Inspection on 30/10/06 for Abbotsfield Residential Care Home

This inspection was carried out on 30th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Abbotsfield Residential Care Home 13/02/06

Abbotsfield Residential Care Home 27/09/05

Abbotsfield Residential Care Home 05/01/05

Abbotsfield Residential Care Home 02/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Abbotsfield Residential Care Home 373 Abbey Road Barrow-in-furness Cumbria LA13 9JS Lead Inspector Marian Whittam Unannounced Inspection 30th October 2006 10:00 X10015.doc Version 1.40 Page 1 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 Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 2 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery 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. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbotsfield Residential Care Home Address 373 Abbey Road Barrow-in-furness Cumbria LA13 9JS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01229 829496 Mr Jayendra J Patel Mrs Lata Jayendra Patel Vacant Care Home 30 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (30) of places Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 30 older people (OP) of whom 5 may have dementia (DE(E)). 13th February 2006 Date of last inspection Brief Description of the Service: Abbotsfield is a care home registered to provide care for thirty older people, five of whom may have dementia. The home is a detached Victorian property with a modern extension and has been owned by Mr. Jayendra Patel and Mrs Lata Jayendra Patel since 1996. The home is in a residential area on the outskirts of Barrow in Furness about a mile from the town centre, the shops, banks and general amenities. There is good access by road into the surrounding areas and the home is on a bus route to Barrow and the surrounding towns. The home has well kept gardens that residents use and this has appropriate seating. There is a small car park for visitors and staff at the side of the building. The home has 3 sitting/dining rooms for service users on the ground floor and a lounge on the first floor used largely by residents for family meetings and privacy. The home has kitchen and laundry facilities on site. There is a main stair lift and two smaller chair lifts within the home linking the floors. Fees payable at the home are £363.00 to £422.00 a week as at 31st October 2006. There are additional charges for hairdressing and private chiropody, personal toiletries, papers and magazines, personal travel and some entertainment The home makes information about its services available through its service user guide and statement of purpose. These are available from the home. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on 30th October 2006. The inspector looked around the home and spoke with the manager, residents and with staff members. Staff recruitment records, training records, medication handling records and care plans were examined and a selection of records required by regulation. The provider gave information about the home and its services, asked for by the Commission for Social Care Inspection (CSCI), before the inspection took place. Before the visit information was also gathered on the service from records of previous visits, notifications and other regulatory activity. All areas of the home were seen and ten residents were happy to talk about their life in the home. What the service does well: What has improved since the last inspection? Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 6 The owner plans ahead for improvements and bedrooms are being redecorated and improved as part of that plan and as occupancy allows. A new kitchen has recently been installed to upgrade the catering facilities. New stainless steel work surfaces, sinks, units, shelves and splash backs have been fitted and a new extraction system. This greatly improves the facilities for preparing residents meals. The home has also recently installed a new call bell system to improve the facilities for residents to call for assistance throughout the home, should they need it Since the last inspection the home has put in place resident photographs to make systems safer for resident identification when medicines are being given out. Also pre admission assessments are being consistently signed and dated by the person carrying them out. 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. The summary of this inspection report can be made available in other formats on request. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre admission assessments done by the home are detailed to ensure individual needs will be met on admission. EVIDENCE: The home’s admission process includes a pre admission assessment of individual needs for residents before and at admission to the home. There are trial periods for new residents, during which time the homes assessment is continued to see that needs are being met. Information is gathered from other agencies and where appropriate a social services management plan is obtained and held on file for information. Where appropriate families, other specialised care agencies and professionals are being involved in providing information on the health and personal needs to be met for residents. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 9 All prospective residents and their families are encouraged to visit the home prior to admission. This gives them an opportunity to assess the quality and suitability of the home. The assessment records and written evidence of consultation with families suggests that the home takes care to make sure that the number of residents admitted with higher levels of dependency does not get too high and affect the care and support given to the other more able residents. The homes Statement of purpose has been updated to reflect changes and is available in the home. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area good, This judgement has been made using available evidence including a visit to this service. There is a care planning and assessment system in place to provide information for staff to meet resident’s individual health, personal and social care needs. EVIDENCE: All residents have an individual plan of care and personal and clinical risk assessments setting out their health, personal and social care needs. The care plans are being reviewed regularly and any changes identified on evaluation and/or following medical visits are included in the care plans and needs assessments. This provides an up to date plan and action needed for staff to work from. There is evidence in care plan records and from resident comments of prompt referral to health care and support services and good working with other agencies such as the intermediate support team. There is evidence from observation, speaking with residents and from their care plans that residents are involved in making choices about their care. Residents confirmed that their Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 11 opinions are sought about their personal care and life in the home generally and say they feel their privacy and dignity is being respected. Medication practices, the storage of medicines and their handling is of a good standard. Staff have been given training on safe administration. The home keeps records of medicines it receives from and returns to the pharmacy. However the home should try to make sure, as a good practice measure, that when doctors make change to the medicines charts that they sign this. If this is not possible any changes written by hand on the chart by care staff should be checked and signed by a second person to promote accuracy and reduce the risk of error. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides social and leisure activities within the home and outside and there is variety and choice in the food on offer to residents. EVIDENCE: All of the residents spoken with like the food provided, one said it was “perfect” and another that they “enjoyed all their meals”. Residents say that there is a choice of food at meal times and there are alternatives to the main menu on display. They say that if they do not want what is on the main menu they can have something else. The menus and other daily information are displayed on the notice board in the main foyer. Residents say that staff generally remind them about what is planned. All spoken with agreed there is a choice of food each day and that there is plenty to eat and drink and that they enjoy their meals. The menus and records of food served show a varied and nutritious diet that catered for special dietary needs. The lunchtime meal of fish pie and vegetables was well presented and assistance given discreetly to residents who needed it. A salad is also available as an alternative on the menu; there is a choice of sweet and Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 13 hot and cold drinks offered with the meal. Some residents choose to eat in their bedrooms, others preferred to use the dining room. The lunchtime meal was observed to be a relaxed and unhurried occasion with residents chatting and taking time over their meal. The owner has recently installed a new kitchen that has greatly improved the kitchen facilities for the preparation of resident’s meals. The home provides some regular activities and organises social and religious events. Carers take the lead from residents on what they want to do on different days and routines are flexible. Residents talked about the musical entertainments provided from outside and within the local community. Residents told the inspector about what they enjoyed doing as part of the activities, such as playing bingo, chair exercises, going out for bar meals, having musical entertainers come to the home and going out for walks with staff and shopping. Individual interests are recorded and activities taken part in recorded including religious needs. Residents told the inspectors that they could chose to take part or not as they wanted and come and go with family and friends as they please as long as staff are aware. Some residents went out into the local community to local pensioners clubs for bingo and social occasions. Staff help residents with individual and group activities and support them with their individual interests. Ideas for Christmas activities were being discussed on the day of the visit and it was agreed that a brass band, which has visited before, should be booked. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints system that residents have confidence in and there are procedures in place to protect residents. EVIDENCE: The home has a complaints procedure that is displayed in the home and complaints received are logged for investigation and the outcomes and actions taken are recorded. The home has not received any written complaints since the last inspection. Residents spoken with are confident that the manager and the owner will deal with any complaints or suggestions they make. They say that the manager and owner are “about every day” and they have a chat and that the manager’s door is always open. If anything is bothering them they could tell them any time. Residents spoken with are aware how to make a complaint. One resident, who was sat in a group in one lounge, said, that they have nothing to complain about and that it is “a very nice place to live”. There are procedures in place to protect vulnerable adults from abuse and whistle blowing procedures. Current multi agency guidance is displayed and available for all staff and these were available for staff in the home. Staff have Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 15 attended training on adult protection and this is updated annually to keep up with good practice. The home has procedures in place for dealing with verbal and physical aggression and for handling gifts to staff. Staff spoken with are clear about how they would approach suspicions or allegations of abuse and what they would do to make sure residents are protected and safe. Information on getting an advocate to help them is available for residents and useful contact numbers and people who can offer advice and support outside the home. The home holds only small amounts of daily spending money on resident’s behalf. All personal monies are recorded, receipts kept and totals checked are correct. Social services or other personal and legal representatives would be contacted for any extra funds if residents wanted them. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 23, 24, 25 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The environment in the home is, clean, warm and homely with a good standard of decoration and there is regular maintenance and refurbishment to give residents a safe and comfortable home. EVIDENCE: The home is being well maintained with regular, planned maintenance and a good standard of décor throughout that provides a clean, tidy and homely environment for residents. Residents and relatives spoken with say that the home is always “clean” and “cosy”. The lounge and dining areas are comfortable and well furnished with good lighting. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 17 Outside the garden areas are attractive, well kept and have some seating for residents. Several residents say that they use the garden a lot in the summer months, and enjoy this. Resident’s bedrooms that were seen have a satisfactory standard of décor and furnishings. Many residents have brought into their rooms personal possessions and items of importance to them. This helps make the bedrooms more personal and homely for the residents living there. A new resident spoken with has done this and said that they were “very happy” with their bedroom. Some residents have items of special significance such as photographs, important names and places displayed in their rooms to help them recall and relate to them in their lives. The home does have some shared rooms, with residents making a choice to share them. These rooms have screening to aid privacy. The home has policies and procedures for infection control and good practice seen in the use of protective clothing. The home has a laundry assistant, and the laundry facilities although small are satisfactory. There are systems in place to test water temperatures to prevent risks from Legionella and to minimise the risk of scalds. There is a well equipped sluice and disinfector away from resident areas. There is a range of bathing equipment, moving and handling equipment and adaptations in the home including a stair lift to help residents make the most of their independence and to get about the home. The home has recently installed a new call bell system to make sure residents can always summon assistance throughout the home. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient care staff on duty day and night to meet resident’s needs. There are training programmes and recruitment procedures in place to help safeguard residents. EVIDENCE: Staff rotas and observation of staff deployment during the visit indicate that the home has a stable staff group providing continuity of care for residents. There is generally very little staff turnover with some long serving staff members. There are enough staff on duty to provide care during the day and night and more staff at busier periods. Domestic and laundry staff are employed in sufficient numbers and keep the home clean. The home has a full time cook. Staff spoken with enjoy their work and morale among the staff team is good. Staff say they feel supported and valued in their work. All staff spoken with felt that if they had any problems in their work the management would act quickly to support them and sort out problems early. Records of formal supervision indicate that this is the case. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 19 Residents say that the home has a friendly atmosphere and there is “good company”. All spoken with spoke well of the staff and one newer resident felt the staff’s kindness and patience has helped them to settle in quickly. One resident felt the staff have “the patience of Job” and another that the staff take very good care of them and they now “just lounge around being waited on”. There is a good rapport between staff and residents and a lot of such lighthearted banter. The home has recruitment procedures reflecting equal opportunities. There are records of the Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks within the home for all new members of staff and suitable references and information obtained. The General Social Care Council codes of conduct and practice are available in the home and given to staff. Records are kept of training attended by staff including inductions taking place in the home. Training is given a high priority in the home and it has good links with local health care professionals who provide relevant additional training for them as well. NVQ level 2 training is underway and well established for care staff and is above the 50 level. The acting manager is implementing a new system for recording and planning training to make it clearer and more individualised. Staff spoken with felt they are well supported to undertake training and further qualifications and are well motivated to take on training. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33,35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to safeguard resident’s financial interests and promote their health, welfare and safety. EVIDENCE: The home is without a registered manager after its long serving manager left earlier this year. After a period with a temporary manager the owner now has firm long term plans to maintain stability in the future management of the home. This involves both the owner and current deputy manager doing the Registered Managers Award/ NVQ level 4. The owner is finding the course of great value in helping to find ways to improve and develop the service further for residents. The deputy is also gaining a greater understanding of the management role as part of this professional development, working with and Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 21 supported by the owner, who is applying to register as manager with CSCI. Staff say the new management system is working well as the owner was already very involved in the daily running of the home and the deputy already knows the home’s systems, residents and staff well. Residents spoken to say their views and opinions were asked for and acted upon to affect the way the home is run and the things they do and take part in. There are residents meeting and minutes kept and matters are also discussed informally as residents raise them, such as the Christmas activities. The home is introducing a system for an annual audit building on its system of surveys to gather opinions on the service. The home monitors its practices but should make sure that it includes in its quality assurance a regular review of all its policies and procedures to make sure they reflect any changes in the law and best practice advice. Staff have their own meetings with an agenda to staff in advance for their items and minutes are kept of the topics discussed. Comments from staff indicate a supportive working environment where staff feel valued and get satisfaction from their work. Supervision is being given to staff and staff are monitored and supported in their roles. Any needs identified at supervision are recorded for action. Records and servicing contracts indicate that the home has systems, training and practices to promote resident health and safety. Records show that servicing and maintenance of equipment is being done as needed. Staff have been given fire training and appropriate training on moving and handling. Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 3 X 3 Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations For good practice, when changes to the medicines charts are made, and they are re written by hand, they should be checked and signed by a second person to promote accuracy and reduce the risk of errors. The home should make sure that policies and procedures and practices are reviewed regularly to reflect any changes in legislation and good practice advice. 2. OP33 Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 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 © 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 Abbotsfield Residential Care Home DS0000022579.V314739.R01.S.doc Version 5.2 Page 25 - 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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