Inspection on 03/06/09 for Church View Residential Care Home

This inspection was carried out on 3rd June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Church View Residential Care Home 25/06/07

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Church View Residential Care Home 1 Main Street South Church Bishop Auckland County Durham DL14 6SL     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: Nicola Shaw     Date: 0 3 0 6 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Older People 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. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Church View Residential Care Home 1 Main Street South Church Bishop Auckland County Durham DL14 6SL 01388451565 01388451560 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross Healthcare (Focus) Limited care home 45 Number of places (if applicable): Under 65 Over 65 25 20 dementia old age, not falling within any other category Additional conditions: 0 0 The maximum number of services users who may be accommodated is 45. 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: Dementia, over 65 years of age - Code DE(E), maximum number of places 25 Old age, not falling within any other category - Code OP, maximum number of places 20 Date of last inspection Brief description of the care home Church View is a purpose built home which has been fully refurbished and renovated within the past 5 years. It is situated in a village setting at South Church just outside Bishop Auckland. There is a regular bus service (with a stop very close to the home) to Bishop Auckland where there is a railway station. The home has a secure private garden and a large parking area. The entrance is accessible for people with mobility problems and there is a passenger lift. Care Homes for Older People Page 4 of 29 Brief description of the care home The home is on two floors which work as separate units: the first floor is for twentyfive elderly people with dementia and the ground floor accommodates up to twenty elderly people. All the bedrooms are well-equipped singles with en suite toilets and wash hand basins. Each unit has its own lounges and dining room. The weekly fees vary between £441.60-£489.14. The fee covers all accommodation, meals and personal care. Hairdressing, toiletries, newspapers, plus services from private opticians, dentists and chiropodists are not included in the fee. The actual amount people pay will depend upon their individual circumstances. Care Homes for Older People Page 5 of 29 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. 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 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. Before the inspection visit: Care Homes for Older People Page 6 of 29 We looked at: Information we have received since the last annual service review in 2008. How the service has dealt with any complaints and concerns since the last visit. Any changes to how the service is run. The providers view of how well they care for people. The visit: An announced visit was made on 3rd June 2009. During this visit we: Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had knowledge, skills and training to meet the needs of the people they care for. Checked what improvements had been made since the last visit. We told the manager what we found at the end of the visit. What the care home does well: What has improved since the last inspection? In the last year the corridors on the first floor of the home have been redecorated. Care Homes for Older People Page 8 of 29 Regular outings have been introduced and the menus have continued to be up-dated to reflect the service users choice. What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Good assessment processes ensure that potential service users needs can be met at Church View. Church View does not provide intermediate care. Evidence: There is a range of information available for people to read about the service including the Statement of Purpose and Service User Guide. Prospective service users are also given the opportunity of spending time in the home before they move in. The manager told us that a member of staff is allocated to them to give them information and to help them understand how the home is organized and run, and the facilities and services available. Before a new person can move into Church View the manager carries out an in-depth Care Homes for Older People Page 11 of 29 Evidence: assessment with them. This includes looking at the prospective service users health and social care needs, as well as their likes and dislikes. For prospective service users, funded by the local authority, the manager obtains a copy of the needs assessment and care plan from the care manager so that she can decide whether Church View is able to meet their needs. Four out of the five people who filed in a survey said that they had been given enough information about Church View before they moved in. Relatives said that they had had the opportunity to have a look at this and other homes before deciding which was the best home for their family member. They said this one ticked all the boxes. Care Homes for Older People Page 12 of 29 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is generally good information in the care plans about the health and personal care needs of the service users. This ensures that everyone receives care and support in a way that they prefer. Staff care practices preserve the dignity and privacy of the people who live here to a good standard. And medication administration procedures protect the service users. Evidence: A range of standardized assessments are in place that lead to the care plans being developed. These cover a number of areas such as communication, mobility and falls prevention, eating, drinking and nutrition, personal cleansing and pressure area care. The care plans we looked at generally provided good information about the service users health and personal care needs and were up-to-date. Nightstaff said that they had recently been writing night care plans and in this way care staff are working as a Care Homes for Older People Page 13 of 29 Evidence: team. Some of the care plans provided clear guidance to staff on how to support the service users. For example, in one there was good information about a persons bathing routine, their personal preferences and the support they need. However, in another one, in the daily records it had been identified that sometimes this person could become agitated, wanting to go home. There was no plan in place to advise staff of the appropriate support to offer them at such times. There is no-one currently with a pressure sore in this home. Appropriate pressure relieving equipment is provided for those people who need it. And regular body maps are recorded to make sure any bruises or marks are recorded and monitored. Care plans are evaluated monthly and there are also reviews carried out involving the service user, their relatives and social worker. Service users weights are monitored each month. Daily records are maintained, however, the quality of these varied. Some entries did not provide information about the care which had been provided although others did. The manager is aware of the shortfalls with some of the care plans and senior staff are in the process of re-writing them. Service users have access to all NHS facilities. There are regular visits from GPs and other health professionals, including opticians, chiropody services, district nurses and dieticians. There was evidence in one persons care plan that their health had got better and a pressure sore they had when they were first admitted to the home had improved. Medication is stored in a locked, secure room. The staff monitor the temperature of the medication room and the medication fridge to make sure that medicines are stored correctly. Senior staff order the medication from the prescriptions to ensure that service users are provided with the correct medication. Staff confirmed that they had completed training in the safe handling of medication. There were no gaps on the Medication Administration Records, (MAR), which we looked at which demonstrated that service users are receiving their prescribed medication. Care Homes for Older People Page 14 of 29 Evidence: The manager does regular audits of the medication to make sure that it has been given to service users as prescribed. There is a small stock of controlled drugs. These are stored securely, and accurate records kept of the administration of these. One person had been prescribed as required medication for agitation. However, there was no care plan available to advise staff of when this should be given. During our visit time was spent with the service users who have dementia and live on the first floor of the home. Staff were respectful in their approach towards the service users and ensured that their privacy was respected. Personal and intimate care tasks were carried out in the privacy of the service users own bedrooms. Staff referred to the service users by their preferred name and it was clear there was a good rapport between the staff and service users. Service users and relatives said the staff treated them with respect. Three staff are currently completing training to become dignity champions. Once they have completed this training they will be working along other staff to think about ways that the dignity of service users could be improved, for example in relation to mealtimes or through communication. This is excellent practice. However, all of the bedrooms on the first floor of the home are kept locked. This means that service users are unable to independently spend time in the privacy of their bedroom should they choose to. The manager agreed to review this practice. One service user commented they care for my well being Care Homes for Older People Page 15 of 29 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Service users enjoy a variety of activities, and are able to maintain family and other contacts if they want to. This ensures service users have opportunities to lead a fulfilling lifestyle and do not become socially isolated. Evidence: The activities available to service users are displayed around the home. Activities are discussed in service user meetings to ensure activities of their choice are provided. There is a designated activities coordinator, who works 25 hours per week. Service users were very complimentary about her and said there is an active programme of activities, the lady in charge has great ideas and activities are well thought out. Relatives told us that when the weather was hot, everyone was out in the garden enjoying ice creams and cold beers. Service users are involved in activities such as gardening as well domestic tasks like polishing. The manager told us about one service user, who has dementia, and became agitated at a certain time of day. Staff realized, through life story work with Care Homes for Older People Page 16 of 29 Evidence: them, that at this time of day they used to hang their washing on the line. Staff provided a washing line so that they could continue with this familiar routine, which is excellent practice in dementia care. Service users said I can go out to the pub for a pint and put a bet on the horses,I can find plenty to do, the home has concerts and things. Relatives said there was a fantastic display for Easter and for Valentines day. The home also has a pet dog, which was obviously very popular with the service users. Although none of the service users go out to Church, the manager told us a priest visits weekly to give communion to those who want this and the Church choir visit the home monthly. Relatives said that they can visit the home any time and are always made to feel welcome by staff. An advocacy service is provided, free of charge, and information about this displayed in the home. Service users, if able to do so, are encouraged to look after their own finances. We spent time with people on the first floor of the home whilst lunch was served. Tables were nicely presented with napkins and table cloths. Those service users who needed support were offered this by staff in a sensitive respectful manner. There is a choice of main meal. The manager told us that they could improve the menu by making this available with pictures to help service users with dementia choose what they would like to eat. We had tea with service users on the ground floor. Again, tables were nicely presented and service users were offered a choice of what to eat. Relatives said that they liked the small dining rooms and the fact that the tables were always nicely presented with cloths, napkins, cups and saucers. Comments from service users included, I like the food, and I am very parky but get what I want to eat, the foods lovely and I love the bananas. Relatives said there is always a choice of fresh fruit, they bought my mother lemon curd, which she loves. Care Homes for Older People Page 17 of 29 Evidence: Care Homes for Older People Page 18 of 29 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. The home has a good complaints procedure so people know that their views will be listened to and acted upon. And staff training helps to ensure that the service users are protected from abuse. Evidence: The home has a complaints procedure. This is on display throughout the home and in the Service User Guide. The manager has recently reminded service users of the homes complaints procedure in a service user meeting, which is good practice. There have been three complaints in the last year. We looked at the complaints record, which showed that these had been thoroughly investigated by the manager. The manager carries out a monthly audit of these to make sure that they have been accurately recorded and dealt with appropriately. She also uses the audit to identify any themes or trends. One service user said in a survey that staff are always available to talk to and act on problems. A relative said they would have no hesitation in asking for a meeting if they had any concerns and any little issues we have are rectified straight away. There has been one safeguarding referral made in the last year, which demonstrates that staff know the procedure to follow to ensure service users are fully protected. Care Homes for Older People Page 19 of 29 Evidence: All staff receive awareness training in safeguarding adults during their induction. In the last year 30 staff have completed a twelve week training course about the protection of vulnerable adults. Care Homes for Older People Page 20 of 29 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, 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. 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. Service users benefit from a clean, homely and well maintained place to live, however, there are not enough assisted bathing facilities to meet the needs of service users. Evidence: When we visited the home was clean and tidy. Service users said in surveys that the rooms are cleaned to a good standard and the home is kept very clean and tidy. The first floor of the home has been adapted to meet the needs of people with dementia. For example there are lots of items of interest along the corridors such as pictures, tactile items and photographs. Staff have developed an indoor garden as a theme in a corner of the corridor where people can sit and relax. The home was purpose built and therefore all bedrooms have en-suite facilities with a toilet and sink. One service user showed us their bedroom which was personailsed with photographs and ornaments reflecting their interests and tastes. The grounds are neat and tidy and can be easily used by visitors and service users in the warmer weather. There is currently only one assisted bath on the ground floor and one assisted shower Care Homes for Older People Page 21 of 29 Evidence: on the first floor, in addition to four low level baths. However, the manager told us that service users rarely use the low level baths because of safety reasons. This means that service users have to go downstairs if they want to have a bath, and also therefore means that there are only two bathing/shower facilities which service users can use. This issue was raised during the last inspection. All staff receive training in infection control through the induction process. Hand washing facilities are provided throughout the home. As part of the homes infection control measures alcohol hand rub gel is available in the foyer for visitors to use. The manager is enrolling staff on a twelve week infection control training course. One service user commented in a survey the laundry is very good. Care Homes for Older People Page 22 of 29 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staffing levels are sufficient, which ensures staff provide person centred care. Staff training is satisfactory and includes specialist training in order to meet the diverse needs of the service users. This ensures staff can effectively meet the care needs of people with dementia. Staff recruitment procedures fully protect the service users. Evidence: On duty when we visited was the manager, two senior staff and six care staff. There is always a senior member of staff in charge on each floor. There were also two domestic staff, a laundress, two catering staff and an administrator. The home also employs a full time handyman. The staff we spoke to confirmed that these staffing levels were always maintained. There has been a low turnover of staff, which is good for continuity of care. All of the service users spoke positively about the staff and there was clearly a good rapport between the service users and staff. Care Homes for Older People Page 23 of 29 Evidence: Service users said: the staff are very patient, they are friendly and there is always alot of laughter which is great, all of the staff are very nice. One or two are diamonds, I like the fact the staff smile, some staff remember my aunt being here. It tells you something about a job when the staff have worked in the home a long time. The manager has identified where there are gaps in staff training and has developed a training programme to address this. For example training called Yesterday, Today, Tomorrow, (this is specialist training in dementia care), has been arranged. Seventy percent of the staff have the NVQ level 2 qualification in care. Staff files showed that the companys recruitment procedures are followed. This includes obtaining two written references and an Enhanced Criminal Records Bureau check to ensure that the prospective staff member is suitable. Care Homes for Older People Page 24 of 29 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. Good management systems ensure the health, safety and welfare of service users. There is a good quality assurance system. This is based on the views of service users, where they are able to communicate their wishes, so that they know their rights and views will be listened to. Evidence: It was evident that the new manager, in the time that she has been at Church View, has worked hard to improve the service for service users. She provided us with good information, before we visited, about what has improved in the home in the last year and it is clear she knows what needs to be done to improve things further. The manager has completed the NVQ 4 award in management and has six years management experience. Care Homes for Older People Page 25 of 29 Evidence: The manager clearly has an excellent rapport with the service users and understands about person centred care. When we arrived she took the time to introduce the service users, explaining to them the role of the CQC. Relatives said we love Sham (the manager) she commands a great deal of respect from residents, families and staff. Staff said she is lovely, you can go to her and shell sort it. Service user satisfaction questionnaires are used to obtain feedback about the service. There are also regular service user/relative meetings. There is a comprehensive internal audit system. This involves a monthly audit carried out by the manager which includes staff training, pressure sores and service user weights, care plans, health and safety issues, the environment and medication. The manager told us that all service user monetary transactions are recorded as per company policy. The home carries out internal maintenance checks and has contractors to service equipment. Maintenance staff carry out regular checks of fire fighting equipment, alarms and emergency lighting. Staff confirmed fire drills are carried out every month so that staff know exactly what to do if there is a fire. Detailed records are maintained of all accidents, which includes the follow action taken by the manager. The manager also closely monitors the occurrence of accidents and incidents in order to identify if there are any themes or trends. There is a trained moving and handling facilitator on the staff team who ensures staff follow best practice. Staff are provided with training in health and safety issues such as moving and handling, first aid and food hygiene. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Older People Page 27 of 29 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 Requirement 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 Requirement Timescale for action 1 19 23 Sufficient assisted bathing/shower facilities must be provided. This is so that the service users personal care needs can be met as well as promoting choice. 26/11/2009 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 7 It is recommended the care plans continue to develop to contain detailed guidance for staff about the support each person needs. Where a person needs as and when medication there should be information in the care plan about when this should be given. This will help ensure continuity of care is provided to people in a way that they prefer. It is recommended the manager review the practice of keeping bedroom doors locked. This is so that people with dementia can independently use these areas should they choose to. 2 10 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 Older People Page 29 of 29 - 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!