Inspection on 06/07/07 for Balmore Country House Care Home

This inspection was carried out on 6th July 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Balmore Country House Care Home 08/04/09

Balmore Country House Care Home 01/08/08

Balmore Country House Care Home 04/07/06

Balmore Country House Care Home 12/01/06

Balmore Country House Care Home 07/06/05

Balmore Country House Care Home 31/03/05

Balmore Country House Care Home 25/05/04

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

CARE HOMES FOR OLDER PEOPLE Balmore Country House Care Home 245/247 Loughborough Road Ruddington Nottinghamshire NG11 6NY Lead Inspector Karmon Hawley Key Unannounced Inspection 6th July 2007 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 Balmore Country House Care Home DS0000026415.V341220.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. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Balmore Country House Care Home Address 245/247 Loughborough Road Ruddington Nottinghamshire NG11 6NY 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) 01159213006 F/P 01159213006 ruddhomes@talk21.com Ruddington Nursing Homes Limited Vacant Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (4) of places Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Ruddington Nursing Homes Limited is registered to provide accommodation, nursing and personal care at Balmore Country House Care Home for service users of both sexes whose primary needs fall within the following categories: Old age, not falling into any other category (OP) up to a maximum of 50 service users. Physical Disability (PD) up to a maximum of 4 service users. Within the category of Physical Disability (PD), 3 service users may be aged 59 years and above. The maximum number of service users to be accommodated at Balmore Country House Care Home is 50 4th July 2006 2. Date of last inspection Brief Description of the Service: Balmore Country House Care Home provides nursing and personal care for up to 50 older people. Balmore is a converted and extended property set in pleasant and extensive grounds in Ruddington village, near Nottingham. There is a welcoming atmosphere for service users and relatives as well as professionals visiting the home. There are several sitting rooms and a private sun room offering sufficient space for service users. There is a passenger lift providing access to the upper floor and there is access for wheelchairs throughout the home. Regular church services are held within the home and there is also an activities coordinator who provided structured activities. The current fees for the home, which are made available on the point of enquiry are as follows: residential high dependency - shared room £334, single room - £425. Nursing care – shared room £360, single room £525. These fees do not include chiropody or hairdressing fees. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken by an inspector looking at information provided by the acting manager about Balmore Care Home and by undertaking a visit to the service with the inspector using a method called “case tracking.” “Case tracking” involves identifying individual service users who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. The inspector also checked that information provided by the manager matched individual experiences of service users living at the home by talking with them and observing the care received. Eight service users were spoken with, all of them expressed that care was at a good standard and staff were very kind and attentive. General records maintained by the service and staff records were also looked at to ensure these were maintained and provided positive outcomes for service users. What the service does well: What has improved since the last inspection? What they could do better: Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 6 To ensure service users individual needs and preferences are catered for plans of care, risk management and activities require attention. Systems must be in place to ensure the safe administration of medication to ensure service users are protected. Service users must be reassured that staff are available to enable their choices to be maintained and their care needs met. Systems must be in place to ensure all parts of the home are kept clean and reasonably decorated. Continue to develop the quality assurance systems to ensure the home is run in the best interest 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. Balmore Country House Care Home DS0000026415.V341220.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 Balmore Country House Care Home DS0000026415.V341220.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assured that their needs will be assessed and that the service can meet these before they make a decision to move in to the home. The service does not offer intermediate care. EVIDENCE: The acting manager visits prospective service users in the community to carry out a preadmission assessment prior to them moving into the home. Evidence of the assessments taking place was available within service users case files. Service users and relatives may visit the home and spend time there prior to making a decision to move into the home. One service user discussed how the manager had come to see them before they decided to enter the home. The service does not offer intermediate care. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 9 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 is adequate. This judgement has been made using available evidence including a visit to this service. Service users health and personal needs are set out in a plan of care, however these are not personalised to reflect service users preferences, thus detracting from individualised care being received. The medication policies and procedures potentially put service users at risk. EVIDENCE: To ensure that all necessary information is gained about service users they undergo various assessments such as the activities of daily living, manual handling and pressure area care. Information gained forms the plan of care. Plans of care were in place for identified needs, however the majority of these were pre-printed and were not individualised to reflect service users personal needs and preferences. To maintain safety, risk assessments were in place for identified risks, however again these were pre-printed and were not individualised in regards to individual management. Service users spoken with offered the following comments; “staff are very nice and they help me when I need it,” staff make sure I have everything I need,” “it is nice here and I am well looked after” and “staff are very caring and help me to with everything.” Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 10 Staff spoken with were able to discuss service users needs and preferences and how they support them in meeting these. There was evidence available within service users files to show that access to the doctor, district nurse, dentist, dietician and other specialist services are accessed as required ensuring that service users get the help and support they need. Service users were seen to be taking food supplements throughout the visit. During the brief tour of the home specialist equipment such as mattresses and hoists were seen. Two members of staff were observed to move one service user with a hoist; they gained consent from the service user and gave full explanations throughout the procedure. One service user spoken with said that they were very comfortable in their special chair and another said that a speaking clock had been organised from the blind society. Medication policies and procedures were checked. Service users medication records corresponded with the prescription. Hand written entries were signed by two members of staff to show these had been checked as correct. The acting manager said that one service user self-administered insulin which had been drawn up by district nurses, however staff spoken with said that trained staff did this. This was discussed with the acting manager, who said that on occasion this happened but only when service user was not able, she stated that she would discuss this further with the district nurses. There was no risk assessment or mention of this in the service users plan of care to ensure this procedure was carried out safely and in accordance with instruction. Procedures of sharing medication such lactulose (a laxative) and paractetamol (pain relief) takes place, therefore service users individual prescriptions on their medication charts are not checked against the prescription on the medication being administered. Registered nurses have undergone syringe driver training following an incident at the home, however have not updated in any other training, this was discussed with the acting manager who stated that she would look into this. To ensure that service users privacy is maintained, curtains are available in shared rooms. Service users spoken with said, “staff are very nice and respectful, they knock before entering my room” and “staff are very good, they make sure my privacy is upheld.” Staff spoken with discussed how they ensured that service users privacy and dignity were maintained whilst assisting them to meet their needs. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 11 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 adequate. This judgement has been made using available evidence including a visit to this service. Although activities are on offer some service users do not find that the lifestyle within the home is fulfilling and offers enough activity. Service users are enabled to exercise choice and control over their lives, however this could sometimes be restrained due to staff availability. EVIDENCE: There is an activities coordinator employed who delivers activities such as bingo, arts and crafts, trips out, reading and games to service users should they wish to join in. The responses from service users about activities were varied, three stated that although there is not much to do they were happy to just sit and relax, whereas two service users wished that there were more to do to occupy their time. One service user said that they enjoyed the activities on offer and looked forward to a daily walk out with a member of staff when there was someone available. There were photographs on display showing service users on the previous boat trip, enjoying a musical event and a party. The routine of the home was described as being flexible and service users may spend their time as they wish, however one service user who agreed with this felt that there were not enough staff available to facilitate this fully. Staff spoken with felt that sufficient activities were on offer and also that staff were Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 12 available as far as reasonable able to ensure choices are facilitated. There are church services on offer within the home, which are Church of England and Methodist; the acting manager said that arrangements would be made should a service user require any other services. To enable service users to maintain contacts with relevant others there are no restrictions imposed upon visiting, however the acting manager said that it was requested that visitors avoid meal times. One service user said “my family are always made welcome and I can entertain them in my room if I want,” and another agreed that family and friends are always made welcome. Regular visitors have access to the door code; several visitors were seen to gain access throughout the day. Equality and diversity issues were discussed with the acting manager, as this had been highlighted as currently not applicable on the forms returned to the CSCI. It was explained that each individual has this right and how this could be fully incorporated into the way the home worked. It was then felt by the acting manger that this is being done in the home, however had not been recognised as promoting equality and diversity. Staff spoken with had a good understanding of ensuring service users rights and choices are maintained whilst showing respect at all times and discussed how they ensured this was delivered. One service user said, “staff are very nice, they listen to me and I can make my own choices.” Another discussed how they have been able to maintain their relationship with their spouse who now lives at the home with them. A wholesome and appealing diet was on offer, with choices available at each meal. Service users spoken with all said the food delivered was at a good standard, however two were not aware that choices were available, this was discussed with the acting manager who said that staff go round the day before and ask what service users want. One service user said that drinks and snacks were available at anytime of the day, you could just ask and they would be brought to you. Staff were observed to assist service users appropriately during the lunch time meal and one member of staff was seen to take time to ensure a service user was assisted to take fluids. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 13 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 and18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and relevant others are assured that staff will listen to any concerns they may have and will act upon them to ensure they are resolved. A competent staff team and policies and procedures are in place to ensure that service users are protected from abuse. EVIDENCE: There have been three complaints received by the home since the previous inspection and two concerns to the CSCI. These were in regards to standards of care, access to information, communication with staff and access to specialist services. These had been responded to by the service and all but one has been resolved. The remainder is currently being investigated. Service users spoken with said that they were very happy in the home, felt settled and that they could approach staff if they were unhappy. Two service users said they had no cause to complain but would do so if necessary. Staff spoken with were able to discuss how they would deal with a complaint should it be received. To ensure service users are protected staff have received training in the protection of vulnerable adults, two members of staff spoken with confirmed this. Staff spoken with were able to discuss how they would respond to abuse should it occur. Two service users spoken with said that they felt comfortable and safe at the home. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 14 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home is generally well maintained the damaged woodwork in doorways, the offensive odour and dirty chairs and tables detract from ensuring a comfortable environment for service users and their visitors. EVIDENCE: Ongoing maintaince and refurbishment is taking place, however several areas of the home were in need of attention such as doorways and walls where wheelchairs had scraped along. CCTV has now been installed into the home ensuring that service users are protected from intruders. One service user discussed how they had a nice room and they had been able to bring in their own belongings to make this more personalised. During the tour of the home an offensive odour was present in the main lounge and hall outside this room, the acting manger said that carpets had been cleaned, however the odour remained. In the small sitting room chairs were Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 15 dirty with dried food and stains, service users side tables were also dirty with dried food. One service user said that the home was always kept nice and clean. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 16 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 adequate. This judgement has been made using available evidence including a visit to this service. Although the duty rotas show that sufficient staff are available to meet service users needs, service users need to be reassured that they are available when needed. Service users are supported by a competent and trained staff team. EVIDENCE: The staff duty rotas showed that two registered nurses are on duty throughout the day and one during the night, in addition to this there are 6 care assistants during the morning, five during the afternoon and three during the night. Service users spoken with gave various responses, “staff are very nice but they are also very busy,” “they do not answer my buzzer very quickly,” “there are not enough staff to help us all to go to the toilet when we need to.” “Staff are ok if you can find them,” “staff are very busy but we are well looked after.” Staff spoken with felt that sufficient staff were available to meet service users needs. To ensure new staff members learn about the service’s policies and procedures and service users needs they undergo an induction. One member of staff spoken with confirmed that they had undertaken this training. Six members of staff have undertaken a national vocational qualification (a nationally recognised work and theory based qualification) level 2 in care and three are Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 17 working towards completing this qualification. One member of staff said that they had undertaken this training and one said they are just starting it. Four staff files were seen all contained the required documentation such as a criminal record bureau check (a police check to see if an individual has a police caution or criminal record) references and proof of identity. Staff training continues to ensure staff are able to meet service users needs. Staff spoken with explained that regular workshops are also held where specialist training such as care of service users with diabetes. There was written evidence available to show that further training has been arranged. One service user spoken with said, “staff are well trained to meet my needs and they work hard.” Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 18 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): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The acting manager requires time to settle into her role and to undergo the fit person process with the CSCI to ensure the home is run and managed by a person who is fit to be in charge. Developments are taking place to ensure service users have more say on the way the home is run and managed. EVIDENCE: The acting manager was previously the deputy manager at the home, a position she held for three years, and therefore she feels that she has a good insight into the management and running of the home. She has applied to the commission for social care inspection to become the registered manager and has also commenced the registered managers award (a nationally recognised work and theory based qualification). Staff spoken with expressed that the Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 19 acting manager was approachable and supportive. One service user spoken with said “the person in charge is very nice and often has a chat with me to see how I feel.” The acting manager is currently working on developing the service’s quality assurance systems to ensure that the service is run in the best interests of service users. Whilst waiting for questionnaires to be devised she has spoken with each service user and logged their views about the service. Views such as “where would I be if I wasn’t here,” “its as near as you can get to home from home,” “I enjoy the chats and activities on offer.” To ensure relatives are also involved in the running of the home regular meetings are held. A general legal advisor has been employed by the service to work with the management and staffing standards to ensure these meet the national minimum standards. The home is not responsible for service users money. Should a service user incur any costs they or relatives are invoiced for this. The home produced documentation outlining how health and safety is managed within the home. The hoists’ maintaince certificate was seen which showed that these had been serviced on a regular basis ensuring they were in good working order. A health and safety officer has been employed who will be delivering training within the home. Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12(2) 15(1) Requirement Plans of care must be individualised to reflect service users personal needs and preferences, thus ensuring these are fully met. This is outstanding since the previous inspection and must be complied with. Systems must be in place to ensure service users are protected from individual risks to ensure they are safe. Systems must be in place to ensure the safe administration of medication to ensure service users are protected. This is an outstanding requirement since the previous inspection and must be complied with. Systems must be in place to ensure service users have the opportunity to carry out activities of their choosing to ensure they lead a fulfilling life. Service users must be reassured that staff are available to enable their choices to be maintained and their care needs met. Systems must be in place to DS0000026415.V341220.R01.S.doc Timescale for action 07/08/07 2 OP7 13(4,c) 07/08/07 3 OP9 13(2) 07/08/07 4 OP12 12(1,a) 07/09/07 5 OP27 12(3) 18(1,a) 23(2,d) 07/09/07 6 OP19 20/08/07 Page 22 Balmore Country House Care Home Version 5.2 OP26 7 OP33 24(1,a,b) ensure all parts of the home are kept clean and reasonably decorated. Continue to develop the quality assurance systems to ensure the home is run in the best interest 07/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Balmore Country House Care Home DS0000026415.V341220.R01.S.doc Version 5.2 Page 24 - 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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