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Inspection on 22/11/07 for Eastfield Farm Residential Home Limited

Also see our care home review for Eastfield Farm Residential Home Limited for more information

This inspection was carried out on 22nd November 2007.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users are well supported by staff who are trained and experienced to provide appropriate and individual care to meet assessed needs. The service users have good access to health service professionals. Admission procedures to the home are good and prospective service users are invited to look round the home before making a decision to move in. There is a good activities programme based on service users` interests. Due to the rural location of the home, involvement with the community is usually by way of visits to the home rather than service users travelling outside. However, some service users have trips out of the home with their relatives. Service users and relatives were particularly complementary about the food provided and meal times are viewed as a very sociable and enjoyable event. Service users and their relatives are encouraged to take part in what goes on in the home. The home make sure all the proper checks are carried out before staff are employed at the home.

What has improved since the last inspection?

The management of the home has made sure that all of the requirements set after the last inspection have been met. This has included making sure that newly admitted service user have a complete plan of care so the staff know how to look after them properly. The home has undergone some redecoration and the manger has introduced a more homely environment for the service users to live in. The kitchen has been refurbished. There is a designated activities room in the home for every one to use at any time.

What the care home could do better:

There are no requirements set from this inspection, however the manager has indicated on the information which they are required to provide as part of the inspection process (AQAA) many areas which she feels would enhance the service provided. Some examples of these are: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Cooks and caring staff to attend new courses on nutrition. New clinical treatment room to be completed and physiotherapy equipment installed Continue with staff training. New storage area to be completed within the grounds for property belonging to the Home ie extra chairs, tables etc for visitors. More staff to attend accredited medication course. Expand activity room further. Fitness equipment to be purchased for fitness and enjoyment. To continue to update decoration and replace furnishings, furniture and carpets as required. Advertise for a second experienced senior carer with a minimum of NVQ III. Continue with all aspects of training, courses and refreshers. Increase the amount of supervisions carried out with staff. To continue the high delivery of care to service users from staff.

CARE HOMES FOR OLDER PEOPLE Eastfield Farm Residential Home Limited Halsham East Yorkshire HU12 0BP Lead Inspector George Skinn Key Unannounced Inspection 22nd November 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 Eastfield Farm Residential Home Limited DS0000062571.V355205.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. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastfield Farm Residential Home Limited Address Halsham East Yorkshire HU12 0BP 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) 01964 671134 Eastfield Farm Service userial Home Limited Mrs Tracy Ann Davies Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25) of places Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: Old age, not falling within any other category - Code OP and Dementia - Code DE (E) The maximum number of service users who can be accommodated is: 25 31st October 2006 2. Date of last inspection Brief Description of the Service: Eastfield Farm Service userial Home is a privately owned care home that is registered to care for and accommodate 25 older people, including those with dementia. The home is situated in a rural setting and local amenities are only accessible via public transport or car. The accommodation comprises of seventeen single rooms and four shared rooms - eleven of the single rooms and one of the shared rooms have en-suite facilities. The first floor is accessible via a stair lift. Communal space comprises of three lounges and a dining room - some of these areas have open views over the countryside. The garden is easily accessible for service users and in the summer benches, tables and parasols are placed outside. There is ample parking space at the front of the building. The range of charges are £334.80 to £435.00 no third party top up is charged. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered provider on an Annual Quality Assurance Assessment (AQAA); Comment cards returned from service users, relatives and staff A visit to the home carried out by one inspector. A site visit was carried out which lasted 6 hours. Service users, relatives and staff were spoken with. Records relating to service users, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home The manager was available to assist throughout the day. What the service does well: What has improved since the last inspection? Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 6 The management of the home has made sure that all of the requirements set after the last inspection have been met. This has included making sure that newly admitted service user have a complete plan of care so the staff know how to look after them properly. The home has undergone some redecoration and the manger has introduced a more homely environment for the service users to live in. The kitchen has been refurbished. There is a designated activities room in the home for every one to use at any time. 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. Eastfield Farm Residential Home Limited DS0000062571.V355205.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 Eastfield Farm Residential Home Limited DS0000062571.V355205.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&3 People who use this service experience good quality outcomes in this area. Service users are given enough information prior to moving into the home to be able to make an informed choice. Service users needs are assessed prior to moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are assessed prior to admission by both the management of the home and the placing authority. The manager gathers pre-admission information to establish if the home can meet the service users’ needs; this also ensures a thorough matching process is undertaken. The manager then undertakes another assessment once the service user had been admitted to the home; this involves the service user, their relative and relevant health care professionals. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 9 The service users are provided with terms and conditions of the home which detail the registered persons responsibilities and the service users’. This was signed by the service user and/or their representative and kept on their files. The Statement of Purpose and the Service User Guide have been updated to reflect the change in management. The manager has produced a smaller A5 size Statement of Purpose which is kept in each of the service users’ rooms. Those service users and relatives spoken with during the site visit confirmed that they had been given plenty of information prior to moving into the home and they were able to visit the home before agreeing to live there. Eastfield Farm Residential Home Limited DS0000062571.V355205.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 & 10 People who use this service experience excellent quality outcomes in this area All of the service users have a detailed plan of care. Service users have full access to health care professional on regular basis and when needed. Service users are protected by the home procedure on handling medication. Service users are treated with respect and their dignity is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of service users’ records were looked during the site visit. These contained written evidence of thorough assessments being undertaken by both the home’s manager and the placing authority; from these assessments detailed care plans are devised. The care plans identified areas of strength and areas which the service users needed help. Detailed recording of what action is to be taken and how to Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 11 enable the service users to lead an independent life style was provided for staff to follow. Risk assessments are undertaken around areas of falls, tissue viability, nutrition and daily living. The risk assessments were updated every month and changes made were appropriate. Risk assessments are undertaken for the use of bed rails, these are in line with Department of Health Guidelines. Care plans are reviewed monthly by the home and formally by the placing authority annually. There was written evidence within the service users’ records which indicated that they or their representative had agreed the care plans and that al interested parties are involved with reviews. At the last inspection it was found that newly admitted service users did not have a plan of care. During this site visit the files of those service users recently admitted were looked at. It was found that all the necessary documentation was in place and these contained a thorough assessment and plan of care. Arrangements continue to be in place to access advice and support from health service professionals through the general practitioner; there is written evidence of regular visits from the district nurse, chiropodist, and optician. Some service users retain their own dentist and others have visits arranged to take place in the home. The community psychiatric nurse (CPN) provides advice and visits the home on request. Diabetic advice is obtained through Withernsea Hospital and support provided from the general practitioner, along with six monthly checks. Medication is appropriately stored and recorded. Only staff who have received appropriate accredited medication training administer medications; there is a medication policy and procedure in place which includes self administration. The storage of medication has been changed since the last inspection and there is appropriate storage for controlled drugs. At the last inspection it was identified at the some medication could not be accounted for due to the staff not indicating whether it had been given or refused. During this site visit it was found that the recording of medication was up to date and accurate. At the last inspection it was noted that the home incinerate any left over medication, this has now been changed and the pharmacist disposes of any unwanted medication. Staff were able to demonstrate how they treat service users with dignity and respect particularly when delivering personal care. When spoken with male staff were able to demonstrate that they were sensitive to the choices of female service users and the delivery of personal care. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 12 Those service users spoken with commented positively on the competence of the staff and comments included “the girls are very good” “I’m please there are male carers on duty as I prefer that” “the staff can’t do enough for you nothing is too much trouble”. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 13 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 & 15 People who use this service experience excellent quality outcomes in this area Service users’ life styles at the home match their expectations Service users’ relatives are warmly welcomed and there are no restrictions on visiting. Service users can exercise choice over their daily lives Service users receive a wholesome, well balanced, varied and nutritious diet This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users’ routines of daily living and interests are identified with them and their relatives and recorded as part of the daily living plan. The manager has made a designated activities area so staff can undertake 1:1 activities with those service users who have dementia and find large group activities difficult. General activities go on around the home and lots of interaction was undertaken with the service users, this was genuinely friendly and it was evident that the service users were used to this level of interaction. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 14 The home are arranging two pantomimes and a Christmas party during December to which relatives and friends are invited; a service user who was at the home on a temporary basis was invited back to the home to take part in these events. Community links have been fostered with the home, but due to the remote location it is easier for events to take place in the home, eg harvest festival, visit by Methodist singers. Ministers from the Roman Catholic and Church of England faiths visit and give a service. The home operates an open house policy and relatives and visitors are welcome at any time and offered a meal. The lunch provided on the day of inspection looked wholesome and appetising. Lunchtime was observed to be a social occasion with all of the service users chatting amongst them selves and with staff who eat their lunch with the service users. Some service users choose not to sit in the dinning room and staff were seen to be assisting those people with sensitively and allowing the service user to set the pace. The menu is displayed in individual bedrooms and indicates wholesome, nutritious food is provided. Lunch is a set meal and is very much meat based, the manager stated alternatives are always available and the cook speaks with service users on a daily basis to discuss the menu to determine individual choices. Service users commented positively one service user said “if you are thinking of living here you will put on weight as they feed you very well” and “the food is very good – I could not ask for better”. Advice and support for special diets is provided for as needed by the community dietician. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 15 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 & 18 People who use this service experience good quality outcomes in this area. Service users are confident that any concerns will be taken seriously and acted upon. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints policy and procedure is displayed on the notice board and is included in the policies and procedures file in the lounge. The manager has had training for the protection of vulnerable adults and information has been cascaded to members of staff who were given supporting literature. Staff interviewed sated that they had not had any formal training concerning safeguarding adults. They were all very clear about what action should be taken if they witnessed or suspected any forms of abuse were occurring in the home. All sated that they had full confidence in the manager and that she would take effective action. Service users spoken with knew they could approach the manager if they had any concerns and that these would be taken seriously, one said he would “see the manager and she would sort it” if he had any concerns. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in this area. Service users live in a well maintained and comfortable environment Service users live in a home which is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is located in a rural setting, is well maintained and presents as being comfortable and homely. Service users are encouraged to bring with them items of furniture and personalise their room with their own possessions and memorabilia. Entry to the home leads into a conservatory type lounge which extends across the width of the home; large windows allow service users to view the gardens and surrounding fields whilst seated. A quiet lounge has been converted for use as an activity room for service users and their relatives. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 17 The home has aids and adaptations to maximise service users’ independence including grab rails and hoists; specialist equipment, eg special mattresses and beds are arranged through the district nurse. The home employs a full-time cleaner and at the time of this inspection all areas of the home were clean and odour free. Since the manager has taken over she has re-decorated some of the communal areas, she is intending to make the home more colourful. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in this area Service users needs are met by the number and skills mix of the staff on duty. Service users are in safe hands. Service users are protected by the homes recruitment and selection procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas in operation at the home indicate that there are staff employed in enough numbers to meet the needs of the service users. A sample of staff files were looked at these contained evidence of proper checks being undertaken prior to staff being employed at the home. The home’s recruitment procedures included obtaining two references and an acceptable Criminal Records Bureau (CRB) check to ensure the safety of the service users. At the last inspection it was noted that the home’s application form did not indicate if the staff member was physically and mentally fit to undertake the job, or require the applicant to account for any gaps in employment. This has been addressed and a new application form has been devised which includes a full employment history and a statement of health. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 19 The staffing structure of the home has been changed since the change in management. The role of the deputy has been taken over by the employment of team leaders. New staff receive induction (this meets the Skills for Care specifications) for the first six to eight weeks of commencing the job. Staff interviewed were able to demonstrate their awareness of the home’s policies and procedures and their commitment to training. More than 50 of the staff have obtained NVQ level II or III. Those staff interviewed confirmed they had received mandatory training in health and safety, lifting and handling, basic food hygiene, first aid and fire. Some staff have received more specialist training in dementia and parkinsonism. Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good quality outcomes in this area. Service users live in a home which is run in their best interests, the manager is well qualified, experienced and competent to undertake the role. Service users are protected by the homes financial procedures. The health and safety of the service users is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the deputy manager has been promoted to manager and is registered with the CSCI . She has achieved the registered managers award and has a long experience of working with older people with dementia. All those spoken with both service users and staff spoke highly of the manager Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 21 and said she was fair, approachable, friendly and professional. A visiting social worker commented positively about how well the home is the managed. At the last inspection it was noted that the registered person was not making the visits required by virtue of Regulation 26 of the Residential Care Homes Regulations 2001. The home has addressed this and the CSCI have received regular reports. The home has parts I and II of the local authorities quality development scheme. The scheme requires questionnaires to be provided to service users, relatives and other stakeholders, for example GPs and District nurses, about how the home is run. The results of these are published and are used to measure success in meeting the aims of the home. Service users and their relatives continue to be encouraged to take responsibility for their own financial affairs, however if necessary the home will advise power of attorney arrangements. The homes regular maintenance continues to be up to date and the health and safety of the staff and the service users is ensured as far as is practicable Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Eastfield Farm Residential Home Limited DS0000062571.V355205.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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