Inspection on 16/06/08 for Bolton Hall Care Home

This inspection was carried out on 16th June 2008.

CSCI found this care home to be providing an Adequate service.

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

Bolton Hall Care Home 21/06/07

Bolton Hall Care Home 25/01/06

Bolton Hall Care Home 14/09/05

Bolton Hall Care Home 08/03/05

Bolton Hall Care Home 11/01/05

Bolton Hall Care Home 03/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Bolton Hall Care Home Carrhead Lane Bolton On Dearne Rotherham South Yorkshire S63 8DA Lead Inspector Michael O`Neil Key Unannounced Inspection 16th June 2008 09:50 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 Bolton Hall Care Home DS0000006473.V365708.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. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bolton Hall Care Home Address Carrhead Lane Bolton On Dearne Rotherham South Yorkshire S63 8DA 01709 881456 01709 891731 bolton.hall@craegmoor.co.uk 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) Yorkshire Parkcare Company Limited Vacant Care Home 80 Category(ies) of Old age, not falling within any other category registration, with number (80) of places Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All 80 OP beds may instead be used in the category PD, Physical Disability for people aged 60 years and above, whose disability is as a result of the ageing process. 21st June 2007 Date of last inspection Brief Description of the Service: Bolton Hall is a purpose built two-storey care home with landscaped gardens and ample car parking space. The home is registered for 80 residents and provides both personal care and nursing care. There are local amenities within the immediate vicinity. The railway station, which serves Leeds and Sheffield, is a few minutes walk from the home, and the A1 motorway is approximately 10 minutes drive from the home. The home’s manager provided the information about the homes fees and charges on 16 June 2008. Fees range from £351.50 to £473.50 per week. There are additional charges for hairdressing, chiropody, toiletries, papers and magazines. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. This was an unannounced key inspection carried out by Mike O’Neil, regulation inspector and Sue Stephens, regulation manager. The CSCI inspectors visited Bolton Hall for a total of 7.75 hours. Jackie Pinches is the manager and was present during the visit. Jackie is in the process of submitting an application to the CSCI to become the registered manager. Liz Slight, area manager of Yorkshire Parkcare Company Limited was also present for the majority of the visit. Prior to this visit the manager had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the home was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of this report. Questionnaires, regarding the quality of the care and support provided, were sent to people staying in the home, their relatives and any professionals involved in peoples care. We received two questionnaires from people using the service, seven from relatives and three from staff. Comments and feedback from these have been included in this report. On the day of the site visit opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home, check the homes policies and procedures and talk to six staff, one visiting health professional, five relatives and seven people who live there. We checked all key standards and the standards relating to the requirements outstanding from the homes last inspection in June 2007. The progress made has been reported on under the relevant standard in this report. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 6 What the service does well: People looked clean, well dressed and had received a good level of personal care. People said “The staff are very friendly” “I’m very happy here and very well cared for” “The staff are lovely to me and to others” Relatives said “Staff are lovely” “My mum gets everything she needs” “I think she is looked after very well” Health professionals said that staff liaise well with them to ensure people receive a good level of support and made other comments such as; “The care is good” Relatives said they were able to visit at any time and were made to feel welcome. Throughout the day friends and family were seen visiting the home and there seemed to be a very friendly and welcoming feel in Bolton Hall. People said that there were some activities planned such as bingo, trips out, luncheon clubs and entertainers visiting the home. People said they enjoyed these activities. People said that they had a choice of food and that the quality of food served was generally good. People said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. People said they were comfortable at the home. People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were “always” or “usually” available when needed. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 8 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 Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 9 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): Standard 3. Standard 6 is not applicable to this home. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were individually assessed prior to admission to ensure their needs could and would be met. EVIDENCE: Care plans showed that people within the service had been assessed before moving into the home. Risk assessments and a detailed plan of care reflected any specialist interventions. The manager and staff liaised with professionals, the person and their families to find out about peoples needs. The manager visited people and undertook assessments, prior to admission. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from the provision of accurate care plans and were satisfied with the care and service being delivered. In the main peoples privacy and dignity was maintained. Some medication procedures need improving to ensure that people are protected. EVIDENCE: Three peoples care plans were checked. The peoples care plans checked were good in that they contained details about the person’s biography, personality and their preferences and choices. The plans were being regularly reviewed and the changes in people’s health were being recorded. Daily records included details of people’s daily routines to help ensure that their health and welfare needs are met. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 11 People looked clean, well dressed and had received a good level of personal care. People said “The staff are very friendly” “I’m very happy here and very well cared for” “The staff are lovely to me and to others” Relatives said “Staff are lovely” “My mum gets everything she needs” “I think she is looked after very well” Health professionals said that staff liaise well with them to ensure people receive a good level of support and made other comments such as; “The care is good” In the main the medication systems were in good order, storage was safe, staff followed good administration procedures. However codes used on Medication Administration Records (MAR) to explain missed medication were inconsistent. Also one MAR sheet contained hand written instructions with no signature as to the prescriber. Two staff members, who check that the correct information is documented, or ideally the General Practitioner should sign any handwritten instructions on the MAR sheets. There was evidence that managers and trained staff were auditing medication administration procedures. Staff said they had completed an in-depth training programme. This gained them the competencies needed to administer medications. People said that staff at the home respected their privacy and dignity in a number of ways, for example, by knocking on their doors and waiting for a response before entering. Staff spoke to people in a respectful way and showed patience when providing personal care to them. People’s privacy and dignity, however, was not fully promoted on occasions around the lunchtime period. Staff were seen and heard having a conversation with each other about their personal life whilst sitting assisting two people to eat their lunch. People were not included in their conversation. On two occasions staff walked into the lounge area provided elements of personal care and left without communicating with people who were in the lounge. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. People were able to make choices about daily living and be involved in some social activities. To improve choices and maintain interests, activities need to be more individualised to peoples assessed needs and preferences. The home had an open visiting policy, which assisted in maintaining good relationships with people’s representatives. Meals served at the home were of a good quality and offered choice to ensure residents receive a balanced diet. However meals were not available at times convenient to some people. EVIDENCE: People said they were able to get up and go to bed when they chose, and were seen to walk freely around the home and the gardens of the home, if able. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 13 Relatives said they were able to visit at any time and were made to feel welcome. Throughout the day friends and family were seen visiting the home and there seemed to be a very friendly and welcoming feel in Bolton Hall. People said that there were some activities planned such as bingo, trips out, luncheon clubs and entertainers visiting the home. People said they enjoyed these activities. An activity coordinator is employed at the home. We spoke about her role. She was enthusiastic and recorded all activities undertaken inside and outside the home. Some people did say they got bored and some people were observed to be sleeping for long periods during the morning. Some people said that they welcome the opportunity to undertake simple activities or talk to staff or other people in the home more frequently. Staff did miss the opportunity to sit and talk to people on several occasions, for example, whilst waiting for lunches to be served. Staff seemed more comfortable in communicating with people when providing direct care to them. The manager, area manager and inspector discussed ways that staff could be come more involved in an activity programme. Also it was discussed how staff could look at providing a much more person centred approach to care delivery and arranging activity programmes for people. People said that they had a choice of food and that the quality of food served was generally good. However the lunchtime period was not a positive experience for some people. We observed that prior to lunch being served at least 6 people were sat for periods of up to fifty minutes at dining tables. People were sat staring at each other without any stimulation and some were not even provided with a drink whilst waiting for the meal to be served. The tables were set nicely and when the meal was served people said “We always get a good meal” “The food is very good, with a lovely variety”. “I’m enjoying my food” Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures were in place and people and their relatives felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. EVIDENCE: People and their representatives had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff. Staff had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Bolton Hall Care Home DS0000006473.V365708.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,24,25 and 26. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some of the homes environment was not well maintained and clean which meant that some people did not live in a comfortable and safe environment. EVIDENCE: People said they were comfortable at the home. The home had a variety of chairs and furniture and touches such as ornaments and pictures that gave rooms a homely feel. In the main the home was clean and fresh. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 16 Generally the décor and some furnishings in the home are worn, tired and in need of refurbishment. Since the last inspection new furniture for the dining room has been purchased and some rooms have been redecorated. The area manager confirmed that a major refurbishment in one area of the home would take place over the next two months. The main inadequacies with the environment of Bolton Hall were: • Unsafe lighting. Some staff were continually turning corridor lights off. This meant that some corridors were quite dark and presented a tripping/hazard risk to people. Some people’s wheelchairs and armchairs in the lounge and moving and handling hoists/equipment had accumulations of dirt and food debris. The bathrooms and toilets in the home are all in need of refurbishment. The rooms are very stark and clinical with the floor coverings stained. • • The garden was accessible. Work had been undertaken to improve the exterior of the home and the gardens looked very pleasant. Bedrooms checked were comfortable, homely and reflected peoples personal tastes. People said their beds were comfortable and bed linen checked was clean and in a good condition. Bolton Hall Care Home DS0000006473.V365708.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. Staff were employed in sufficient numbers and recruitment procedures promoted the protection of people. People receive care from a generally well-trained staff team. EVIDENCE: People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were “always” or “usually” available when needed. Staff and the manager confirmed that staffing levels were adequate although there had been shortages over the previous few months. The manager confirmed that staffing numbers would be boosted further as new staff have just been recruited to work at Bolton Hall. Three staff files were checked at this visit. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 18 at the enhanced level. This confirmed thorough recruitment practices were in place, which was sufficient to safeguard people. On examination of the staff training records there were records that indicated the staff had received moving and handling, fire training and other relevant clinical training. Staff interviewed said that they enjoyed working at the home and got a lot of job satisfaction. Staff were able to talk about the various training courses that they had attended. Over 70 of the staff team had achieved their NVQ Level 2 or above and others were due to commence this training shortly. Bolton Hall Care Home DS0000006473.V365708.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,and 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including random and key inspection visits to this service. The procedures and ethos of the home ensure that the home is run in the best interests of people who use the service. In the main the homes procedures promote the health, safety and welfare of people who use the service and the staff. EVIDENCE: A manager, Jackie Pinches, has been appointed to the service. Her position had been discussed with the CSCI.She is in the process of submitting an application for registration to become the registered manager. Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 20 Jackie has many years experience within the nursing and caring profession. She is committed to ensuring that people staying in the home were consistently well cared for, safe and happy. People staff and relatives said they were all happy to approach the manager at any time for advice, guidance or to look at any issues. They all said that they were confident that she would respond to them appropriately and swiftly. The home had a comprehensive quality assurance system. There was evidence of internal auditing of the homes environment, services and records. Staff meetings were held and minutes of these meetings were seen. The responsible individual visited the home on a regular basis, a report was written following the visits. People who use the service met with the management of the home. These quality assurance systems will help to ensure that the service is operating in the best interest of the people who live there. The health and welfare of people could not be fully protected, as: Several people were being moved in an unsafe way. Staff were escorting people around the home in wheelchairs, which were not fitted with footplates. To minimise the risk of injury footplates must be used (unless risk assessment does not warrant this) when assisting people to mobilise in their wheelchairs. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. The fire risk assessment had been reviewed in May 2008. No issues requiring attention were highlighted in the review. A sample of people’s personal money accounts were checked. Receipts and records tallied. This will promote the safety and welfare of the people. Bolton Hall Care Home DS0000006473.V365708.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 3 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13 Requirement The home must make sure medication procedures are safe and use consistent codes to indicate when people have not had their medication. Previous timescale of 31.07.07 not met. Where handwritten entries are added to medication administration record charts, these must be signed and dated and all relevant information must be included i.e. quantity of medication received. The privacy and dignity of people must be respected at all times. People must have the opportunity to exercise their choice in relation to social and leisure activities. Meals at the home must be served at a times convenient to people who use the service. A programme of renewal of the fabric and decoration must be produced, and work started to implement the plan. Suitable and adequate lighting DS0000006473.V365708.R01.S.doc Timescale for action 01/08/08 2. OP9 13 01/08/08 3. 4. OP10 OP12 12 16 01/08/08 01/12/08 5. 6. OP15 OP19 16 23 01/08/08 01/07/09 7. OP25 23 01/08/08 Page 23 Bolton Hall Care Home Version 5.2 8. OP26 13 9. OP38 13 must be provided in all areas of the home used by service users. The home must introduce a cleaning system that ensures people’s wheelchairs are clean and free from accumulated food debris. Previous timescale of 31.07.07 not met. To minimise the risk of injury footplates must be used (unless risk assessment does not warrant this) when assisting people to mobilise in their wheelchairs. 01/08/08 01/08/08 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 Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Bolton Hall Care Home DS0000006473.V365708.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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