Inspection on 01/12/06 for Benthorn Lodge

This inspection was carried out on 1st December 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

Benthorn Lodge 29/09/09

Benthorn Lodge 03/09/08

Benthorn Lodge 14/03/08

Benthorn Lodge 27/11/07

Benthorn Lodge 13/02/06

Benthorn Lodge 12/07/05

Benthorn Lodge 27/01/05

Benthorn Lodge 10/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Benthorn Lodge 48 Wellingborough Road Finedon Northants NN9 5JS Lead Inspector Mrs Linda Preen Unannounced Inspection 1st December 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 Benthorn Lodge DS0000012705.V314613.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. Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Benthorn Lodge Address 48 Wellingborough Road Finedon Northants NN9 5JS 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) 01933 682057 Mr Frank Bennett Mrs Pam Bennett Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (4) of places Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home will limit its services to the following service user categories: No person falling within the category Older Persons (OP) can be admitted where there are already 4 persons of category OP in the home. No person falling within the category DE (E) can be admitted where there are 18 persons in the category DE (E) already in the home. The total number of service users in the Home must not exceed 18. 2. 3. Date of last inspection 13th February 2006 Brief Description of the Service: Benthorn Lodge is a home providing personal care and support for 18 Older People, by reason of old age and dementia. Community health care professionals meet health care needs. The home is situated on a main road leading into the centre of Finedon and is within easy access of public transport and local shops. The home comprises of a three-storey building of which the first two floors are used for resident’s accommodation. The original frontage of the house has been retained so that the home blends in with others in the road. There is off road parking at the side of the house, and a small paved garden to the front, which is accessible for residents. Accommodation is provided in both single and shared rooms, one of the single rooms has en suite facilities. Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for residents, and upon their views of the service provided. Two hours were spent prior to the inspection reviewing previous requirements and recommendations The Commission sent comment cards out to a random selection of residents and to General Practices providing a service to the home, but none of these were returned. The primary method of inspection used was ‘case tracking’ which involved selecting 3 residents and tracking the care they receive through review of their records, discussions with them, and with the care staff, and observations of care practices. The inspection took place during a weekday over a period of 4.5 hours and was carried out on an unannounced basis. Communal areas, and some bedrooms were visited. A selection of care records, and essential records of the home were reviewed. A number of the residents were spoken to as part of the inspection process, as well as resident’s relatives. What the service does well: What has improved since the last inspection? Staff have received training in the local reporting systems in place for the Safeguarding of Adults from abuse. Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 6 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. Benthorn Lodge DS0000012705.V314613.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 Benthorn Lodge DS0000012705.V314613.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Comprehensive assessments are completed prior to residents being admitted to the home in order that they may be assured that their needs may be met in the home. EVIDENCE: Copies of needs assessments completed by the care management team and also staff from the home were seen on the files checked. This assessment included records of resident choices and likes and dislikes. Benthorn Lodge DS0000012705.V314613.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. Insufficient guidance is provided in order for staff to meet resident’s assessed needs. Care is not always provided in accordance with the care plan in place. EVIDENCE: All residents are registered with a local General Practitioner and any appointments are recorded. There is evidence, in the files that advice and input is sought from relevant specialists, these have included psychiatry, audiology. optician and community nurse input. Residents have detailed care plans in place to instruct staff how to meet their physical needs but no plans are in place to guide staff as to how their mental health needs may be met. As the majority of residents in the home have some degree of dementia, this raises concerns that their needs are not being met. Staff on duty stated that they had all undergone dementia training but there was no evidence that this training had been put into practice. There was no evidence that residents were enabled to use the skills remaining or to maintain any level of independence. Advice was given concerning the formulation of Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 10 person centred care plans to address this issue. A requirement was made in this respect. Although detailed care plans are in place in order to guide staff concerning resident needs, these plans are not always put into action. For example one resident with a diagnosis of dementia was sitting in the lounge and not interacting with staff or her fellow residents. Her care plan stated that she needed to wear hearing aids in both ears and also that she had had an optician appointment for new spectacles. It was observed that she was not wearing either of these aids, which obviously would make her communication even more difficult, and would not help with her confusion. A requirement was made in this respect. One resident was being cared for in bed and staff stated that she had been assessed as requiring nursing care and that she was awaiting a suitable placement. Community nurses were directing her care in the interim. This lady was reported to have a pressure ulcer on her sacrum and had been provided with an alternating pressure mattress to help prevent any further breakdown. She was being nursed on a hospital type bed that had been supplied by Medical Loans. This bed had been supplied with ill-fitting bedrails and no padding to prevent the resident from becoming entrapped. There was no risk assessment or consent in place for this form of restraint and the senior carer on duty appeared unaware of the risks associated with the use of bedrails. She placed temporary padding on the rails when this was brought to her attention. A requirement was made in this respect. Concerns had been raised by the community nurses and a General Practitioner about the level of physical care provided to residents who are nursed in bed when their physical condition deteriorates. This resident appeared comfortable, clean and well groomed at the time of inspection. Records of her food and fluid intake were seen, and these demonstrated that her fluid intake was adequate. There were however no records kept demonstrating that the required two hourly changes of position were being carried out. Staff confirmed that this was being done during the daytime, but not at night, as there is only one member of staff on duty at night with a second sleeping in the building in case of emergencies. Staff were advised that her transfer to a nursing home must be expediated as they were unable to meet her needs. A requirement was made in this respect. A relative spoken to stated that she visited frequently and although the general care was satisfactory, care was not always taken with details. For example her relative always drank from a china cup and saucer prior to admission and although this had been brought to the homes attention on admission, no attempt was made to provide for this simple request and she was given the same Pyrex mug as everyone else. Her relative was always clean and neatly dressed but staff made no attempt to co-ordinate her clothes. This was very important to her, as she had always taken a pride in her appearance. (This Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 11 visitor had come to wash and set her hair and manicure her nails at the time of the inspection). Systems for the ordering, administration, recording and disposal of medication were seen and found to be satisfactory with the exception of the administration of antibiotics which were being given during the daytime hours only and not at evenly spaced intervals throughout the 24 hour period. Instructions concerning this from the pharmacy were ambiguous as they stated that they should be given evenly spaced throughout the day. Staff were advised of the reasons for the twenty-four hour spacing and agreed to do this in future. A recommendation was made in this respect. Benthorn Lodge DS0000012705.V314613.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Social Activities and meals are both well managed, creative and provide daily interest and variation for people living in the home. EVIDENCE: Residents were observed to be sitting in one of three lounges provided or in their own rooms according to individual choice. An activity co-ordinator is employed at the home and organises group and individual activities according to resident’s capabilities. Records are kept of activities offered and of individual participation in these activities. Residents are encouraged to take part in the local community, with some attending the local over sixties club, one man going to watch the local football teams and records of some residents attending the cenotaph for the Remembrance Service. Photographs were available of parties and activities arranged to celebrate special occasions and residents had been involved in making cards in preparation for Christmas. A Christmas party for residents and their relatives was planned for the week following the inspection. Residents were involved in board games and Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 13 dominoes during the inspection, and choice was offered concerning their participation in these activities. The menu for the day is on display outside the kitchen and lunch both looked and smelled appetising. A recent environmental health officer visit had made some requirements and the cook was able to demonstrate that these had been complied with. Visitors can visit at any reasonable time, and residents can receive visitors in the privacy of their own room. One visitor said that he spent three days a week with his wife and that the staff made him very welcome, arranging for them to eat lunch and tea together. He confirmed that he and his family had been invited to attend the Christmas party and that he was very happy with the care provided. Benthorn Lodge DS0000012705.V314613.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents and relatives have access to the complaints procedure. Staff are trained to protect residents from potential abuse. EVIDENCE: A copy of the complaints procedure is displayed in the home. As stated above The Commission had received one concern for Social Care Inspection from the community nursing team and a General Practitioner about the level of care provided to residents nursed in bed and the administration of antibiotics. This concern was partially founded and the requirements were made to address the issues. Staff training records were not available on this occasion, but those spoken to confirmed that they were aware of abuse issues and their responsibility in reporting any suspicions. Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. Attention is required to some areas of the home where the standard of décor and maintenance is inadequate. No environmental adaptations are provided to meet the specialist needs of the resident group. EVIDENCE: A limited tour of the home was undertaken. The lounges on the ground and top floors were decorated in a homely manner, and were clean and tidy. However, the lounge on the middle floor was in a poor state of repair and decoration. Wall-paper was hanging from the ceiling and there was a dark stain around the light fitting, possibly indicating an old water leak. The carpet in this room was extremely dirty and badly stained. A television set in the corner was switched on but residents were unable to watch it even if they wished to owing to the very poor picture reception. Resident’s rooms seen were well decorated in a modern manner, but maintenance in these rooms was also poor. For example one bedside locker Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 16 had the door hanging off the hinges in one room, another room had a hole in the carpet by the entrance, causing a trip hazard, a radiator cover was propped up by a plant pot to prevent it falling off. The overhead light in this room was also not working and the resident had to manage with a bedside lamp. This was obviously of concern to her as she repeatedly asked her visitor if she could see all right as it was dark. There were no environmental adaptations for those residents with a diagnosis of dementia and no signage to help them find their way round the home in order to maximise their independence. This was particularly noticeable regarding bathrooms and toilets, which were completely unmarked, so that the only way to discover their function was to open the door. One toilet on the ground floor had an “out of order” sign. In discussion, it became apparent that this had been the case for several weeks. A cleaner is employed in the home, but standards of hygiene are limited by the lack of toilet paper, hand towels and soap in toilets. These were available and supplied when requested but not replenished automatically. Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, and 30 Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. The company has a commitment to staff training. Staffing levels are not based on the needs of the residents. EVIDENCE: The pre- inspection questionnaire sent to the provider had not been returned and staff files and training records were not available owing to the Registered Manager’s absence. It was therefore not possible to monitor recruitment practices on this occasion and this will be covered at the next inspection. Staff spoken to stated that new staff work alongside an experienced member of staff until they have learnt the routines of the home and that they undergo a formal induction programme. The senior carer on duty stated that three senior carers are currently working towards a National Vocational Qualification at level 4 and that five other staff have completed level 3 with two more waiting to be assessed at this level. The remaining staff are due to begin work towards level 2 in the next week. This ensures that all staff are trained in meeting the care needs of residents. In addition to this, it was reported that all staff had completed dementia training. Given this reported level of training, it is of concern that the poor care practice recorded earlier in the report was found and that staff are obviously not putting their training into practice. Staffing levels in the daytime appear adequate to meet resident needs but as previously stated, there is only one waking member of staff at night, making it Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 18 impossible to fully meet the needs of physically frail residents at night. A requirement was made in this respect. An equal opportunities policy is in place with staff from both sexes with a range of ethnic backgrounds, religions and age groups being employed. Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38. Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. In the absence of the Registered Manager, the home lacks direction. The lack of quality assurance systems has contributed to the falling standard within the home. EVIDENCE: The Registered Manager/Provider is unable to run the home at present owing to personal circumstances and has designated three senior care staff to run the home in her absence. She does however visit the home on most days to offer advice. None of these carers has management experience and although they demonstrate keenness to do their best and are willing to take advice, the home is therefore suffering from lack of direction. Advice was given concerning record keeping within the home and staff undertook to ensure that all records were dated and signed in full and that no Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 20 gaps were left between entries, in order that they could demonstrate their continuity. A system of regular staff supervision is in place, with the senior staff supervising juniors on a two monthly basis. Resident personal money accounts are dealt with by the Registered Manager and were therefore not available for inspection. Records of the testing of fire alarms and emergency lighting were seen and found to be satisfactory. It was reported that staff fire training is now up to date, with the last group receiving updates on the previous night. There was no evidence of Quality Assurance systems being in place. Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 21 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X 2 3 2 2 2 STAFFING Standard No Score 27 2 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 3 2 3 Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Residents with a diagnosis of dementia must have care plans formulated to instruct staff on how to meet their mental health and emotional needs. Residents who have been assessed as requiring communication aids, must have these in place during the day. Risk assessments must be in place for all residents using bedrails and be regularly reviewed. Consent for this restraint must be signed by the resident or their advocate. Bedrails, where fitted, must be padded to prevent residents becoming entrapped in the rails and these rails must be suitable for the bed provided and securely fixed. The resident assessed as requiring 24 hour nursing care must be moved to a home suited to meet her needs throughout the 24 hour period. Staffing levels in the home must be adequate to meet resident’s assessed needs and must be DS0000012705.V314613.R01.S.doc Timescale for action 01/01/07 2 OP8 12(1)a 24/12/06 3 OP8 12(1)a and 13(8) 01/01/07 4 OP8 12(1)a 01/01/07 5 OP8 12(1)a 01/01/07 6 OP27 18(1)a 01/01/07 Benthorn Lodge Version 5.2 Page 23 7 8 OP19 OP19 23(2)b 23(2)b 9 OP38 8(1)b adjusted as these needs change. Attention must be paid to the poor state of décor in the first floor lounge. A planned maintenance programme must be drawn up to address the other maintenance issues highlighted and this plan must be sent to the Commission for Social Care Inspection. Management arrangements must be in place to ensure that the home is adequately managed during the Registered Manager/provider’s absence. 01/02/07 14/01/07 01/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP14 OP14 OP9 Good Practice Recommendations Staff should be reminded of the need to maintain resident dignity in relation to their appearance. Efforts should be made to comply with resident choice. (This refers to the type of drinking vessel). All staff with a responsibility for administering medication should be made aware of the need for this to be given evenly spaced throughout the 24 hour period and not just in daytime hours. Hand washing facilities must be available in all bathrooms and toilets. Environmental adaptations and signage should be available to enable residents with a diagnosis of dementia to maintain their independence as long as possible. A quality Assurance system based on seeking the views of residents or their advocate should be in place. 4 5 6 OP26 OP4 OP33 Benthorn Lodge DS0000012705.V314613.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Benthorn Lodge DS0000012705.V314613.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. 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