Inspection on 02/12/08 for 84 Kingsthorpe Grove (Royal Mencap Society)

This inspection was carried out on 2nd December 2008.

CSCI 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

84 Kingsthorpe Grove (Royal... 10/02/07

84 Kingsthorpe Grove (Royal... 09/02/06

84 Kingsthorpe Grove (Royal... 01/02/05

84 Kingsthorpe Grove (Royal... 16/04/04

84 Kingsthorpe Grove (Royal... 03/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 84 Kingsthorpe Grove (Royal Mencap Society) 84 Kingsthorpe Grove Northampton NN2 6NT The quality rating for this care home is: two star good 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: Judith Roan Date: 0 2 1 2 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 33 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 33 Information about the care home Name of care home: Address: 84 Kingsthorpe Grove (Royal Mencap Society) 84 Kingsthorpe Grove Northampton NN2 6NT 01604792845 F/P01604792845 helen.kimber@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: Total number of beds 4 Service User Category Learning Disabilities over 65 years of age (LD) Date of last inspection 1 0 0 2 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home 84 Kingsthorpe Grove, is a terraced property in a residential street and provides personal care, without nursing, for four adults with learning disability. The home is in the style of a large family house, with a bedroom for each service user. There is one ground floor bedroom, with shower. As there is no lift facility, service users do have to be able to safely negotiate stairs to use first floor bedrooms. There is a kitchen diner and a separate communal lounge. Furnishings and decor are to good standard throughout. To the rear of the premises, there is an enclosed garden, with garden furniture and a barbeque. 84 Kingsthorpe Grove is owned and run by the Royal Mencap Society, a national organisation for children and adults with a learning disability. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 33 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced inspection, which took place in the late afternoon and evening. We selected two people who use the service to case track which involved reviewing the care they receive through review of their records, meeting with them and support workers. The inspection also took account of all information received since the date of the last visit and comment cards received. An annual service review was undertaken in March 2008 which did not change our view of the service provided. Care Homes for Adults (18-65 years) Page 7 of 33 A number of safeguarding referrals have been made over the past year. The staff team have managed these well and developed positive strategies in managing behaviours that challenge. Prospective users of the service are advised to contact the office to obtain up-to-date charges. People using the service said I can make my own decisions about what I do I can talk with a member of staff if I am worried or not happy I like living at the home I have my own room which I like I would like to have more staff so I can go out more often Care Homes for Adults (18-65 years) Page 8 of 33 Relatives said My daughter is very happy at the home always ready to go back In general I am quite satisfied with the way my daughter is looked after I feel quite confident and have peace of mind that she is well cared for They are good at assisting people with communication difficulties They keep in touch at all times by phone Staff said We need more staff later in the day to enable more people to access activities I have supervision every six weeks Access to training is good It gives me confidence in supporting the people at the home Health care professional said They ask for advice and use it They put the people using the service first Care Homes for Adults (18-65 years) Page 9 of 33 What the care home does well Kingsthorpe Grove is a warm and friendly home. You will be made welcome during your visit. Bedrooms viewed were clean and pleasant and contained personal items. Support plans are developed with people who use the service. People who use the service are involved with decisions made about the home and in developing their support plans. People using the service are supported to be as independent as possible. Care Homes for Adults (18-65 years) Page 10 of 33 Support workers will assist people in meeting their personal and health care needs. Your privacy will be was respected. Support workers are well trained and have good support. The service is well managed. Care Homes for Adults (18-65 years) Page 11 of 33 What has got better from the last inspection What the care home could do better New regulations in relation to the storage of medication means that the service needs to ensure that they can comply if and when any person using the service has a controlled drug prescribed. Care Homes for Adults (18-65 years) Page 12 of 33 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judith Roan Cambridge Office Capitol Park Fulbourn Cambridge CB21 5XE Tel 01223 771300 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 13 of 33 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 14 of 33 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 admission process ensures that needs are assessed and that people using the service are fully involved within the process. Evidence: Since the last inspection the Statement of Purpose and Service Users Guide have been reviewed and improved to make them more accessible for people who use the service. Three people living at Kingsthorpe Grove have lived at the home since for several years. There has been one admission since the last inspection. An assessment of need was undertaken. In discussion with the acting manager they are concerned that the four people who live together have competing needs and these can impact on their development and overshadow each others needs. Files contain good information that had been gathered as part of the assessment process. This information is updated with ongoing work especially in relation to social Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: and health care needs. People who completed the survey confirmed that they had been consulted about moving into the home and had visited several times before making a choice. A relative said in their survey that the Move to this home from another Mencap home was managed well with their relative being the focus of the decision making. Care Homes for Adults (18-65 years) Page 16 of 33 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 . People using the service can expect that practices within the home promote their involvement and independence. Evidence: Support plans are in place for people using the service. These are being updated to make them person centred and accessible for people using the service. It is evident that they are reviewed on a regular basis. An annual review is undertaken with the funding authority. People using the service meet with their key workers at which time support needs are reviewed to ensure that there is continuous development. People spoken with during the inspection were very positive about living at Kingsthorpe Grove and the support they receive with their personal care. They said that we are happy and that our views on how they are supported were respected. Feedback from families confirmed that overall they pleased with how their son or daughter was being supported. Comments from one relative however felt that there family member was not always dressed appropriately for the weather. In discussion Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: with support workers it was evident they are very knowledgeable about the needs of individuals using the service. They did however confirm that it was not always possible with present staffing levels to meet all of the needs of people using the service outside of the home. This does have impact at times on relationships and increases tensions between individuals. Support plans seen contained strategies for support worker to minimise risks within relationships. Risks within activities are considered on an individual basis and plans made to minimise these for each person. People using the service users are encouraged to be as independent as possible with appropriate support. In this way individuals are included within activities and not excluded because of any behaviour that may arise In observation of practice within the home support was seen to enable people using the service to develop their skills and participate in everyday activities that they previously were not able to achieve. Skills are achieved by the consistent approaches used by support workers. People using the service have access to a wide range of daily living activities. One person was out shopping at the start of them inspection whilst another was encouraged to set the table for tea. Care Homes for Adults (18-65 years) Page 18 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Planned intervention enables and supports people to develop personal skills and take opportunities for social and community activities. Evidence: Each person at the home also attends a day centre during the week. Records of all recreational activities were maintained. Activities taking place included cinemas, clubs, bingo and visiting the pub. Activities do have to be planned and cannot always be spontaneous because of the level of support required by individuals. This was noted in surveys from people using the service and from staff. I wish I had more funding for leisure activities If its not my turn I really get upset More staff during the afternoon to allow for more than one person using the service to go out for activities It was evident that staff enabled residents to maintain links with family and friends. This was confirmed within the relative surveys. Visitors would be were made welcome Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: and people using the service are supported to make phone calls and go out to visit their friends and family. People using the service said that they could choose what to do at the home and that daily routines are flexible to suit their preferences. Support plans recorded individual choices. Menus are prepared on a weekly basis in discussion with people using the service at their weekly meeting. The menu can be changed to reflect changes in the weather or activities. The evening meal served during this inspection appeared appetizing and well presented, the dining area was congenial and people were relaxed. Information provided in the pre inspection questionnaire stated that people using the service are actively encouraged to eat a healthy diet Picture cards are used to enable people using the service to plan their meals for the next week. These are colour coded in accordance with government guidelines e.g. Green means a healthy choice. In discussion with people using the service and staff they felt that the quality of meals provided was good. Care Homes for Adults (18-65 years) Page 20 of 33 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 . A trained staff team ensures that people using the service are supported in meeting their healthcare needs. Evidence: People using the service users are supported to have regular health checks and there is evidence on files that GP, specialist, dentist and optician appointments are made. Personal support is provided in a discreet manner and with individual preferences being a top priority. The support plans are person centred and clearly state how people wish to be supported. Medical profiles have clear information about each persons health care needs. The files contained background information on specific medical conditions that aide support workers understanding of the healthcare needs of people using the service. All people living at the home are supported with medication as the risk would be high to self medicate. A good medication recording system is in place that demonstrates the path of medication coming into the home with safe administration and disposal. The home does not have a controlled drugs cabinet and this needs to be reviewed so that the Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: service would comply with the new regulation that came into force in 2007. All incidents are recorded on file to show how support workers have reviewed practice to minimise future risks. Here necessary individuals have detailed plans that support their healthcare needs. Support workers were found to be fully aware of the details of these plans. People using the service were seen to use their files and were aware of their contents. The community learning disability healthcare team supports the service and provides support when required. Health care professional said that staff seek advice and act on it and to what the service does well People using the service come first Care Homes for Adults (18-65 years) Page 22 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using the service users are protected by policies and practices within the home. Evidence: Information provided in the AQAA and through notifications to CSCI the service has referred eight safeguarding incidents and investigated these. The manager states within the AQAA that Over the last 12 months we have improved the way in which we deal with safe guarding procedures. Unfortunately this is through experience of completing safeguarding forms. Actually dealing with safeguarding incidents has given the staff team a renewed understanding of how important safeguarding procedures are. It is evident within care records that support workers have developed strategies in supporting people using the service to minimise the escalation of behaviours that are disruptive and place others at risk. Records show a significant reduction in incidents. One complaint has been received since the last inspection and this was investigated. The complaint was upheld and resolved. The services complaint procedure is available in a user-friendly format and available to all people using the service. In discussion with people using the service they said that if they had any worries or fears they would tell a support worker or the manager. All support workers receive induction and foundation training, which includes training on the safeguarding of vulnerable adults. Support workers spoken with were aware of the correct procedures to follow. Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: Recruitment processes also protect people using the service as records confirm that Mencap have robust checking procedures for references, criminal record disclosures and Protection of Vunerable Adult checks. Care Homes for Adults (18-65 years) Page 24 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is maintained to a good standard, providing a warm and relaxed environment with good personal and communal space. Evidence: There are adequate rooms to enable everyone to have their own personal space in the large converted dwelling. Individual rooms are personalised, comfortable and well maintained. People using the service are supported in maintaining their rooms to a high standard of cleanliness and safety. The acting manager states in the AQAA that We have a daily task sheet and cleaning is separated in morning and evening tasks, service users are encouraged to be involved with the cleaning when possible, on weekdays this is not always possible in the mornings as service users leave the house by 9:30am, but at weekends they are encouraged to be involved with cleaning tasks. Service users actively take rubbish out to the bins and are aware of how separate items for recycling and need very little support to do this. The home is well maintained and decorated to a good standard. There is a family size kitchen that is large enough for people to be assisted to be part of meal preparations. A large dining area enables people to share meal times in a relaxed and warm environment. Over the past year the following areas have been upgraded and redecorated as confirmed in the AQAA. Over the last 12 months the kitchen and Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: dining room area has been replaced and redecorated. Service users were consulted on what units and worktops they would like for the kitchen Service users were also consulted on what colour they would like the area painted. The communal space provides for individuals to undertake a range of activities within the house. Records demonstrate that health and safety checks are undertaken with people using the service to maintain a safe home. Care Homes for Adults (18-65 years) Page 26 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The trained, competent and supported staff team ensure that the service is professional and meets identified needs of people using the service. Evidence: Recruitment procedures are robust as files seen contained all of the required documentation to confirm that security and employment checks had been undertaken. References and Criminal record Bureau checks were in place. There has been considerable change in the staff team at the service over the past year but the team is strong and have good support from the acting manager. The manager is due to submit her application to CSCI to become the registered manager. New support workers undertake an induction programme and work alongside experienced members of the team to gain full knowledge about the needs of people using the service living at the home. There is evidence of a good communication system within the home by the use of daily task list, the communication book, incident reporting and diary. Support workers are offered a range of opportunities to train. Five of the current staff team of six hold National Vocational Qualifications at level two or above. This exceeds the national Minimum standards. Records confirm that mandatory training is Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: undertaken and that support workers have good access to ongoing training. Supervision is available with the manager meeting with staff on a regular basis. Staff surveys confirmed this fact. The staff team also meet to discuss development and dayto-day management issues. Mencap are introducing Continuous Professional Development and all staff are drawing together portfolios to evidence there training and ongoing development. This is in preparation for registration with the General Social Care Council guidelines. Care Homes for Adults (18-65 years) Page 28 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is effectively managed and ensures that people using the service receive a quality service where their views are respected and their safety is safeguarded. Evidence: The acting manager effectively manages the home in the best interests of people living at the home and the support workers. The AQAA states that as a service provider, Mencap has a Continuous improvement framework that sets out how we promote and assure the quality of service to the people we support. This begins with the way we work with people everyday using person centred planning. We also have clearly defined processes for gaining feedback from service users and stakeholders, meeting our compliances, monthly monitoring visits and annual reviews of the service. People who use the service are regularly consulted on how the service can be improved, minutes from residents meetings demonstrate that the following areas are discussed- food shopping, holidays, activities, going out for meals, health and safety and fire training. Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: Regular visits from the area manager are part of the quality assurance within the organisation. At these visits the continuous improvement plan is reviewed and updated. Individual finances are recorded with two signatures and receipts. Health and safety policies and procedures were clear and accessible for staff and people using the service. Information provided within the pre inspection questionnaire confirmed that the appropriate health and safety checks and maintenance were undertaken. These records were seen at the inspection Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes  No  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 31 of 33 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 Description 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 Description 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 20 New regulations in relation to the storage of medication means that the service needs to ensure that they can comply if and when any person using the service has a controlled drug prescribed Care Homes for Adults (18-65 years) Page 32 of 33 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 © (2009) 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 33 of 33 - 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!