Inspection on 23/06/05 for 2 Thornhill Close

This inspection was carried out on 23rd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

2 Thornhill Close 28/07/06

2 Thornhill Close 13/12/05

2 Thornhill Close 22/12/04

2 Thornhill Close 04/08/04

2 Thornhill Close 05/01/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 2 Thornhill Close Dorchester Dorset DT1 2RE Lead Inspector Marion Hurley Unannounced 23 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 2 Thornhill Close Address Dorchester Dorset DT1 2RE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01305 266589 Leonard Cheshire Dorchester Homes Mrs Glynis Elizabeth Baker CRH PC - Care Home Only 3 Category(ies) of LD Learning Disability (3) registration, with number PD Physical Disability (3) of places 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mrs Baker to undertake an adult protection managers course (agreed suitable by the Commission) by September 2005. Date of last inspection 22nd December 2004 Brief Description of the Service: 2 Thornhill Close is a care home providing personal care and accommodation to three adults who have a learning disability. The home is one of seven similar services in Dorchester that are owned and operated by the Leonard Cheshire Foundation, a ‘not for profit’ organisation providing services to people with disabilities. The registered manager is Mrs Glynis Elizabeth Baker, who is based at the provider’s local office in Alexandra Road, Dorchester. The home is located in a popular residential area of Dorchester, within walking distance of the town centre. Dorchester has a wide range of shops, banks, GP surgeries and other amenities, which are used by service users on a daily basis.The property is a single storey building. All service users have single bedrooms and share the communal lounge/diner, and kitchen. There is level access throughout and to the front and rear doors. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Thornhill was assessed according to the Care Home for Adults (18-65) National Minimum Standards. The overall time spent to complete the inspection process was a total of five hours, one of which was spent at the Home. In the course of this inspection both the Registered Manager and two members of the staff team were available. All three residents were at home but did not participate in the process of the inspection. All records, documents and files were easily accessible on the day. The premises and garden are suitable to meet the needs of the three residents. From discussions with staff it is clear there is positive job satisfaction and they genuinely enjoy the company of the residents. This was a positive inspection of a service that continues to develop and aim for high standards of practise working side by side with residents with varying abilities and complex needs. The inspection process was assisted by the openness of the staff and management and the inspector was grateful for their time and commitment to the inspection. What the service does well: The Registered Manager and staff are committed to meeting the needs of this well-established small group of people living at Thornhill within flexible and informal routines. The three residents and two staff were observed throughout the visit and seemed to be relaxed and enjoying each other’s company. Staff were working side by side with residents in making and supporting daily decisions. This group of people have varying abilities and needs and these details were reflected in the written support plans. The Registered Manager and staff team have established very good working relationships with Community Services and this positive and seamless approach to the care and understanding of the residents is of great benefit to the individual residents and the staff in their daily jobs working side by side with the residents. Thornhill offers a needs-led service through flexible routines and good staff relationships. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed at this unannounced inspection. EVIDENCE: 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7, & 9 • • • Care Assessments and Plans are in use for each of the residents, which specify the services and facilities available to them. Residents are encouraged to participate and make decisions in all aspects of their daily lives to enable them to retain as much independence as possible All risk assessments were in the process of being reviewed and updated. It is important these include risks identified in the resident’s assessment and Plans and specify the appropriate action which must be taken to safeguard each resident. The level of participation is very personal to each resident’s abilities and interests • EVIDENCE: Each resident has a support plan, which is a combination of care assessments, and care planning. These documents contain a lot of relevant information but do not give the reader a feel of the person and this is partly due to some of the terminology used which refers to people as “ clients”. The care/support plans set out how residents current needs should be met but do not clearly identify short /long term goals for each person. Not all the care and risk assessments had been regularly reviewed. The risk assessments were generic and not 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 10 specific to the individual person (in name only) and because they had not all been reviewed there was no evidence to indicate how that person’s behaviour may have changed and developed since the assessment was originally completed. All assessments/plans should be reviewed every six months to reflect any changing needs/abilities. The Registered Manager and staff need to consider ways to develop and produce a simple plan for each resident which through graphics and symbols may be recognisable to them and reflect their different activities. Discussions with the member of staff clearly indicated their knowledge and understanding of the residents in the Home and did reflect the practise of working with residents for both short and long term achievements. All resident have an annual review and staff advised this is generally conducted with the funding authorities and forms the basis of the annual contract. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,13,14 &16 • • • Residents are given every opportunity to learn and develop through participating and experiencing a wide range of appropriate leisure and daily living activities. All residents have opportunities to join in local activities and social events outside the home, which enhance the residents’ local network and understanding of the community in which they live. Members of staff treat residents with respect and this forms the foundation of a positive and respectful relationship between staff and residents. Residents are afforded privacy and personal space. EVIDENCE: All the residents have varied weekly routines that include many activities away from the Home. The two staff on duty at the time of this inspection described some of the events and pastimes pursued by the residents. One person regularly goes horse riding, another two were shortly off to a Music Festival. Residents access all local amenities and go to the local pubs for suppers and use all the local shops. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 12 Residents assist according to their abilities and interest in kitchen and household tasks. All three residents living at Thornhill are totally dependent on staff for all their daily needs yet from observations there appeared to be a genuine mutual respect between staff and residents and staff worked “side by side “ with the residents irrespective of their complex needs. Records specified the different activities each person enjoyed. It is recommended the benefits of these activities should be included in the recording to reflect which activities also have a therapeutic value. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,& 20 • • Staff provide flexible support and personal care for each resident ensuring their health and general well-being is carefully monitored and maintained. Medicines in the custody of the home must be handled according to the requirements of the Medicines Act 1968. EVIDENCE: The records of one of the residents were read and these contained evidence of regular access to NHS services for health needs. Notes of all appointments with health and social care professionals were recorded. Community Nurses support staff regularly and the Registered Manager advised that the Home had a very positive working relationship with the Consultant who attends House Meetings to discuss any changes in the residents well being. The staff on duty said they encourage all the residents to make their own decisions about when to go to bed and get up, which offers each an opportunity to take some control of their lives. All the residents rely on staff to totally manage, store, and administer their medication it is therefore essential that those staff completing any tasks relating to the residents medication must complete an accredited course in The Safe Handling of Medication. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 14 It is understood that Leonard Cheshire Homes, Dorchester have recently agreed a contract with Boots The Chemist and the first training course has been scheduled for July 2005. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 • The current group of residents would have great difficulty in understanding the concept of a complaint or information on the subject However from observations it was evident staff listen carefully and do act on the residents views and wishes and moods. The Registered Manager must ensure that all staff undertake training relating to the Protection Of Vulnerable Adults and Physical Interventions and ensure refresher training takes place. • EVIDENCE: Evidence to support this standard was obtained through discussion with both staff and the Registered Manager and from observing staff interact with the residents seen on the day of this inspection. The three residents all have different levels of comprehension and each has developed their own method of indicating their pleasure or apprehension. On occasions this behaviour may become quite extreme and may be directed at others. Both the Registered Manager and member of staff explained their methods to ensure the behaviour is handled carefully without denying the resident any personal liberties. Staff have considerable intuitive knowledge and it would be advantageous for this to be recorded in the residents support plan. The plans contain some information about communication but when talking with the support staff their sensitivity and detail surpassed the written documents. No complaints or concerns have been raised since the last inspection. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,&28 • • • The premises are homely and domestic and are suitable for the needs of the current group of people living there. Residents all have single bedrooms, which are personalised according to their wishes and which enable them to retain a degree of independence according to their own abilities and needs. There is sufficient communal space for all the residents EVIDENCE: A tour of the premises was conducted with a member of staff and one bedroom was viewed with the resident. The other two residents did not join in the tour however their permission was sought prior to entering their bedrooms. Each of the three bedrooms reflected the resident’s different interests and each was individually decorated with layouts according to their needs and abilities. The lounge/dining room is in need of redecoration/ refurbishment and the sliding /patio doors leading to the garden need to be replaced and at the time of this inspection were not in use. It is understood the kitchen area is due for refurbishment. Staff spoke of the difficulties of maintaining the home, as some residents do not understand the need to respect the furnishings or the fabric of the 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 17 property. None of the residents are able to safely use a bedroom lock. The home has a domestic style washing machine and tumble drier. The washing machine has a cycle, which will wash, to temperatures of 95 degrees centigrade. Any foul laundry is washed in dissolvable sealed “ red bags”. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 ,34,35 &36 • • All staff receive regular supervision and the support they need to carry out their jobs. This contributes to maintaining a quality staff team working for the benefit of all the residents. The home aims to ensure staff have appropriate skills and competencies through generic and specialist training specific to the needs of residents. EVIDENCE: Discussions with two staff demonstrated their knowledge and understanding of their daily work with this small group of residents. Both were clear about their individual roles and responsibilities. One member of staff had been working for the Leonard Cheshire Foundation for many years and said how much they appreciated the training and thought it relevant and linked to the varying needs of the residents. There is a comprehensive training matrix which indicates when staff have received training and when refresher training for mandatory courses is due. This validated previous information received during the course of this inspection. The Training Co-ordinator who is based in the Leonard Cheshire Administrative Office in Dorchester ensures information is kept up to date; this is then passed to the Regional Office to be included in the Regional Training Matrix. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 19 Observations of staff talking to and supporting residents demonstrated an easy informal partnership between them and the residents seemed very happy in the company of the staff. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38, & 42 • Residents benefit from the Registered Manager’s experience and ability to run a relaxed but efficient home. The two staff on duty at the time of this inspection confirmed the Manager’s approach and skills. Both the staff and the residents were observed to be happy and confident in the Manager’s presence during this inspection visit The Registered Manager is competent and experienced to run the home and is currently studying for NVQ level 4 in both management and care. At the time of this unannounced inspection safe-working practices appeared to be satisfactory ensuring a safe environment for both residents and staff. • • EVIDENCE: Fortnightly “house meetings” are held with the staff team and Registered Manager. Both the Manager and support worker said they felt the meetings were productive ensuring information between all staff was kept up to date. All minutes and notes from these meetings are kept and were noted. These meetings contribute to the on going self-monitoring however; no residents contribute to this informal evaluation. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 21 Despite the complex needs and behaviour of some of the resident both the Manager and staff had a very positive approach and sense of loyalty to all residents. The house is fitted with smoke and heat detectors in addition to fire extinguishers and blankets. All staff have completed basic first aid training and all members of the management team are Approved first aiders and available on a 24 hour call out basis. From discussions with the Manager it was evident they are fully aware of their responsibilities for the practical day-to-day health and safety issues for both residents and staff. However overall management responsibility for fire prevention, risk assessments and safe working practises is the responsibility of the designated “ Health & Safety” employee who is based at the Dorchester Administrative offices. This person has completed a range of risk assessments. These assessments are generic and do not specifically relate to the individual residents and their different abilities and understanding of risk and personal safety. It is important these risk assessments are completed and regularly reviewed with or by staff that live and work side by side with the residents and who therefore have a good practical understanding of the residents abilities and needs. All electrical testing has been completed. Certificates and records verifying this information were readily available and checked. The designated responsible person, on behalf of Leonard Cheshire Homes, completes monthly visits. The reports are detailed and regularly provided to the CSCI offices. The last report in April 2005 indicated there were no areas of concern. 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 3 x 2 x x Standard No 11 12 13 14 15 16 17 3 x 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2 Thornhill Close Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 23 Regulation 13 Timescale for action All staff must receive appropriate 31st October, training in physical intervention and restraint. At the time of this 2005 inspection 50 of staff have completed training. Incidents of physical intervention/restraint must be recorded in detail and in a format which can be easily monitored by Management. Staff must be aware of the correct procedures to follow to protect residents from harm and abuse. The homes policy must inform staff of the correct procedures to be taken if they witness or suspect abuse. All staff must receive regular refresher training in the Protection of Vulnerable Adults. The home must establish and 31st mainatin a system for reviewing October, and monitoring the quality of 2005 care provided by the home and where possible invovling residents or their representatives. The Registered Manager must 31st make arrangements for October, reveiwing fire precautions.All 2005 staff must receive three monthly fire prevention training . At the Version 1.30 Page 24 Requirement 2. 39 24 3. 42 23 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc time of this inspection this requirement was being addresed but not completed. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations The individual care/service user plans need to be written based on the principles of Person Centred Planning and should include a record of the residents short and long term goals and acheivements. Risk assessments should be reviewed regularly and provide details of who has been involved /consulted with during the assessment process. Risk assessments must reflect the individual residents abilties/needs and the hazards applicable to them and the plan of actions to minimize the hazards and risks. All staff adminstering and handling medication must receive accredited training in basic knowledge of how medicines are used, how to recognise and deal with problems and the principles behind all aspects of the Homes policy on medicines. At the time of this inspection aspects of tis recommendation were actively being addressed. Each member of staff should have an individual training and devlopment assessment. 2. 9 3. 20 4. 35 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole, Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 2 Thornhill Close D55 S26745 THORNHILL CLOSE V223215 230605 Stage 4.doc Version 1.30 Page 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. 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