Inspection on 08/11/05 for Cranmer

This inspection was carried out on 8th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cranmer 05/09/06

Cranmer 05/07/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 28/10/2008.

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Cranmer Cranmer 237 Coleman Street Whitmore Reans Wolverhampton West Midlands WV6 0RG Lead Inspector Gurinder Cheema Announced Inspection 8th November 2005 11:00 Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cranmer Address 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) Cranmer 237 Coleman Street Whitmore Reans Wolverhampton West Midlands WV6 0RG 01902 747945 01902 712610 Milbury Care Services Limited Mr Kenneth Gofton Care Home 8 Category(ies) of Learning disability (8), Old age, not falling registration, with number within any other category (8) of places Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Maximum number of residents - 8 persons category MH/E Any Mix Date of last inspection 27th April 2005 Brief Description of the Service: Cranmer, 137 Coleman Street, is a care home providing accommodation and personal care to eight adults with learning disabilities or old age. It is one of a group of homes owned by Milbury Community Services Ltd. The home is located in the Whitmore Reans area of Wolverhampton. It is close to local amenities and on a main bus route into the city. All bedrooms are single occupancy and are individually decorated to a high standard. The lounge and dining areas are comfortable, homely and well furnished. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second annual inspection of the year. Care homes are inspected at least twice a year. The inspection was announced and took place on 8th November 2005 between 11:00am and 2:00pm. The manager, staff on duty, and the service users, who were available, were all very welcoming and helpful throughout the inspection. All but one of the National Minimum Standards inspected were met identifying that the overall quality of care provided is very good. Written comments and feedback via questionnaires were sought prior to the inspection from a number of individuals. These included: Service users, staff, General Practitioners, Health and Social care professionals and service users’ carers. Only questionnaires from service users and relatives were received back and these were all found to be very positive. On this inspection mainly standards one to twenty three were inspected. The other standards were inspected at the home last inspection conducted on 27th April 2005. To get a full over view of the homes findings both inspection reports should be read together. What the service does well: Information available for service users is good. Personal care needs are assessed and met, with each service user having their own care plan, which were found to be regularly reviewed. These are detailed and appropriately documented giving clear instructions to staff on service users individual care needs. These are also accessible to all service users. Only one service user was met in private the remainder were talked to and appeared content with the care they were receiving. No relatives were available during the inspection. Comments received on the day of inspection and on the returned questionnaires were all very positive and included: “…Is very well looked after” “It is the staff at Cranmer Home that make my sisters stay worthwhile. To … they are her friends and I can not praise them enough” “Kept clean and tidy (home)” “Staff work well…very helpful and take me shopping to Asda” Risk assessments are detailed and information regarding individuals is provided to staff before they begin caring for the individual. There is a clear and accurate complaints procedure with a detailed history of all complaints and there outcomes. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 6 In regard to the general administration of the home, the inspection revealed that there is a commitment to providing accurate and relevant records. The Care Manager and staff are commended for their efforts to maintain good standards of care and comfortable environment for the service users. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Appropriate procedures are in place that would enable the successful admission of new service users to the home. EVIDENCE: The home has a good statement of purpose that the Care Manager has recently revised to up-date on staffing issues. The statement of purpose has been designed to incorporate the service users guide. The Service users at the home are long standing and there has been no new admission into the home for about five years. From the sample of files inspected it was evident however that all the service users were admitted to the home following a full multi-disciplinary assessment. An initial care plan is produced from the assessment and is used as a basis for the care that is provided. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 9 The home provides detailed care plans for each resident, which is reviewed on a regular basis. There is a care plan on every resident’s individual file to show that where necessary, special services are obtained to meet the resident’s individual needs. The Registered Manager informed the inspector that any prospective residents would be encouraged to visit the home prior to admission. An introductory visit would always be offered to prospective residents and their family. The home has a good Life style agreement that has been produced and is in line with the national minimum standards. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 Staff respect service users’ rights and there is a constant monitoring and review process to ensure that their identified needs are being met and individualised care given. EVIDENCE: The home provides a satisfactory care plan for each resident that is firstly based on the initial assessment and then the subsequent reviews. From the files inspected reviews were seen to be held at six monthly intervals by staff in consultation with the residents and their families. However, dependant on the need a review would be held more often. The residents are encouraged by their key-workers to be involved in the day to day running of the home as much as possible and encourage them to make Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 11 decisions regarding social activities, menus, outings and decoration of the home. There was evidence to show that staff at the home involve the residents in decision through house meetings and key-workers systems. The Staff at the home have undertaken risk assessments on all of the residents and copies are placed on resident’s individual files. It was clear that none of the residents are un-duly restricted in any way by the assessments. The home has good written policies and procedures regarding confidentiality and all the staff are aware of their responsibilities regarding the Data Protection Act 1998. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 and 17. The lifestyle of the service users living at this home is good and through a framework of activities, independence, personal and social skills they are encouraged to develop. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 13 EVIDENCE: From the three files inspected it was clear that residents care plans reflect that they are encouraged to be involved in a wide range of independent living skills activities. Residents are encouraged to continue to attend places such as Adult Training centres and local colleges and are also involved in a wide range of other activities. Staff also support residents to engage in a wide range of community activities at weekends. The home has the use of its own transport and residents visit shopping centres, parks and other preferred outings. There is good evidence on files to show that residents are encouraged to choose from a wide range of leisure activities both within and outside of the home. The staff assist residents to maintain contact with their relatives by arranging meetings and contacting their relatives. Visitors are made welcome at the home and family and friends are invited and attend parties and celebrations. During the day of inspection staff were sending out invitations to relatives for a Christmas party. The home has a very relaxed and happy atmosphere and good interaction between staff and residents was noted. All the activities and mealtimes are organised to meet the individual needs of the residents. From observations made and the comments received by the residents who could express themselves in a meaningful way confirmed particular attention is given to residents individual preferences in regard to the food provided in the home. All the comments regarding the quality, quantity and variety of the food and meals was complimentary. It was noted that residents also visit local restaurants, pubs, snooker halls and obtain take-a-way meals on occasions. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21. The personal and health needs of service users are well met with evidence of regular review and of good multi disciplinary working taking place on a regular basis. EVIDENCE: All staff are aware of the need to provide sensitive care and to maintain the residents privacy and dignity. All these issues are clearly set out in the homes statement of purpose and aims and objectives. Also they are included in the homes induction programme and N.V.Q. training. The Care Manager stated that the home is well supported by a local G.P. and all of the paramedical services when necessary. Where ever possible the residents, are encouraged to attend local Opticians, Dentists and G.Ps. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 15 Individual residents files indicate that all the residents are receiving appropriate attention on a regular basis. The home has good policies and procedures on all aspects of medication. Only staff appropriately trained administer the medication and this is delivered by means of a monitored dosage system. Until recently the home also administered insulin but this is now done by local District Nurses. The Care Manager and staff have not had to deal with the loss of a resident but are conscious of the need to provide extra support to the resident in their final days at the home. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The service users are protected from abuse and the staff enable their views to be taken into account despite the nature of their disabilities. EVIDENCE: The home has a good complaints procedure and the residents and relatives are made aware of the procedure through the statement of purpose and the Life style document. Also the home has developed appropriate material to assist service users with their complaints. There have had no formal complaints since the last inspection conducted in April 2005. The home has very good policies and procedures regarding the Prevention of Abuse, Restraint, Dealing with Aggressive Behaviour and a Whistle Blowing policy. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The standard of the environment is good providing service users with a homely and comfortable place to live. EVIDENCE: These standards were not inspected on this occasion but on the day of inspection the home was found to be clean and tidy and free from any offensive odours. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There appeared to be satisfactory numbers of competent staff on duty to meet the identified care needs of the residents. EVIDENCE: These standards were not inspected fully on this occasion. However, there appeared an adequate number of staff on duty and those spoken showed knowledge and understanding of the needs and wishes of the residents. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Health, safety and welfare of service users and staff are promoted by safe working systems in place. EVIDENCE: Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 20 Only standards 39 and 42 were inspected on this occasion as they were not met at the last inspection. All health and safety checks and tests are now been conducted with good records kept. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT 37 x 38 x 39 2 40 x 41 x 42 3 43 x Standard No 6 7 8 9 10 LIFESTYLES 11 12 13 14 15 16 17 Score 3 3 3 3 3 3 3 3 3 3 3 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA39 Regulation 24 Requirement The registered person must ensure that the homes Quality Assurance systems are further developed to ensure that all of the relevant stakeholders such as relatives, care professionals etc are annually consulted. That an annual development plan is produced from the findings. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Cranmer DS0000029983.V256732.R01.S.doc Version 5.0 Page 24 - 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!