people and significant dates. Care Homes for Adults (18-65 years) Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs met. They participate in decision making regarding their lives and are supported to take risks as part of an independent lifestyle. Evidence: A care plan for each person is drawn up, based on the assessment. All specialist requirements are included in this plan with particular emphasis upon medical and health needs. All care plans are reviewed monthly by the keyworker with the person involved. The review is in depth and covers each area of the care plan, including consideration of any restrictions on liberty to ensure people are enabled to have as much autonomy as possible. People are encouraged and supported to manage their own finances and contracts are in place for people who need assistance with budgeting. People are also encouraged to access advocacy to enable them to benefit from independent support and advice when making decisions about their lives. Three care plans were examined and these contained detailed information on care needs and how these would be met. Care plans were presented in an easy read format, to assist people to understand them. People are encouraged to make decisions in every area of Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: their lives. Each person had a work book in which they recorded their life preferences in words or pictures. These were tailored to individual capacity and were used in reviews. The manager said the workbooks were particularly helpful in giving a voice to people whose verbal skills were limited. Peoples lives had been considered holistically, with specific assessments in place to ensure the risk of harm is minimised, whilst promoting acceptable risk taking within the context of a full and interesting life. One person said: I used to shout a lot, but since Ive been here I am doing lots of things and going out. I like it here. A relative wrote: I cant thank the staff enough for the care and consideration they have shown my relative over what has been a very sad period. They were very supportive. The help was really appreciated. A health care professional wrote: I work one to one with a service user and feel the quality of care from this service is excellent. Another health care professional wrote: I am very impressed with the support staff have given to PCR processes thus far and the work and thought that has gone into supporting people in this. Care Homes for Adults (18-65 years) Page 13 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have excellent opportunities to have the lifestyle they choose. They are enabled to pursue educational and leisure activities of their choice and they are involved in providing varied and interesting meals they enjoy. Evidence: Care plans include day or social care needs, spirituality, cultural needs, hobbies and interests, employment, learning and education. Several people living at the home have voluntary or paid jobs in the community they enjoy. The home staff have rewritten the leaflets and forms from the jobcentre into an easy read format so that people at the home understand what they need to do when looking for a job and know what help is available to them from the disability employment adviser. Each person is enabled to access educational opportunities suitable for them. Some people attend Dalewood House, a local day centre where they can become involved in activities ranging from cooking, to crafts, woodwork, gardening or assisting in a Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: shopping scheme. People also have the opportunity to attend Elders Street in Scarborough, another day centre. People who live at the Whitby Scheme attend regular meetings at the centre to provide feedback on the courses and activities on offer and to contribute ideas about future provision. One person said: Ive done a cook and eat course and it was good. Each person keeps an activities folder where they describe what they have done and either write or depict responses. Each person has the opportunity to engage in leisure activities such as swimming, cafes, pubs, holidays and days out. One person had discussed and planned a recent holiday to Gracelands in America with the help of staff at the home and his family. This had been a long held dream and required a considerable amount of organisation and risk assessment. The person said he had the time of his life. Other people had been to Majorca, and residents had decided they wanted to go to Skegness this year. A relative wrote: Very pleased that *** was taken shopping to spend her allowance. She really enjoyed the outings and was made to feel special. Meals are varied and interesting. People have a nutritional assessment and individual diet plans where necessary. People get involved in shopping, cooking and presenting their meals. One person said. Im making pizzas for everyone today because I want to get into a catering job and this helps get me used to it. Care Homes for Adults (18-65 years) Page 15 of 25 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. People receive excellent personal and healthcare support. Evidence: Staff provide flexible and sensitive support. People have a choice of keyworker and have recently met to discuss whether they wish to have the keyworker regularly changed. They have decided against this. Details of preferred daily routines and preferences in clothes and presentation are all recorded on care plans. People have excellent support to understand and take control of their own healthcare. For example, one person required a hospital stay but was anxious about going to an unfamiliar environment. The home developed a talking diary for the person. This is a folder with photographs of every stage of the journey through the hospital including the doctors, nurses and the treatment room, with an explanation of the equipment to be used. At each photograph there was a button to press with a verbal description, recorded by the keyworker, addressing the person by name and saying reassuring things about the visit. The person could then keep the diary and return to it as many times as necessary to reduce anxiety. Each person has a health action plan on file which gives an overview of all healthcare needs. Keyworkers support each person to access the healthcare they need and staff keep detailed notes on any GP visits or Care Homes for Adults (18-65 years) Page 16 of 25 Evidence: other medical involvement. Evidence was seen on file of routine health checks and specialist healthcare information about particular conditions, with further written evidence that people had been helped to understand their own healthcare needs. A mental healthcare professional wrote: The main strength is a familiar group of staff (who) offer a very person centred approach. Incidents can be diffused by staff with good knowledge of residents. The home handles medication well according to policy and procedure and staff who administer medication have received suitable training to ensure people are kept safe. Each person has a self medication assessment and those who have capacity to manage their own medication have a lockable facility available to them to keep their medication safe. Care Homes for Adults (18-65 years) Page 17 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their complaints listened to and acted upon. They are protected from harm. Evidence: The home has a complaints policy and procedure. People said they knew they could say if there was anything they were unhappy about either in the Your Voice meetings or to individual keyworkers or other staff. This ensures that people are enabled to express a complaint and to have this listened to and acted upon. Staff have received safeguarding adults training and also specific training in managing challenging behaviour. The home sends regulation 37 reports to CQC when necessary and are very good at communicating any concerns to us by telephone and in writing. The home has a whistleblowing procedure to ensure people have a method of alerting staff to any inappropriate practice. All staff have CRB and POVA first checks to make sure that those unsuitable to work with vulnerable adults are not recruited. The home has a safeguarding policy. The manager said that she was planning to offer safeguarding training to families who expressed an interest to enable those around each person living at the home to raise their awareness of how to protect vulnerable people. Care Homes for Adults (18-65 years) Page 18 of 25 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. People live in a safe, clean, well maintained environment. Evidence: The Whitby Scheme provides care to people from three separate houses. Two of the houses are relatively small whilst the third, Endeavour, can accomodate up to fourteen people. Anchor and Haven houses have been largely redecorated since the last inspection. The communal rooms, kitchens and bathrooms are now pleasantly decorated with modern decor. Room colours and furniture had been chosen by people living at the home in their meetings. Most individual rooms have been refurbished to provide comfortable private accomodation. Endeavour house has been redecorated in part. Endeavour is a large building which is not ideal for its purpose, however, within the restrictions of the building, the manager, staff and people living at the home have produced a comfortable home environment. All houses comply with the local fire and environmental health authority. This ensures the people living at the home remain safe. The home has a policy and procedure on infection control and domestic cleaning routines are in place. The staff also carry out regular auditing of hygiene standard to ensure people continue to live in a clean well maintained home. Care Homes for Adults (18-65 years) Page 19 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from well recruited and trained staff in sufficient numbers. Evidence: Each house is well staffed so that people can follow the lives they choose, including any activities which may take place in the evenings. Staff are well trained in relevant skills. All receive induction and foundation training. All senior care staff have at minimum NVQ level 2 in care and 6 staff have completed NVQ level 3. This means people benefit from well trained staff. Staff are well recruited. CRB and POVA first checks are carried out on all new members of staff. Two references are sought and staff are placed on a 3 month initial probationary period. This means only people suitable to work with vulnerable people are recruited. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the excellent management of the service. Evidence: The registered manager is well qualified in her role and continues to update her knowledge through reading relevant material and enrolling on training courses. She has recently been doing some work on the Mental Capacity Act and Deprivation of Liberty safeguards and this will be discussed with staff in meetings. Staff and people living at the home spoke of the managers strong leadership. All found her easy to approach and consistent. One person said: She is very good at supporting you and we can ask her anything if were not sure. The home has an excellent quality assurance system, where the results of surveys are fed back to people living at the home and others in a report. The home has comprehensive internal auditing systems which are used to improve the service. There are monthly service user meetings where a spokesperson is nominated for the quarterly regional, and national meetings for Craigmoor. These meetings are called Your Voice and have resulted in changes to the way the service has been delivered. For example, people asked about what staff did when they completed internal audits Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: and a number said they would enjoy being involved in the auditing process of the home. Since then, several people have assisted in environmental and other audits which has given them a greater insight into how the staff of the home maintain a quality service. Staff are well trained in all areas of safety. People are protected by the extensive health and safety procedures, risk assessments and up to date servicing of equipment and safety checks on utilities. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 24 of 25 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). 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