Inspection on 22/12/08 for Broad Lane

This inspection was carried out on 22nd December 2008.

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

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

Broad Lane 21/11/06

Broad Lane 27/02/06

Broad Lane 06/10/05

Broad Lane 19/10/04

Broad Lane 15/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Broad Lane 199 Broad Lane Bramley Leeds West Yorkshire LS13 2NJ The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Frederick Rawlins Date: 2 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Broad Lane 199 Broad Lane Bramley Leeds West Yorkshire LS13 2NJ 01132558659 01132558659 broadlane@c-i-c.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Community Integrated Care Name of registered manager (if applicable) Mrs Doreen Lesley Holmes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 2 3 care home 5 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD and Code LD(E) The maximum number of service users who can be accommodated is: 5 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Community Integrated Care, a registered charity, provides the care and services at the home whilst South Yorkshire Housing Association owns the property. The care home provides personal care and support to five ladies with learning disabilities. The home is a single storey building; bedrooms are single occupancy, with shared facilities in the lounge and dining room. The house is surrounded by gardens, and is situated in Bramley, a suburb of Leeds. Nearby is a large shopping and leisure complex with a wide range of amenities regularly used by the ladies. The home has its own mini bus that enables the ladies to participate fully in community life. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced visit to the home by one inspector, which lasted about seven hours. This report is based on information gathered in a number of ways. A review of the information we have received about the home since its last inspection. Information sent to us by the registered provider in a document called the Annual Quality Assurance Assessment (AQAA) self assessment information, which tells us what the home does well, what improvements they have made and what they could do better. Comments made from people and staff during the inspection. This visit included a tour of the premises and talking to people who live at the home, staff and management. We also looked at menus and people’s care plans and watched staff looking after people. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use Care Homes for Adults (18-65 years) Page 7 of 30 services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well The home welcomes people who use the service and their Representatives to visit the home to look around and assess if the home can meet their needs. Information is gathered from various agencies about the person who wants to move into the home, as part of the assessment process. This is to make sure the home is able meet their assessed needs. People living in the home receive good care and support from staff. Staff deliver a good standard of care to people which is based on their knowledge and training. People have detailed plans which have be made with them and their representatives. Staff care and support people in an environment that is respectful, caring and friendly without being familiar. People said that staff are very good to them. Staff said they know that this is a persons home and they can have what they want and have their care delivered how they wish. Care Homes for Adults (18-65 years) Page 8 of 30 What has got better from the last inspection What the care home could do better Although there has been an improvement in staff signing records, peoples care and support plan should be signed by people and or their representatives, to indicate that they have read and agree with the plan. The kitchen needs redecoration and refurbishment, so that health and safety and infection control is not compromised. Care Homes for Adults (18-65 years) Page 9 of 30 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Frederick Rawlins 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 10 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 considering moving into the home are given all the required information to make sure they have an informed choice about where they want to live. The assessment procedure ensures that staff know individual needs and people are assured that the home can meet their needs. Evidence: People and their family members are given a copy of the statement of purpose and any other information about the home and the service it provides. There has been one new admission to the home since the last key inspection. We were told that this person was provided with a copy of the homes information and the Service user guide which has pictures to help people to understand it. The homes admission procedure confirms that anyone considering moving into the home would have their needs fully assessed. The manager told us that careful consideration was given to make sure that anyone Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: admitted would be able to fit in with the people already living there. People in the home have the opportunity to meet any prospective persons before their admission was agreed. The care file seen showed copies of the placing authority, initial assessments carried out by the home and a contract agreement for the service to be provided. In the Annual Quality Assurance Assessment (AQAA) the home told stated that a full needs assessment which inclues a risk assessment is undertaken. There is involvement of the multi disciplinary team as well as family members and the person. All information is in an accessible format to all parties. All views are taken seriously, pre-visits and overnight stays are included in the assessment of persons before decisions are made. The Manager is assigned to be the key worker for initial 3 month settling-in period. All the people living in the home are provided with a contract with all relevant information. Care Homes for Adults (18-65 years) Page 13 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this 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 living in the home are involved in decisions about their lives, and play an active role in planning the care and support they want and receive. Evidence: We were told that everyone in the home requires some degree of help with their personal care, communication, health care management and their physical needs. We looked at two peoples care (support) plan and we found that they had information that described the support required in relevant areas. We also saw that support plans are evaluated every month and are reviewed twice yearly with the person, key worker, relatives and any professionals involved in the persons care being involved in this process. People told us that they were well looked after by staff. The information in the care plans gives staff clear and detailed instructions on the actions staff need to take in order to support people in areas such as daily living, Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: personal care, eating, mobility and social care. We saw simple clear instructions for such tasks as moving and handling. There was also directions for staff to follow when using a hoist in order to transfer a person from bed to chair. We saw records of monthly key workers meetings about individual persons care as well as monthly evaluations. Reviews are held twice yearly involving the person, staff, relatives and health care professionals involved in their care. Any assessed changes in peoples needs is actioned by putting a plan in place. We observed that staff are perceptive in understanding ways in which each person makes their wishes and choices known, for example one person who has a speech impairment communicated by writing down what they wanted to say. We saw staff assisting one person to choose their make up and helping her to apply. During the visit we observed good conversations between people and staff and the atmosphere was happy, friendly and caring. We saw that personal risk assessments were detailed with the action staff must take to manage or minimise the identified risk, for example one person was at risk of choking, the action staff must take is to cut all food in small pieces and give the person time to eat and not to be left alone when eating. The home told us in the AQAA that they work in a person centered way, all support plans are derived from our own needs and risk assessment process, the person health needs, finances and support requirements. Fully include the person in all planning and others in line with confidentiality and data protection procedures, all records will be accurate and up to date, staff are trained in confidentiality of information. Care Homes for Adults (18-65 years) Page 15 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this 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 who live in the home are helped to develop their skills and relationships in the home as well as in the community and to follow interests of their choice. People are provided with a healthy diet which suits their needs and preferences. Evidence: We saw good recording of information such as the daily log being used to record how people spend their time and what activities they attend. This includes spending time at the Day Centres, attending classes such as pottery and visits made by or to family and friends. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: People are supported to go on holiday either individually or in a group. We were told that staff support people to maintain contact with families and friends. We were told that discussions take place with people as a group or individually about the support they get in various areas such as the food to be served or buying new clothes. People are encouraged to take part in some household jobs such as tidying and laundry. The home has a planned menu that takes into account peoples likes and dislikes and provides a varied and balanced diet with the main meal being served in the evening. The kitchen was well stocked with a variety of good quality food and fruit and vegetables. We saw that peoples favorite food is recorded and we were told that people are given the opportunity to try a variety of foods from different cultures. Despite being told that people have their weight monitored monthly by either the home or the Day Centre they attend and they were records in place for such, it was noted that nutritional risk assessments are not carried out for people as part of their assessment , to make sure that they are not nutritionally at risk. The home has their own transport which gives people the opportunity to go shopping in the community as well as attend other outings. Public transport and taxis are also used to take people to appointments. In the AQAA the home told us peoples choice and needs dictates their lifestyle. There is speech and language therapy involvement when needed as well as training and information for staff regarding peoples individaul needs when eating and drinking. Meals take into account peoples likes and dislikes and cultural and religious beliefs People have the opportunity to go to shopping for the household shop and there are no ridged routines for people to follow. but what they could do better is have staff who can drive the homes vehicle. People have the opportunity to go on holiday if they chose, or have day trips out. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live in the home receive support and care in the way they prefer and need. Peoples health needs are met and are protected by the homes policies and practices regarding medication. Evidence: We saw and heard staff seeking permission to enter peoples bedrooms, talking to individuals in a friendly and respectful manner and offering assistance with personal care discreetly. Records seen showed that care is provided in the ways indicated in peoples support plans. Although people did not have a nutritional risk assessment there was an action for their nutrition and weight checks to be carried out. The health needs of each person are recorded in their health action plans and their health monitored and recorded. People are visited by a various healthcare professionals and attend hospital appointments. The home use a monitored dosage system with medication stored in a secure locked Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: cupboard. There are procedures in place for safe handling of medication such as self administering and recording of medicines. All staff have undertaken a medication course as part of their induction and have also done or are in the process of doing the distance learning course on safe handling of medication, which they said provides them with more information about handling medication to make sure people are safe. During the visit we saw administration of medication carried out by staff and records showed that the home complies with the (RPS) Royal pharmaceutical guidelines for residential homes. Staff are clear on the procedure they must follow when ordering repeat prescriptions. There is a list of staff signatures, for quick reference to the staff administering the medication. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 are protected from abuse by the homes procedures and staff training and their views are listened to and acted on. Evidence: We were told that people are supported to raise any concerns they may have. The homes complaint procedure is included in the service user guide in format of pictures, symbols and words and this is given to people when they move into the home. This is also included in the statement of purpose which is given to people and their Representatives at their visit to the home. There has been no complaints made to us about this home in the past twelve months. The registered provider has reviewed their Policy for protection of vulnerable adults and all staff have had training on recognising the possibility of abuse and what to do. During discussion with staff they confirmed that they know what to do if a situation of abuse did occur. We were told that the home operates a no restraint policy in respect of physical intervention. Some staff have had training in handling challenging behavior. We saw that there are polices, suitable recording systems and secure facilities for managing money on behalf of people living in the home. We checked the balance of Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: the money held for three people and found them to be correct. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 live in a homely, safe and comfortable environment which is clean. Evidence: The home is a one storey building that is purpose built to accommodate people who have a physical disability. There are spacious communal areas with adequate space for aids and adaptations and specialist bedrooms which meet the needs of the people in the home. Individual bedrooms are well decorated and furnished in according to peoples taste. Areas used by people are in a good state of repair and decoration. However, some areas in the kitchen were showing signs of wear and tear, such as cracked and missing tiles around the sink and a rotting window frame. The perimeter fencing offers privacy to people when they are in the garden. There are some garden seats which can be used by people in the better weather. At the time of the visit the home was found to be clean. Staff have had infection control training which included the prevention and management of cross infection. They also have access to protective clothing. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The home has a small laundry that has all the appropriate equipment that meets the needs of the number of people living there. Bedrooms are personlised to a good standard. There is a redecoration and refurbishment 5 year schedule. The home is well maintained with dedicated maintenance staff and robust repair polices and all adoptions and equipments are regularly serviced by professionals. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this 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 have their needs met by a competent team of staff who receive training to meet their needs and are protected by the organisation’s recruitment and selection policy and practice. Evidence: At the time of this visit there were three members of staff available to people. One was designated the person in charge at the time of the inspection and due to illness of another staff membet the manager was on duty and only participated in the inspection process for a short time. The third staff member was a new starter and was on induction training and was therefore not included in the numbers. We were told all new staff work supernumerary for two weeks as part of their induction to the home. Over fifty percent of the staff team have have National Vocational Qualification (NVQ) in care at level 2 or above. Staff have undertaken further training in a range of areas relevant to their role and we were told that training is Learning Disability Frame work accredited that helps staff to deliver peoples care in a specialist way. There is a training plan in place for further and update training for all staff. We looked at three members of staff recruitment files. We saw completed application forms with details of the interview, two references and evidence that CRB ( Criminal Records Bureau) and Protection of Vulnerable Adult (POVA) first check had been Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: completed before they commenced employment, to make sure the people living in the home are safe from harm or abuse. We also saw that staff have regular supervision and had undertaken the organisation’s induction training course. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 are protected by the arrangement for managing the home, monitoring the quality of care and checking equipment, so that their health, safety and welfare are promoted. Evidence: The manager has the experience and qualification to manage the home, she demonstrates many areas of good practice and showed that she can identify where improvement is needed. There are systems in place to get the views of people about the service they get at the home, in ways such as one to one discussion, group discussions at house meetings and questionnaires. We saw records to show that portable appliances, hoists, fire detection and equipment, heating systems, gas and electricity have all been serviced in the past twelve months. We looked at some records and found this to be the case. There is a secure storage space for products which may cause harm that should be Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: kept locked away and relevant risk assessments for the building were in place. In the AQAA we are told the manager organises training, staff supervision, house and staff meetings are held regularly. we were also told that Quality assurance is carried out through the six monthly monitoring and there is yearly in house surveys with people and their Representatives. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 17 Some consideration should be given to carry out nutritional risk assessments, to make sure people are not at risk. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!