Inspection on 17/11/08 for 70 and 72 Worting Road

This inspection was carried out on 17th November 2008.

CSCI found this care home to be providing an Excellent 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

70 and 72 Worting Road 07/12/06

70 and 72 Worting Road 11/11/05

70 and 72 Worting Road 12/05/05

70 and 72 Worting Road 23/11/04

70 and 72 Worting Road 12/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 70 and 72 Worting Road 70 and 72 Worting Road Basingstoke Hampshire RG21 8TP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter McNeillie     Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 70 and 72 Worting Road 70 and 72 Worting Road Basingstoke Hampshire RG21 8TP 01256844057 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Catrina Jean Knapp Type of registration: Number of places registered: Advance Housing and Support Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 70/72 Worthing Road is a care home owned and managed by Advance Housing and Support Ltd registered to provide care and support for to to eight persons with a learning disability. The home comprises of two semi-detached properties that have been converted into one home, and is located in a residential area within walking distance of Basingstoke town centre. All residents are accommodated in a single bedroom with en-suite bathroom and share two lounges, two kitchens and a conservatory. At the time of this visit charges were £561 per week. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 Care Homes for Adults (18-65 years) Page 5 of 29 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: This report was written after taking into consideration a number of sources of information and evidence including a site visit to the premises, examining residents and staff records, personal observations, talks with staff and management, responses to a C.S.C.I. pre inspection survey, results from an in house quality survey and responses by the manager to an annual quality assurance assessment (AQAA) The inspection took place on 17/11/ 2008 between the hours of 09.00am and 12.45pm. During the inspection the inspector who was assisted by the Registered Manager had the opportunity to discuss living and working in the home with a number of staff and residents. Care Homes for Adults (18-65 years) Page 6 of 29 The results and findings contained in this report which looked at all of the key standards for care homes for younger adults and any previous requirements will determine the frequency and type of future inspections. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a well developed system of assessing and identifying residents needs which ensures residents safety and assessed needs can be met. Evidence: There have been no admissions since the last inspection. We were informed that all admissions are carried out in accordance with a corporate admissions policy that requires that no resident is admitted without a full assessment of needs and attendant risks being carried out, this included the prospective resident prior to a permanent place being offered visiting the home on a number of occasions including overnight and weekend stays. During these visits a detailed assessment of residents needs and risks overseen by the manager or a member of senior staff would be carried out. Four of the residents files were viewed all included, an initial assessments covering a Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: number of topics including housing related support, personal care support, daily living skills, managing money, looking after their physical and mental health as well as areas of risk. External health and social care professionals also contributed to the assessments process including a pre placement review. All assessments of need and risk are reviewed on a regular basis. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear and consistent care planning system in place, which ensures residents needs are met within a risk management policy that involves residents in decisions that affect them. Evidence: After talking with the manager staff and residents we formed the view that staff saw themselves more as enablers not carers and were there to assist residents in achieving their personal goals, aspirations and independence within a risk taking framework. A view with which the residents, staff and manager agreed. We viewed four residents care plans chosen at random. All contained details on how assessed needs were to be met , how any risks were to be managed and confirmation that residents were consulted when the plan was formulated. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Residents had contributed to their care plans by completing personal planning books produced in a written and pictorial format completed with the support of their advocate. These indicated an individuals choices, aspirations wishes hopes and aspirations. Topics covered included personal daily routines, showering,bathing, cleaning teeth, cooking skills, kitchen hygiene, using domestic appliances, personal appearance, finance, medication, getting up routine, travel, and issues outside the home including taking responsibility for there own actions. Residents right, and the opportunity to take risks is seen as fundamental. Residents were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. Should any risk assessment indicate any type of restriction be called for this would not be implemented without the full consent of the resident. Currently Plans viewed are produced in both a written and pictorial format as required, We were informed other communication methods would be used if appropriate. Residents are given the choice on which version they prefer to receive. All plans are reviewed on a regular basis. Risks assessments covered a number of topics, safety in the home environment, personal care, financial abuse, and specific risk assessments pertinent to individual needs. If following a risk assessment any type of restriction was indicated, this would not be implemented without the full consent of the resident. Care Homes for Adults (18-65 years) Page 13 of 29 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. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: Any decision taken that affects individuals always seeks to empower the individual by taking into consideration the individual residents choices,wishes,aspirations and independence . These were reflected in the manner in which the home is run and day to day life conducted. This is in line with the staffs perception of themselves as enablers first and carers second. Monthly Residents meetings where any matters that affect living in or the running of the home are discussed. These could include an individuals conduct to other residents, food, staff and staff attitudes, group activities, and arrangements for special times of Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: the year such as Christmas.No subject is taboo as long as all of the residents agree. There is an expectation in the home that residents take responsibility for keeping the home clean and tidy on a rota basis and to prepare their own meals with assistance if required. Residents are responsible for choosing daily menus. The homes management in recognizing the individuality of residents has enabled each resident to prepared a personal daily menu which reflects their preferences and choices for which they they carry their own shopping. Individuals shopping is stored in personal storage, including individual containers in the fridge. In producing menus staff offer guidance and use colour coded pictures which to assist the building of a balanced meal. Not all residents are able to read. When asked how a particular resident was able to shop unescorted we were showm a system by which the shopping list is produced in pictures which are attached to a key ring arrangement enabling the resident to shop with confidence.This is an excellent example of best practice,those responsible are to be commended. Residents are responsible for choosing and arranging their own social activities with help ,support and encouragement from staff. Residents confirmed they were not forced to participate in any activity unless they wished to do so. The range of activities currently being undertaken include, dining out, trips out, work, advocacy group, pubs, gym, clubs, day services, theatre, bowling, swimming, cinema, art work. Currently Five residents also have jobs four paid and one voluntary. Visitors can also be entertained in the house by individual residents as long as it does not interfere with the others living in the home. We were also informed, residents are also involved in the recruitment of staff. Three or four residents decide with help from a with a member of staff the questions they want to ask the candidates, and then interview the candidate (with the member of staff as a silent observer) after they have been interviewed by the manager. Residents spoken with told us during our visit and in a CSCI pre inspection survey,they liked living in the home ,were treated with respect and could do what they chose. This view was also expressed by a health care professional in response to a CSCI pre inspection survey, when asked to state areas in which the home does well wrote, Involving service users in making decisions and what theyd like for the future this is a view mirrored by a relative who wrote in response to the same question Promoting Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: independence and empowering the clients to learn their life skills and move to independent living. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. Evidence: For most of the time residents are independent with regard to their personal health care needs and only require prompting with regard to personal hygiene. Should assistance is required staff and management informed the inspector this would be delivered in private,this was confirmed by residents who told us they could take care of themselves. Residents informed us were able to see the doctor of their choice or any other health and social care professional when they needed to. The records viewed indicated that apart from doctors, district nurses, physiotherapists, occupational therapists, the local community disability team other specialists would be consulted as required. Records were kept of appointments with GPs, dentist, optician, chiropodist and any other external health and social care professional and included details of any advice Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: and treatment given. All drugs are which securely stored are administered disposed of and recorded in accordance with an in house and corporate medication policy and procedure by trained staff. Records of administration and disposal of unwanted drugs and medicines viewed were complete and accurate. Currently no residents are self-medicating, however, following a detailed risk assessment since the last inspection two residents assumed responsibility for their owm medication. In the first instance the resident reverted at their request to staff administering to them in the second the resident is rather ambivalent and changes their mind from day to day.this situation is being closely monitored. Care Homes for Adults (18-65 years) Page 18 of 29 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. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse. Evidence: The complaints procedure, which is also included in the service users guide included information on how to contact The Commission for Social Care Inspection (CSCI), was seen, as was the record of complaints. No complaints have been received by CSCI since the last inspection. All members of staff spoken with of stated they felt confident in discussing any concerns, complaints with management either in house or external on behalf of any resident and were confident any issues raised would be dealt with promptly and fairly. The homes corporate adult protection policy is works in tandem with the procedure produced by Hampshire County Council, which is based on National Guidelines and the document No Secrets and is designed to safeguard residents from abuse. Management and staff who were spoken with confirmed they had all received training in recognizing various types of abuse, this was confirmed by records viewed. All were able to demonstrate they knew the procedure to follow should they witness or suspect the abuse of any resident. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Care Homes for Adults (18-65 years) Page 20 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. Evidence: The home comprises two large adjacent terrace houses converted into one building which is situated in a residential area within walking distance of Basingstoke town centre, close to shops and communal facilities. A situation residents described as Great. From the outside there is nothing to distinguish the home from its neighbours,there are no discriminatory signs and nothing to indicate it is a care home. Residents told us they liked this ides as they did not wish to be seen as different. All areas of the home were clean and free from unpleasant odours and obvious hazards. Residents who are responsible for the day to day cleaning told us the home is always clean and smells fresh. Furniture was comfortable, homely and in a good state of repair in keeping with the decor and met residents individual and collective needs. All communal areas were accessible by residents including the well-tended established and safe garden. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Residents commented how satisfied they were with the accommodation and how much they liked their rooms. An infection control policy and procedure was in place as were disposal aprons, gloves, antiseptic hand soap.and a washing machine fitted with a high temperature and sluice programme. at the last inspection we highlighted damage and wear at the bottom of a sliding door in the conservatory. This matter has since been attended to. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all service users. Evidence: In our view, with which the residents agreed,was that at the time of the inspection staff numbers and the deployment of staff was sufficient to meet the residents needs. The manager informed us the planned staffing level for the home is two staff at all times at all times during the day and evening and one staff sleeping in at night plus telephone back up for emergencies. She also informed us staffing could could be raised if residents needs increased or a particular days programme required additional staff. As part of this inspection, we viewed three staff recruitment and training files selected at random. All files viewed included evidence that staff are employed in accordance with a robust equal opportunities recruitment, and selection procedure, which is designed to protect Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment, records seen confirmed that all staff are subject to an in house induction and a training programme that include first aid, handling medication, food handling, moving and handling, safeguarding and infection control. Following completion of their induction programme All staff are expected to undertake a National Vocational Qualification N .V. Q.) Course. Information provided by the Manager indicated that 100 of has been trained to at least NVQ level 2, of these one had completed NVQ level 3 and one was on a course leading to a level 3 qualification. Those responsible for this result are to be commended. Care Homes for Adults (18-65 years) Page 24 of 29 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. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. Evidence: From the evidence seen we were satisfied that the service is well managed by the Registered Manager who has a number of years managing services for persons with a learning difficulty and is is qualified to National Vocational Qualification level in care and management at level four. Comments made by residents confirmed they can speak to the manager and all care staff at any time and they are always willing to listen and give them time.This view that was also echoed by the staff who described the manager as available and approachable. staff also that confirmed that there is a clearly defined management structure and that the operate an an open door policy, and encourages them to share any concerns or ideas they have for the betterment of the service. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: It was also evident from our observations that the manager has enthused the highly motivated staff team who were all fully aware of there responsibilities, worked within clear lines of accountability and guidelines and recognized and promoted the ability of the individual residents not the disability. A relative in a CSCI satisfaction survey when describing the staff team staff team said I cant fault the care home or the staff, they provide a very professional service. As part of the homes quality monitoring system, residents residents representatives and health and social care professionals staff and social care professionals are invited to participate in satisfaction surveys in line with comments made following the last inspection. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future development of this service. Following the last inspection a requirement was made that Risk assessments should be carried out to ensure it can be demonstrated that residents are protected from burning from hot surfaces, in particular radiators. Records viewed confirmed a health and safety policy was in place as were records of weekly health and safety checks, the servicing of equipment, staff training in the techniques of moving and handling, first aid, health and safety, the procedures to follow in the event of fire (including evacuation) and accidents. We were informed that the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all hot pipes and where appropriate radiators were covered or risk assessments were in place to protect residents from burning. In view of our observations and risk assessments viewed we were satisfied the previous requirement had been complied with. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!