Inspection on 08/10/09 for Sandley Court Care Home

This is the latest available inspection report for this service, carried out on 8th October 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Sandley Court Care Home 39 Queens Road Southport Merseyside PR9 9EX     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: Patricia Thomas     Date: 0 8 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 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 Older People 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 Older People Page 3 of 26 Information about the care home Name of care home: Address: Sandley Court Care Home 39 Queens Road Southport Merseyside PR9 9EX 01704545281 02086320972 sandley39@talktalk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Accommodating Care (Southport) Ltd care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following categories 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:- Old age not falling within any other category - Code OP, (maximum number of places: 23 Physical disability 1 named service user - code PD, (maximum number of places : 1 The maximum number of service users who can be accommodated is : 23 Date of last inspection Brief description of the care home Sandley Court is a care home for twenty-three elderly residents, which is owned by Accommodating Care (Southport) Limited and managed by Mrs. Marie Heslin. Sandley Court is a converted dwelling house with an enclosed rear garden and with parking spaces and planting at the front of the building. Bedrooms, bathrooms and lounges are situated on the ground and upper floors. There is a ramp at the front of the home, and a passenger lift for those who are accommodated on upper floors. Sandley Court is Care Homes for Older People Page 4 of 26 Over 65 23 0 0 1 Brief description of the care home situated in a pleasant residential area, which is a short car ride away from Southport town centre where there are public transport links, shops and restaurants. Care Homes for Older People Page 5 of 26 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means that people who use this service experience good quality outcomes. Thie visit was just one part of the inspection. Before the visit took place we (the commission) asked the manager to fill in a questionnaire that we call an Annual Quality Assurance Assessment or AQAA. It gives us information about how the home is meeting the needs of people who use the service and includes plans for further development. During our visit, we looked at various records and walked round the home. We spoke with a number of people who live at Sandley Court and staff who work there. We also spoke with relatives who were visiting, they gave us their views about Sandley Court and these are included in the report. Before the visit we sent out questionnaires to people who live and work in the home have included some of their comments in the Care Homes for Older People Page 6 of 26 report. We used a system called case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We track peoples care to see whether the service meets their individual needs. The weekly charge in Sandley Court is £383.00 - £450.00. There are extra charges for hairdressing and chiropody. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: We looked at the way people receiving pressure care were being supported. We found there are arrangements for providing pressure relieving equipment and monitoring fluid intake for people who are frail and at risk of developing pressure sores. We saw gaps in the fluid balance charts in use at the time of the visit. We recommend that when filling in these charts, staff should ensure that the amount of fluid taken or refused is recorded. This will give a true record of the persons fluid intake and mean action can be taken without delay to avoid people becoming dehydrated. From our observations during the visit and through speaking with people who live in the home we found that a lack of social activities means that they are not being provided with a stimulating environment and may become bored. We recommend that people be consulted about what they like to do, and activities be arranged for them according to their abilities and preferences. When we walked round the home we found that it was clean and odour free. However, the fittings and work surfaces in the kitchen were not very clean. We have recommended that the kitchen be thoroughly cleaned to avoid food contamination. Care Homes for Older People Page 8 of 26 We spoke with people who live in the home and from comments received from one person about staff conduct, we recommend that staff receive guidance about how to speak with people more respectfully. This will help to ensure all staff will support people in way which respects their dignity and rights. We found that there are safety procedures in the home, and checks on the building and equipment are carried out regularly. We saw risk assessments and signed permission for use of bed rails, however there were no records of regular safety checks for bed rails. This equipment should receive frequent safety checks which are recorded, and remedial action taken if necessary to ensure the rails are safe for people to use. 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 Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. People are given information and have their needs assessed before deciding to move in to Sandley Court so they know that their needs can be met. Evidence: Records showed us that there is a good system to introduce people to the home. Information about the service provided in user friendly formats and needs assessments are carried out by firstly qualified professionals and then by staff from the home. In this way people will know that their needs can be met at Sandley Court and they can make an informed decision about whether it will make a good home for them. We looked at the records of a person who moved in to Sandley Court recently. There was a full written assessment of the persons health, social and personal care needs carried out by a social worker. The manager of Sandley Court had met with the person and carried out a further needs assessment to make sure the home would be able to meet the individuals needs. The persons cultural and religious needs were recorded Care Homes for Older People Page 11 of 26 Evidence: and also their personal preferences about, for example, how they like to spend their time and what they like to eat and drink. We looked at the service user guide for Sandley Court. This gives a lot of information about the home and the service it provides, the staffing and accommodation. We also looked at contracts of residence which set out the terms and conditions of residency and states what is included in the fees. These documents are available in user friendly formats (such as large print), to ensure that people have access to all the information they need before they move in. Care Homes for Older People Page 12 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Sandley Court have their needs met and their care is provided in a way that protects their privacy. More attention is needed when completing fluid balance charts to ensure they give a true record of each persons intake of liquids. Evidence: Care plans to assist with personal care tasks were completely person centred. This means that staff knew exactly what they needed to do to help the person to meet their needs in the way they preferred. The plans focused on what people are able to do for themselves, which helped them to stay as independent as possible. We looked at care plans for two people who live in Sandley Court and noted there were action plans in place to meet each area of the persons assessed needs. For staff guidance, there was a lot of detail in care plans about how to support the person and help them to stay independent. A good example we saw was guidance for staff about the positioning of furniture in a bedroom so that a person could easily reach a drink without assistance. Care plans we read had been reviewed every month and altered in response to any change in the persons condition so that staff would have up to date information. Care Homes for Older People Page 13 of 26 Evidence: There were risk assessments in place to keep the person safe in their home. Where people were assessed as at risk of pressure sores, pressure relieving equipment was in place, such as special mattresses and cushions. In reading the records kept about a persons pressure care we noted that there were gaps in the fluid balance charts. In most instances where drinks given to the person had been recorded, the amount of fluid taken was not given. Lack of accurate recording in this could mean that people may not receive enough fluids and become at risk of dehydration. In care records, there were good examples of how peoples health is supported through visits from their doctors, district nurses and specialist services. There was also evidence of arrangements for treatment from chiropodists, dentists and opticians which means their full range of needs were being met. For staff guidance, there are written procedures for managing peoples medication and those who give out medication have received training in this with a recent update. We looked at the system in place and storage of the stocks of prescribed medication for two people. We read the records filled in by staff as they give out medication and these were found to be in order. Peoples ability to self-medicate is assessed on admission and those who manage medication for themselves are provided with a locked drawer for safe storage. People we spoke with said the care and support they receive is very good. They said they have single bedrooms which they consider to be their own private space. In two surveys received from people who live in this home they wrote that Sandley Court looks after people very well. Two visitors we spoke with said their relative is well cared and comfortable in Sandley Court. For staff guidance there are procedures in place for privacy and confidentiality. During our visit, people living in the home whom we spoke with expressed no concerns in this area. Staff were aware of the procedures in place and records had been written in a way which respected each persons dignity. Care Homes for Older People Page 14 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. The daily routines are flexible although lack of social activities means people are not provided with a stimulating environment and may become bored. Evidence: There was a lot of evidence in care records to show that peoples preferred lifestyle is recorded when they move in to Sandley Court, and steps taken to ensure that they are given choices. Some examples seen were about where people prefer to spend their time, when their meal would be served and when they like get up and go to bed. There was good evidence of family contact in care plans and a person told us their family had recently visited and brought in some personal items he needed. Visitors we met with said they are always made welcome and given privacy with their relative. In reading care records we found that peoples cultural and religious needs are recorded when they move in and steps taken to ensure they are able to visit local places of worship or have visits from local ministers. This means that their spiritual needs will continue to be supported in Sandley Court. During the visit, there were no activities taking place and staff told us that a number of people do not want to take part in bingo or dominoes which they used to enjoy in the past, although some people had been out for a meal recently with staff. Activities in the home should be in keeping with the current social needs of people who live Care Homes for Older People Page 15 of 26 Evidence: there and be changed according to their preferences and abilities. In a survey we received, one person asked for more outings for those who wish to go out. There was good evidence that peoples meal preferences are catered for. This is done through asking them what they like to eat and passing this on in writing to the chef. During the visit, we saw evidence of nutritional assessments and catering records for special diets. Peoples weight is monitored to ensure they are properly nourished and staff said that a person showing sustained weight loss would be referred to their G.P. People told us the food is very good and well presented with plenty of choice and alternatives. There was evidence during the visit that meal times are flexible as some people were served in their bedrooms or ate later by choice. There is a pleasant dining room next to the kitchen with neatly laid tables. People told us they are regularly served drinks and they were satisfied with this aspect of the service. Care Homes for Older People Page 16 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 good procedures so that people who live Sandley Court are able to express their concerns and be listened to, their rights are protected and they are safeguarded from abuse. Evidence: The home has a complaints procedure which is given to people when they move in and displayed in the home so they know their complaints will be taken seriously. There is a record of all complaints received into home, the outcomes and any action taken to put things right. The home has safeguarding procedures and staff receive training in this to ensure they are aware of the indicators of abuse and how to report suspected abuse of any person who lives in the home. We spoke with three members of staff who said they had received this training and could explain the principles of safeguarding and the reporting systems. Care Homes for Older People Page 17 of 26 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, 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. 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. Sandley Court provides a safe and comfortable home that is well maintained and decorated and furnished to a good standard. Evidence: Sandley Court is a converted dwelling house which has been adapted to provide a residential service for older people. There is a pleasant garden at the back of the property and a ramp, car park and seating area at the front. The building is well maintained and in good decorative order being furnished in a comfortable domestic style. The home has single bedrooms, assisted bathing facilities, and toilets on each floor for convenience. For people who are frail, a series of mobility aids are provided such as hoists, slide sheets, grab rails and raised toilets. There is a passenger lift to all floors. People told us they were comfortable and satisfied with their home. They said they like their bedrooms and that their home is always nice and warm and well lit. There is an ongoing maintenance programme and the AQAA gives a summary of work carried out since our last inspection including safety improvements to fire doors, upgrading of several bedrooms and replacement of furniture. The home employs domestic staff and in general, the building was clean. For staff guidance their are procedures for infection control and control of substances hazardous to health and staff receive training and updates relating to health and safety and infection control. The laundry and kitchen were well organised, however Care Homes for Older People Page 18 of 26 Evidence: the kitchen is in need of a thorough cleaning on the work surfaces and fittings to avoid contamination of food. Care Homes for Older People Page 19 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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 receive support from staff who have the skills to support them correctly. More guidance will be needed for staff about how to speak to people in a way which is respectful and supports their rights and dignity. Evidence: We looked at the staff roster which gave a true representation of the staff who were on duty on the day of our visit. There is a low staff turnover in this home and all the staff we spoke with had worked there for several years. The manager was able to confirm that there are enough staff employed to maintain the necessary staffing levels to support the people who live there.. A group of bank staff is employed to cover absences and holidays and they are recruited and trained in the same way as permanent staff. The training records show that staff receive mandatory training with regular updates and National Vocational Qualification achievements are good, most of the staff having at least levels 2-3. This means that staff have the qualifications and skills they need to support people properly and safely. We spoke with four members of staff and received four staff surveys. Staff informed us they received good training and a lot of support from the manager. They said that the care plans are easy to follow and gives them good guidance about peoples support needs. In general, people told us they are satisfied with the care they receive and the way staff support them. One person who lives in the home told us a member of staff Care Homes for Older People Page 20 of 26 Evidence: sometimes speaks abruptly to him/her. Although they have skills and qualifications in care giving, staff will need guidance about how to speak to people in a way which respects their rights and dignity. We looked at the way staff are recruited by looking at four staff files, including those for the most recently employed people who work as bank staff to cover vacancies. All the files had been well maintained and gave evidence of the clearances and references obtained before people came to work in the home and of the induction training they receive when first employed. Staff are issued with job descriptions and have contracts of employment and for their information there is a staff handbook. Care Homes for Older People Page 21 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 was well run and a high level of consultation with people meant that they could contribute to the development of their home. Evidence: The manager is has several years experience managing the home and holds care and management qualifications. Staff who were spoken with said they get good support from the manager and people who live in the home said she is approachable and helpful. The manager has established good systems for records management and keeps up to date with current legislation and best practice in care giving. An example of this is regarding deprivation of liberty safeguarding guidance which is now included in the homes procedures. Staff have been given in-house training to help ensure they will be aware of peoples rights and how they should be promoted and protected in their home. Sandley Court has achieved investors in people and there are a number of monitoring and review systems in place for obtaining peoples views on the service. Records showed us that people have the opportunity to state their opinions on their home Care Homes for Older People Page 22 of 26 Evidence: through care plan reviews held with social services. Also, the registered provider visits the home regularly to monitor the standards of care and writes a report on his findings which is made available to the commission. There is an independent annual auditing system and people living in the home, their relatives and staff are given satisfaction surveys every six months to inform the audit. The outcomes are monitored and if necessary, improvements made accordingly and any compliments received are built upon. In this way peoples opinions are valued and they have a say in the way their home is run. The home does not become involved in peoples personal finances and those who have no family have access to independent advocates. The AQAA confirms that there is a safe system for securing and auditing peoples personal allowances so they have access to money as they need it. We saw up to date certificates for the servicing of the building and equipment, which means the home will be safe for people to live and work in. The fire records were up to date and showed that there are regular drills, system and equipment checks and instruction in fire safety for staff. There is a system for recording and monitoring accidents and for eliminating environmental risks to help ensure people are safe in their home. More attention will be needed regarding the use of bed rails as these need to be frequently checked, records kept, and remedial action taken to ensure they are safe for people to use. Care Homes for Older People Page 23 of 26 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 Older People Page 24 of 26 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 1 7 When filling in fluid balance charts, staff should ensure that the amount of fluid taken or refusal of fluids is recorded. This will give a true record of the persons fluid intake and mean action can be taken without delay to avoid them becoming dehydrated. People should be consulted and activities aranged to meet their interests, abilities and preferences. This will ensure they are provided with a stimulating environment and meaningful social activities. The work surfaces and fittings in the kitchen should be thoroughly cleaned to avoid the contamination of food. Staff need to receive guidance about how to speak to people in a way which is respectful towards their rights and dignity. This will help to ensure that all staff fulfill the aims of the home in accordance with the statement of purpose. Bed rails should receive frequent safety checks which are documented and remedial action taken if necessary to ensure the rails are safe for people to use. 2 12 3 4 26 30 5 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!