Inspection on 23/02/07 for Brockhampton Court Nursing Home

This inspection was carried out on 23rd February 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brockhampton Court Nursing Home 10/11/05

Brockhampton Court Nursing Home 15/04/05

Brockhampton Court Nursing Home 10/12/04

Brockhampton Court Nursing Home 03/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Brockhampton Court Nursing Home Brockhampton Herefordshire HR1 4TQ Lead Inspector Lorraine Briggs Unannounced Inspection 23rd February 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brockhampton Court Nursing Home DS0000027673.V330390.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. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brockhampton Court Nursing Home Address Brockhampton Herefordshire HR1 4TQ 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) 01989 740239 01989 740289 Dr Christopher John Allen Mrs Joanne Debra Parker Care Home 58 Category(ies) of Old age, not falling within any other category registration, with number (58), Physical disability (58), Physical disability of places over 65 years of age (58) Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2005 Brief Description of the Service: Brockhampton Court is a Grade II listed building set in six acres of wellestablished gardens. It is situated in the village of Brockhampton, which is midway between Hereford, Ledbury and Ross-on-Wye. There is a village post office. The provision of public transport is very limited with a local bus which goes to Hereford 1-2 times each week. The Home provides a car driven by a member of staff, which can transport up to three residents at one time to enable them to access local facilities. The Home was purchased in 1996 by the Provider Dr C J Allen and converted into a care home. It is registered as a care home with nursing for a maximum of 58 residents. The service is able to offer care for adults of both sexes, who have a physical disability or are frail due to old age. There is a passenger lift to all floors. The gardens are well maintained and are accessible to residents. Fees are available upon request. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? An extension has been commissioned offering further accommodation. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 Quality in this outcome area is excellent. Residents who move into the home have their needs fully assessed. The planning process undertaken by all levels of staff assures the resident that these needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Significant time and effort is spent making admissions to the home personal and well managed. There is a high value on responding to individual needs for information, reassurance and support. Planning meetings take place before admissions and notes were seen regarding the resources required to meet residents needs. The service considers carefully the needs assessment for each prospective resident before agreeing admission to the home. Examples of assessments Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 9 were within care plans viewed. The manager ensures that a summary of any assessment undertaken through the care management arrangements is obtained and insists on receiving a copy of the care plan. Prospective residents and their family, always have the opportunity to visit and spend time in the home prior to agreeing admission. A resident survey returned commented that: “ As a former resident of the village of Brockhampton I knew the home and the people involved. In addition I was given the opportunity of a trial stay before deciding whether to move in or not.” Staff are prepared to visit the prospective resident and their family to get to know them and answer questions. The home provides various formats for giving information on the statement of purpose and resident guide on the services and facilities the home can offer e.g. leaflets, brochure, photographs. Residents were involved in developing them. Staff are qualified and skilled to meet the specialist needs of a prospective resident. Staff are well briefed on the needs of new residents through weekly team meetings. Each care plan reflects the needs of the individual taking into account their cultural, religious and social preferences where this is appropriate. Brockhampton Court Nursing Home DS0000027673.V330390.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): 7, 8, 9 and 10 Quality in this outcome area is excellent. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From discussions with the manager it is clear that the home has a strong ethos of involving residents in all aspects of their life. All residents have a concise care plan. The home has systems in place to ensure the care plan is reviewed and updated monthly and arranges additional reviews when changes take place. Feedback and involvement is a continuous ongoing process, staff spend time with individual residents to ensure they understand decisions and actions. The provider has robust quality monitoring systems in place which ensure that staff comply with policies and procedures, i.e. questionnaires, regular visits by the owners, clinical supervision and appraisals. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 11 The care plan is written in clear language and can be used in an emergency by people who are not familiar with its content. Each care plan seen included a comprehensive risk assessment element. Management of risk takes into account the needs of residents balanced with their wishes for independence and choice. Records show that staff keep up to date with training, professional research and literature, in both the social care and clinical fields, and ensure that care plans are informed by the relevant social and clinical guidance. Care plans demonstrated that staff actively promote the residents’ right of access to the health and remedial services that they need, both within the home and in the community. Regular appointments are seen as important and there are systems in place to make sure residents are reminded and appointments are not missed. Records show that the home arranges for health professionals to visit frail residents in the home and provides facilities to carry out treatment. Staff keep a regular check on health aids, making sure they are working effectively and that each resident has the necessary aids to improve their quality of life. The home operates to an efficient medication policy, procedure and practice guidance. Staff all have access to the written information and understand their role and responsibilities. Quality assurance systems confirm that policy is put into practice. Medication records were seen to be completed in full and are seen as key to the efficient management of health care matters for residents who have complex needs. The need to respect residents privacy and dignity when delivering health and personal care is a key principle of the homes aims and objectives. Residents are consulted and can decide which staff members they want to help them with their personal care. The staff group is balanced to enable choice of male, female and age related preferences. A resident comment states: “ I have lived here for only two months but am constantly impressed by the care and sympathy displayed by all the staff, in whatever capacity”, and “Always a friendly and caring ambiance.” The manager and provider routinely observes staff attitude and approach to privacy and respect and constantly seeks and values residents’ views and experiences. A relative’s comment from the CSCI survey stated that: “ The nursing home provides a superb service and we are very pleased with the care they give my mother.” Brockhampton Court Nursing Home DS0000027673.V330390.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 Quality in this outcome area is excellent. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From information seen and results of residents surveys, the home is able to enable a full and stimulating life style with a variety of options to choose from. The home seeks the views of residents through meetings and quality assurance surveys and considers their varied interests and abilities when planning the routines of daily living and arranging activities. Routines are very flexible and residents can make choices in all areas of their life. The routines, activities and plans are resident focussed, regularly reviewed, and can be quickly changed to meet individual residents’ needs. Policies, procedures and practice guidance focus on residents being in control of their life. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 13 The home employs an activities coordinator who is responsible for creating meaningful activities and experiences both in the home and the wider community. She meets with new residents and individual activity care plans are produced which review the effectiveness of activities engaged in by each person. Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them to have a drink or a meal with the resident. Residents can choose to entertain visitors in their own rooms or perhaps a lounge or garden area. The home clearly records and actions any restrictions, which the resident may make on who they wish to visit them. The system in place and the practice and attitude of the staff team give residents the opportunity and support to remain independent. They are encouraged to be responsible for their own money for as long as they wish, and are able to maintain their independence, for example, paying for shopping and managing their own bank accounts. Staff give help when it is needed and have contact information for advocacy groups and encourage their involvement with individuals in the home. The home’s policies, procedure, guidance and quality assurance systems ensure that residents are protected from financial abuse. Food is considered to be highly important and meal times considered a social occasion. The home employs catering staff. Records show that they are qualified and experienced in cooking for older people, and are important members of the care team and are well aware of the recorded dietary and cultural needs of each resident. The resident meetings engage residents in menu planning and make sure that they are provided with food they prefer and like. The menu is varied, balanced and nutritious. Food is served to meet the need of all residents including those who have swallowing or chewing difficulty. Resident surveys returned stated they appreciate the good quality food they are served and being able to have a drink when they wish and the availability of snacks. They also enjoyed being able to eat in their own room when they wish. “‘Excellent cakes”, “The meals are extremely well cooked and presented. I have been very impressed with the variety of menus. Christmas day here was a triumph”, “If I do not like what is on the menu, I can always ask the chef for an alternative.” Brockhampton Court Nursing Home DS0000027673.V330390.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): 16 and 18 Quality in this outcome area is good. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. Residents comments and others associated with the home demonstrate a good understanding of how to make a complaint and they are very clear of what can be expected to happen if a complaint is made. “I have talked to Sharon and indeed to Matron on several occasions when I have had concerns”. The policies and procedures regarding protection of residents are in place and are regularly reviewed and updated. The service is now clear when incidents need external input and who to refer the incident to. Training of staff in the area of protection is regularly arranged by the home. The issues from an ongoing referral are being managed well and aims to be resolved to the satisfaction of all involved. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 15 Residents and others associated with the service state that they are very satisfied with the service provision, feel very safe and well supported by an organisation that has their protection and safety as a priority. The promotion of the individual’s rights is central to the aims and objectives of the service. Policies, procedures and the home’s documentation reflect the rights of the individual. Through discussion and understanding documentation, residents are enabled to be aware of their rights, and to access places of worship or community facilities of their choice. Staff are skilled and understand the importance of actively promoting individuals rights. Systems are in place to ensure that resident’s rights are respected and enjoyed by residents in all areas of their life. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. Residents have bedrooms that suit their needs and offer enough space for them to arrange them in a way that they prefer. The furniture and fittings supplied by the Provider are of a high quality ensuring that the physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager, staff and owners encourage residents to see Brockhampton Court as their own home. It provides a very well maintained, safe, comfortable, attractive home which has all the specialist equipment and adaptations needed to meet individual residents’ needs. As well as a good selection of general aids such as hoists and variable height beds, the home Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 17 also ensures that equipment is individualised for each resident and all staff members are trained in the safe use of aids and equipment e.g. electric wheelchairs. Records show that residents are assessed for their need to have equipment or aids before they move into the home and these are provided to them on admission. There is evidence in the care plans that the home meets the changing needs of residents promptly, and especially where they have different specialist care needs. The home meets the requirements of the Disability Discrimination Act and the layout and design of the home is suitable to meet the specific needs of the people who live there, for example people with physical disabilities. The rooms are very well planned and have on-suite facilities and are above the average size. The fixtures and fittings are of a high quality, well maintained and adapted to meet the wishes of the present resident. Residents seen in their rooms stated that they were satisfied with the cleanliness, décor and views of well maintained grounds and the surrounding countryside. There is a selection of communal areas, this means that residents have a choice of place to sit quietly, meet with family and friends or be actively engaged with other residents. The bathrooms are comfortable and easy to use and include a selection of different ways to bath, for example assisted and unassisted showers and baths and there are a number of toilets strategically placed around the home. The home was well lit, clean and tidy and smelt fresh. The management has a proactive infection control policy and their quality audits identify good practice and any problems. Action plans to address problems are developed. Clinical waste is properly managed and stored. Call bells are left within reach of residents and these are responded to promptly. The management monitors the effective function of the system. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staff in the home are being trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of residents This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents have confidence in the staff that care for them. Rotas show that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. Management encourage staff members to undertake external qualifications beyond the basic requirements, and recognise the benefits of a skilled, trained workforce. The service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications. Residents surveyed report that staff working with them are very skilled in their role, and are consistently able to meet their needs. The service ensures that all staff within its organisation receives relevant training that is targeted and focussed on improving outcomes for residents. The service uses external providers to deliver this training if they have not got the appropriate skills within the organisation. This training can be small scale Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 19 and individualised if necessary in order to promote the delivery of person centred services. The service has a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of residents. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. The management and administration of the home is based on openness and respect and has effective quality assurance systems developed by the provider. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has the required qualification and experience to meet the key standards, is highly competent to run the home and meet its stated aims and objectives. Discussions demonstrated that she has sound knowledge of both strategic, and financial planning and review, and manages the service efficiently providing value for money through effective management. The manager is visionary in her approach to the service and is able to demonstrate Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 21 through formal qualification, and experience and ability that she is highly competent in the following areas: care of older people, conditions and diseases associated with old age, quality assurance systems, equal opportunity issues, development and implementation of the services policies and procedures, good people skills, strong leadership of staff which leads to confident workers, responds to need and provides an excellent role model for her junior staff. The manager ensures that the policies and procedures are followed by staff. Staff have easy access to all documents, which are discussed during clinical supervision, staff training and team meetings. Quality monitoring systems provide management evidence that practice reflects the homes policies and procedures. The provider is committed to ensuring the health, welfare and safety of residents and staff. Records are clearly written and up dated, the quality assurance system confirms that the findings from risk assessments have been actioned. There is strong evidence that the ethos of the home is open and transparent with the views of both staff and residents listened to, and valued. The service has recently received the Investors in People award. The home actively encourages residents who wish and are capable, to manage their own money and valuables, making sure they have the facilities to do this safely. The home has very efficient systems to ensure effective safeguarding and management of residents’ money including record keeping. Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 22 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 4 4 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Brockhampton Court Nursing Home DS0000027673.V330390.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Brockhampton Court Nursing Home DS0000027673.V330390.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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