Inspection on 08/12/05 for Blackburn Drive, 13

This inspection was carried out on 8th December 2005.

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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blackburn Drive, 13 10/06/08

Blackburn Drive, 13 24/07/07

Blackburn Drive, 13 22/05/06

Blackburn Drive, 13 21/03/06

Blackburn Drive, 13 15/11/04

Blackburn Drive, 13 27/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Blackburn Drive, 13 13 Blackburn Drive Halewood Liverpool Merseyside L25 0QF Lead Inspector Ms Lorraine Farrar Unannounced Inspection 8th December 2005 12:05 Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 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 Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 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 Adults 18-65. 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. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Blackburn Drive, 13 Address 13 Blackburn Drive Halewood Liverpool Merseyside L25 0QF 0151-486-2054 0151 486 2054 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) www.c-i-c.co.uk. Community Integrated Care Mrs Mary McGibbon Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User to Include up to 2 LD Date of last inspection 16th February 2005 Brief Description of the Service: Blackburn Drive provides support and accommodation for two adults who have a learning disability and some additional physical disabilities. The home is operated by CIC who provide staff, budgets and support, the building itself is owned by Liverpool Housing Trust who are responsible for maintaining the structure of the premises. The home is a detached bungalow in a residential area of Halewood and fits in well with other houses in the nearby area. Outside there is a front garden with some parking and an enclosed back garden with small patio. Inside the home provides two single bedrooms, an office, lounge, dinging room, one bathroom and kitchen, there is also a small extension at the back, which is used for some storage and laundry facilities. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process included meeting service users, discussion with staff and a relative, reading files and records in the home, a tour of the building and observation of daily life in the home. What the service does well: What has improved since the last inspection? What they could do better: The home need to provide a better service to one service user in accessing activities and meaningful ways to send part of their day. They need to make sure staff have appropriate training which is up to date, particularly in areas relating to health and safety such as medication and fire, to ensure they can keep themselves and service users’ as safe as possible. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 6 They should prepare a training assessment of the home to make sure staff receive training appropriate to service users needs. The bathroom in the home needs to be upgraded to an acceptable standard. The organisation need to be more open regarding the way in which they manage service users monies and provide explanations on file as to how this is managed and why. They also need to consult with service users’ using relatives, care planning process, keyworkers and advocates and cease the practice of ordering furniture and supplying cares without assessing their needs and choices. 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. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&4 The home has an appropriate policy in place for introducing potential new service users and refers current service users for re-assessment if needed. EVIDENCE: Both of the people living at Blackburn Drive have lived there for over 10 years, therefore parts of standards 2 and 4 could not be practically looked at. Records in the home showed that staff refer service users’ for re-assessments from other professionals when needed and the home has a policy in place for introducing new service users. This states that a full assessment must be carried out and that trial visits will be offered. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7,8,9 There are clear care plans and risk assessments in place for service users covering all aspects of their daily life. Staff in the home are aware of service users choices and support them in decision making, however the wider organisation do not always take service users choices and needs into account when making decisions. Records of service users monies are out of date and could not be fully inspected. EVIDENCE: Individual care plans are in place for both of the people living at Blackburn Drive. These are updated regularly with the last update taking place on 23/11/05. Plans contain good, clear information about the person, the support they need with their personal care, mobility, healthcare and communication as well as information regarding their daily lives and preferences. Although plans are regularly reviewed and updated the home should consider holding more formal reviews on occasion, this will offer relatives the chance to attend and contribute their views and feelings. Although the people living at Blackburn Drive do not communicate verbally staff spoken with were able to give detailed information about their choices and preferences and how they try to meet these. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 10 However it is the homes policy to ask relatives their opinion when the service user is spending over £150 and at times this has conflicted with the opinion of staff as to what is in the persons best interests, in order to establish as far as possible what the service user wants the home should support them to use a local advocacy service who can provide impartial support. One service user had new bedroom furniture, however when asked how this had been chosen staff advised that the organisation had ordered it and it ‘arrived’, in a similar way a dining table had also ‘arrived’ in the home with no consultation as to what suits the service users needs. In not consulting with service users, keyworkers and if appropriate, relatives, the organisation are not offering service users the opportunity to participate in decision making within the home, and ensure that choices are made with their needs and preferences taken into account. The organisation act as appointee for the service users benefits and also manage their bankbooks. Records in the home regarding services users finances were confusing and out of date and it was not possible to establish if their money is being managed safely and appropriately. One example of this is that both service users are in receipt of mobility allowance however no records of this are maintained in the home. The home currently has a vehicle supplied by the organisation, this is an S registration Volvo that was given to the home a couple of years ago by CIC and was formerly a company car. It is not adapted for use by people with physical disabilities and staff advised that they find it difficult to drive, as a result there is only one driver working in the house. Service users have an agreement stating they pay £32.50 a week for this car, which includes petrol and the lease, is signed by the same person on behalf of the service user and as guarantor. No explanation is available in the home stating how much mobility money service users receive each week, how much the actual rental of this car is or why an unsuitable car is being used. Staff did advise that they have looked at other vehicles and ordered a new vehicle, which they anticipated would take 14 weeks to arrive, when asked, they advised that the company were aware of the difficulties with the current car. No current details about how service users benefits are paid or the name of their bank account were kept in the home. It was therefore not possible to accurately check monies. CIC must arrange a meeting with the CSCI to discus the ways in which they manage service users monies. Care plans contained up to date risk assessments for service users covering various aspects of their life. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,16 The home provides good support to one service user in accessing a range of educational and leisure opportunities. However support to the other service user is very limited, although plans are being made these had not been implemented and the service user was spending large periods of time in the home, with little to do. Staff have a good understanding of service users and their rights and daily routines within the home are based around the persons care plan and choices. EVIDENCE: On the week of the inspection service users had been supported to get out and engage in different activities, these included, shopping, day out and Christmas meal and going for a walk. Staff advised that one service users has a lot of support with getting out and about and with different activities including college, shopping going to the theatre etc. Staff acknowledged that this support is not in place for the other service user and explained some of the reasons for this are due to the unsuitability of the car and lack of drivers. A relative spoken with said that they felt there is a lack of stimulation in the home and at times a complete lack of activities. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 12 Staff spoken with said that they are planning to alter this and looking at obtaining passes for local leisure facilities. Records for this service user showed periods of time with little activity. As a lack of stimulation can lead to people becoming withdrawn and under stimulated, the home must prepare a weekly activity programme for this service user and record whether or not these are carried out. Both staff and the service users relatives said that the service user enjoys going for a drive or walk and these activities should also be recorded. Staff were seen to interact with service users and spend time with them, whilst also offering service users the opportunity to spend time alone in the lounge or their room, as they preferred. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Staff have a good understanding of service users support needs and personal care is provided in keeping with their needs and choices. The home supports service users’ to access healthcare when needed. Medication is well managed within the home, however not all staff have received training in this area which could cause an increased risk of error. EVIDENCE: Staff were able to give a good clear explanation of the support they provide to service users with their personal and health care, this was backed up with clear information in the persons care plan. Records showed that the home support service users with their healthcare and in accessing healthcare professionals. A relative spoken with stated that they are “happy with the way (their relative) is looked after”. Medication is stored in a locked cabinet which was seen to be well organised with clear systems in place and records kept of stock checks and medication given. The home has a medication policy in place, which is provided by CIC. Not all staff who deal with service users medication have had training in this area which could lead to potential problems not being recognised, the home must arrange this training for all staff dealing with service users medication. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The home has suitable polices and procedures in place for dealing with complaints and adult protection and this information is made available. Records of service users financers are not maintained in the home and as identified at previous inspections it was not possible to fully inspect these. EVIDENCE: The home have a copy of the organisations complaints procedure, which states how the complaint will be dealt with and timescale for doing so. There is a facility for recording complaints made to or about the home, although no formal complaints have been received. Information about how to make a complaint is made available via the homes service user guide and statement of purpose. Copies of the organisations and local authority adult protection procedures are also available and some staff have received training in this area. As detailed elsewhere in this report there are no clear records maintained within the home of how the organisation manage service users monies. Records did show that the home carried out suitable checks prior to appointing new members of staff. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 30 Overall Blackburn Drive provides a homely well maintained environment, however the bathroom is cold and uninviting and not of a standard found in most domestic homes. There are suitable procedures and practices in place for dealing with infection control. EVIDENCE: Blackburn Drive is a bungalow and provides easy access for service users. Overall the home appears comfortable, light, warm and homely. Both service users’ have their own bedroom and the communal areas include a lounge and separate dining room providing plenty of space for service users, staff and visitors. Outside there is an enclosed garden with small patio. The home is in a residential area and fits in well with other houses nearby. The home has one bathroom, which provides a toilet, sink, bath and walk in shower. This room was very cold and uninviting, although there is an overhead fan heater this can not be left on all day, staff advised it is switched on when people plan to use the bath / shower but at other times the room is cold. The room is old fashioned and needs to be refurbished, there are four different types of tile used on the walls, the shower chair was rusty, the floor tiles appeared to have ground-in grime, the sealant around the bath was rotting and the windows are single glazed adding to the lack of warmth. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 16 Staff also advised that there have been a number of difficulties over the past years with the drain for the shower. The home must refurbish this room within the next 6 months to ensure it is warm and of a standard acceptable in any domestic home. The home has an industrial washing machine with sluice facility and provides, disposable clinical waste bags, gloves and aprons, the manager advised that staff receive training in infection control via their induction. The laundry facilities are reached via the kitchen, although the home use covered boxes to take washing into the laundry room it is recommended that they obtain a supply of water soluble bags, these will help prevent the spread of infection from laundry, if needed. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33.35 Staff have a good understanding and knowledge of service users and their support needs and are working towards obtaining a care qualification. There are sufficient staff working each day to meet service users needs, however a risk assessment is needed for the times when a member of staff is alone in the home with a service user. The organisation have a training department and some training has taken place for staff this year. However staff are not all up to date in areas of health and safety training, including medication, moving and handling and fire, which could lead to an increased risk for both service users and staff. EVIDENCE: There are 6 regular staff working in the home, of these one holds a care qualification and the other 5 are working towards obtaining this qualification, once some of the staff have completed this the home will be meeting the national target of having 50 of staff qualified in care. Staff were seen to spend time talking with and interacting with service users and in discussion it was evident that they have a good understanding and knowledge of service users personalities, needs and choices. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 18 There are usually two staff on duty during the day with one staff awake at night. Staff advised that at times there are three staff on duty and the manager explained that there is a staff vacancy and they are currently looking at ways to use these hours, one possibility they are considering is to use them for an activity worker to support service users to get out and about. At times there is 1 member of staff in the home with a service user whilst the other is out. The home must carry out a risk assessment of this practice to make sure both service users’ and staff are safe, if a risk is identified they must put measures into place to minimise this. The organisation have a training department, which organises training for staff and sends out details of training planned. In the past year training has taken place in dealing with medication and protection of Vulnerable Adults. There company also have a structured induction programme, which all new staff work through. Some training for staff is overdue, this includes fire and medication for some staff and updates in manual handling. The home must make sure all staff have an up to date manual handling certificate. They should also put together a training needs assessment of the team so that training can be planned to meet service users needs. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The home have carried out regular safety checks and keep satisfactory records. Not all staff have had recent fire training which could cause a risk to service users, there is a potential risk to service users and carers from the self closing fire doors which needs to be assessed. EVIDENCE: The home had satisfactory records and certificate available for, gas, hoist, electrics, fire alarm and emergency lights. Fire training was out of date for staff, the manager was aware of this and said that there were plans for it to be carried out with another home and this should be completed by 31/12/05. The home must make sure that all staff receive fire training in order to make sure service users’ are safe in the event of a fire. The fire brigade visited the home in April 05 and found fire matters to be satisfactory. In discussion with staff and through watching practice in the home it was evident that there is a difficulty with the self-closing fire doors. These close automatically but due to service users disabilities this can cause a risk to them or their carer in getting through the door using a wheelchair. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 20 The home must carry out a risk assessment of these doors taking into account the risk to service users of fire and to their mobility and act upon any findings. The risk file had been updated and there are records of hazardous substances maintained. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 1 1 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 1 X X 3 LIFESTYLES Standard No Score 11 X 12 2 13 1 14 1 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 2 3 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Blackburn Drive, 13 Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000021459.V272147.R01.S.doc Version 5.0 Page 22 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 YA20 Regulation 18(1)(c) Requirement The home must provide accredited training for all staff who support service users with their medication. Timescale for action 30/03/06 2 3 YA27 YA7 23(2) 17(2) 4 YA33 13(4)(c) The home must arrange for the 30/05/06 bathroom to be refurbished to an acceptable standard. The organisation must arrange a 10/02/06 meeting with the CSCI to discuss their management of service users monies. The home must carry out a risk 15/03/06 assessment for their practice of leaving one member of staff in the home. They must act on any findings from this assessment. The home must make sure all staff have up to date training in manual handling. The home must ensure all staff have up to date fire training The home must carry out a risk assessment of the self-closing fire doors and act on any findings. 15/03/03 5 YA34 13(5) 6 7 YA42 YA42 23(4)(d) 13(4)(c) 28/02/06 28/02/06 Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 23 8 YA43 25 & 20 All finances relating to the running of the home and individual service users must be maintained within the home. (This requirement was previously issued on several occasions. 28/02/06 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 4 Refer to Standard YA6 YA7 YA30 YA35 Good Practice Recommendations The home should hold formal care reviews for service users and invite relatives to attend. The home should support service users to access an appropriate advocacy service. The home should keep a stock of water soluble bags for use with any potentially infected laundry. The home should compile a training needs assessment for the staff team. Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Blackburn Drive, 13 DS0000021459.V272147.R01.S.doc Version 5.0 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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