Inspection on 24/04/07 for Crown Rest Home

This inspection was carried out on 24th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Crown Rest Home 09/04/10

Crown Rest Home 20/10/05

Crown Rest Home 01/06/05

Crown Rest Home 11/01/05

Crown Rest Home 30/06/04

Crown Rest Home 21/10/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Crown Rest Home Station Road Little Dunham Kings Lynn Norfolk PE32 2DJ Lead Inspector Mrs Jacky Vugler Unannounced Inspection 24th April 2007 09:30 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 Crown Rest Home DS0000027514.V337238.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. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crown Rest Home Address Station Road Little Dunham Kings Lynn Norfolk PE32 2DJ 01760 722039 NO FAX # lindsey.wood2konline.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Christopher Wood Mrs Lindsey Wood Not applicable Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Crown Rest Home provides residential care for twelve older people. Although a range of needs is catered for there is no ‘specialised’ service. The home comprises of the original building (which was a public house) plus some more recent extensions. Care has been taken to make access as easy as possible throughout the property. The home is situated a short distance out of the village, and there is a better than average (four times daily) bus service. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, lasting seven and a half hours. A pre-inspection questionnaire had been completed prior to the inspection, which the Mrs Wood had returned to the Commission with all the relevant details. Not all of the standards were assessed on this occasion. Where a standard has been inspected, the complete range of sub-elements, as set out in the National Minimum Standards, may not have been assessed. The score given represents those aspects viewed on the day, and which are commented on within the text of the report. Mr and Mrs Wood, the proprietors, were both present throughout the inspection. Fifteen residents were accommodated on the day of inspection. During the day, a tour of the premises was undertaken and many records were viewed. Two comment cards were received from residents and one from a relative. Four residents and three members of staff were spoken with privately. The comment cards received were positive of all aspects of the home, and the views are reflected in this report. Overall, the information received prior to the inspection and the information and evidence observed and inspected on the day, suggested that The Crown Rest Home is an excellent service offering good quality care to those who live there. The inspector would like to thank the residents, staff and proprietors of the home for their hospitality, courtesy and help, which facilitated the writing of this report. What the service does well: The home achieved the Investors in People Award in February 2005. Mrs Wood is a Registered Nurse and both Mr and Mrs Wood have continuously undertaken training to keep their knowledge updated. The Crown is very homely, but yet professionally run by the proprietors. Throughout the day there was a calm, relaxed atmosphere at the home. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 6 A very high standard of food is provided with all of it home-cooked. The residents are very much part of the running of the home and have regular meetings to enable them to make group decisions. Staff were not rushed and seemed to have plenty of time for the residents. The training opportunities are good and student nurses from the University of East Anglia now come to the home for their first placement of total patient care. All of the returned questionnaires and comments made by residents and staff indicated a high level of satisfaction with the service provided. A returned questionnaire from a relative said that if all the homes were up to the care and standard of this one, you would have a lot of happy residents. Staff said its like a home not an institution. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Crown Rest Home DS0000027514.V337238.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 Crown Rest Home DS0000027514.V337238.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): 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their families are given plenty of information and opportunity to visit the home so they can make an informed choice about whether they wish to live at The Crown Rest Home. A thorough assessment of needs is undertaken before any resident is admitted so all parties can be sure that these can be met. EVIDENCE: Plenty of information is available to prospective residents and their families prior to admission. A brochure is available in the entrance hall along with the latest inspection report and the statement of purpose. On enquiry, the family usually come to look around the home and they are given a brochure. Mrs Wood said that enquiries mainly come from recommendation by word of mouth. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 9 Mrs Wood visits the prospective resident in their home and then invites them to spend a day at The Crown. A written assessment is undertaken at this time and is repeated after a months trial period, and monthly thereafter when a carer discusses the care plan with them and asks if there is anything else they need. When a resident was recently admitted as an emergency, Mrs Wood said that she visited her in hospital the day before admission to ensure that they could meet her healthcare needs. Residents or their representatives sign the terms and conditions on the day that they agree to admission. One resident said I came to look around before I came in …… they gave me a brochure …… I was here for quite a few hours. Crown Rest Home DS0000027514.V337238.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 good. This judgement has been made using available evidence including a visit to this service. The individual care plans clearly set out the residents care needs and other healthcare professionals are involved when necessary to ensure those needs are met. The residents are protected by the homes policies, procedures and practices for dealing with medicines. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: The care plans are kept in the residents bedrooms and all spoken to were aware of them and able to say where they were (in a Perspex rack on the wall). The care plans are detailed, regularly reviewed and signed by the resident or their representative. The care plans are very clear and some facts have been cross referenced to another document, for example, a risk Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 11 assessment. This is good practice. Risk assessments are in place, including falls and a falls diary, infection control monitoring and moving and handling. Other healthcare professionals are involved when necessary and GPs and district nurses are used from four different practices, and a record is kept of their visits. The residents are able to use the local opticians if they prefer, or another visits the home, as does the chiropodist and dentist. Mrs Wood said that the dietician is regularly contacted for advice regarding the menus. A GP visited during the inspection and it was evident that the relationship was good and in the best interests of the residents. Mrs Wood said that the Occupational Therapist visits new residents. All residents spoken to said that the staff were respectful and that they protected their dignity when providing personal care. During the day staff were observed knocking on residents doors before entering and generally treating them with respect. The home uses the Boots monitored dosage system and all medications are appropriately stored. The medication records were well completed. One resident manages her own medication, which she stores in a locked drawer in her bedroom. A risk assessment is in place and this is updated monthly with the resident. Internal medication training takes place during induction and then the carer administers medications under supervision until they and their supervisor are confident. Other medication training is provided by an external company at the home and evidence of this was seen. All staff have completed medication training. Crown Rest Home DS0000027514.V337238.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. This judgement has been made using available evidence including a visit to this service. The residents are very happy that their lifestyle matches their expectations. They have a lot of contact with the outside community and families and friends are encouraged to visit the home. Residents are helped to exercise choice and control over their lives. Residents received a nutritious, balanced diet with plenty of home-cooked food. EVIDENCE: Since the last inspection a carer now works as an activities coordinator for two full days a week. She takes out or spends time with residents either individually or in small groups, for example, when a new resident is admitted, she will spend time with her to unpack clothes and get to know her, and will highlight to staff any particular interests of certain residents. Each resident has an activities sheet on which any activities undertaken are recorded and an Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 13 activities folder is in place. Flyers for events or days out that Mrs Wood thinks the residents will enjoy are put in the folder and discussed at the next residents meeting to see if they would like to go. A photograph album is available with photos of residents participating in activities. There is currently a collage of Christmas photos which will eventually go into an album. Residents spoken to said that they were happy with the level of activities provided within the home. One gentleman spoken to was outside tending plants in the greenhouse, he said that he loved to do this and liked to be active. The home has an open-visiting policy and many visitors were seen on the day of inspection. The home has its own resident dog and visitors include an Age Concern befriender who visits fortnightly, Jehovah Witness and the mobile library. The home enjoys a good liaison with local primary school and in the summer they put on a concert, which all the residents attended. At Christmas they perform a nativity play and at Easter the residents buy the children an Easter egg. The residents hope to take part in the Village fete and may have their own stall this year. They are currently looking forward to their Families Day on 24th June when residents and staff bring their families and a BBQ and band are provided. They usually all go out for Christmas dinner, but last year a few residents were unwell so instead they stayed in and had a Chinese banquet. The residents spoke of huge choices available to them, they said, we can do what we want, when we want, and during the day staff were heard to offer choices to residents as a matter of course. A questionnaire said that residents can be as independent as they like. The menus seen were nutritious and varied, and the meal on the day was well presented, and looked and smelled appetizing. The residents were seen to enjoy their meal and a glass of wine in a pleasant dining room chatting amongst themselves and with the staff. There is an additional small dining area for those who prefer. Tea offers a choice of two hot and two cold dishes. The cook makes everything fresh including different types of bread, cakes and biscuits. A questionnaire returned from a resident said that the menus are discussed with the cook each season and anyone not liking the days menu is given a choice of something else. The kitchen was clean and tidy and no recommendations were left by the environmental health officer. The cook is very experienced and her qualifications include the malnutrition universal screening tool and this knowledge was seen to be evidenced in her practice. The home has been awarded the Good Food Hygiene Award by the Environmental Health Office. Crown Rest Home DS0000027514.V337238.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, 17 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents and their families can be confident that their complaints will be listened to and taken seriously. Residents legal rights are protected and they are protected from abuse. EVIDENCE: A folder is available in the entrance of the home in which to record comments and complaints. Within this folder is the complaints procedure, paper, a pen and envelopes addressed to the proprietors. This is good practice as it makes it very easy for people to make comments and complaints if they so wish. Mrs Wood said that there have been no complaints since the last inspection. Some residents go out with relatives to vote and others have a postal vote. The home has abuse and whistle-blowing policies in place and all staff have completed abuse training through an outside trainer and new staff have it in their induction until external training can be provided. All staff have a completed criminal records bureau disclosure in place. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, clean and well maintained environment that is clean and hygienic. The extension is built to a high standard and provides extra facilities for the residents to improve their quality of life. EVIDENCE: Since the last inspection an extension has been built to a very high standard. The home now has eighteen single bedrooms each with an en suite facility. Ten on the ground floor and eight on the first floor, one of which is larger and able to cater for disabled residents. The new bedrooms have under floor heating with individual thermostatic controls so residents may regulate the temperature in their bedroom. There is an additional room, which can be used as a salon, treatment room or a visitors overnight room. There is a communal TV lounge, a cinema lounge, a communal garden/dining room and a Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 16 conservatory. Access to the first floor is provided by a passenger lift or stair lift and doorways are wide enough for wheelchair users. There is plenty of natural light throughout the home and all areas are decorated to a high standard. The proprietors said they now have plans to make the outside patio area into a large enclosed sun lounge and relocate the patio to a different part of the garden with access via a pathway, this work is expected to commence in the very near future. In the meantime they are continuing to improve the appearance of the outside area in general. Residents bedrooms were personalised and contained many personal item and pictures and photographs were displayed on the walls. They were nicely furnished, some with the residents own furniture, and those spoken with were very happy in their room, one saying, Ive got a lovely room, its always spotless. The outside areas are accessible to residents and one gentleman was down the garden working in the greenhouse. The courtyard has a raised fish pond. The home was very clean and tidy and the laundry duties were carried out in a suitable area. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are good levels of staffing at this home. The staff are well trained and competent to do their jobs. The residents are protected by the homes recruitment procedures. EVIDENCE: In the entrance is a board displaying photographs of the staff. Fifteen residents were accommodated on the day of inspection. A duty rota received by the Commission shows that care staff provide 21.3 hours a week per resident over the 24 hour period. This equates to three carers during the morning, four during the afternoon, two during the evening and two waking night staff. In addition, catering hours of 2.9, domestic hours of 1.8 per resident per week and two days for the activities organiser are provided. An on call system is in place and back up, if proprietors on holiday, is provided by a very experienced carer. During the day of inspection staff were not rushed and seemed to have time to spend with the residents. A questionnaire said that someone is always there to help. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 18 Seven of the sixteen carers have achieved the NVQ level 2 and four are undertaking it as well as one who is currently undertaking the NVQ level 3. If these staff are successful and retained, the home would exceed the 50 of staff required to be trained. The recruitment records seen showed there to be an improvement in the recruitment practices since the last inspection. Two references were in place as well as a criminal records disclosure. Each file had an equal opportunities form, a job description and a code of conduct. The proprietors work hard to ensure the staff are up to date with their training. A list of mandatory training is displayed in office and it is ticked when completed, so at a glance the proprietors can see who has done what. Evidence of training is kept and all staff have a new training record annually. Previous years training documents are kept separately for reference. Evidence was seen of all training, including induction and foundation training. Staff spoken to said, training is brilliant, we all go regularly on courses, there are plenty of opportunities. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is run by competent providers who are fit and of good character, and the home is run in the best interests of the residents. The residents benefit from the open leadership approach within the home. The quality assurance system is complex and effective. The health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 20 Lindsey Wood is a Registered Nurse and has achieved the NVQ level 5 in Health and Social Service Management. She has attended a course Supervision Skills for Social Service Managers. Other training she has undertaken includes, advice and guidance, train the trainer in Malnutrition and the English National Board certificate for Nursing the Elderly. Chris Wood has completed a course on Introduction to ISO 9001 and the QMS Internal Auditor training course for customer satisfaction measurement. An annual management review and an annual quality audit were conducted in September 2006. A comprehensive quality assurance system is now in place, which includes, a training evaluation form for outside training, internal audit schedule for procedures, non conformance register, non conformance report, analysis of routine monitoring of the quality system. Residents have meetings held approximately every four months. At these they discuss, among other things, menus, activities and what they would like to spend their amenity fund on. Minutes are taken and made available to residents and their families. The Proprietors do not attend these meetings to ensure that the residents feel they can freely speak. Some cash is held for one resident and this was checked and found to be correct. There is a record of the income and expenditure and receipts are kept and signed by her daughter and a member of staff. This gives a good audit trail. Evidence was seen of regular supervision sessions with the staff regarding their clinical practice. However, a new format has been devised and this will include regular one to one supervisions sessions with staff. Records of weekly fire alarm tests and fire extinguisher checks were seen. The existing fire alarms were serviced when new fire alarm zone was completed 12th January 2007. The fire extinguisher service was completed on 7th March 2007 and the emergency lighting on the 8th April 2007. Fire risk assessment were seen. Stair lift was serviced on 10th November 2006. The passenger lift was new in March 2007. Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 3 18 3 4 3 3 x 3 3 3 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 x 3 3 x 3 Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 22 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 Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Crown Rest Home DS0000027514.V337238.R01.S.doc Version 5.2 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. 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