Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 08/08/06 for Eastfield Nursing & Residential Care Home

Also see our care home review for Eastfield Nursing & Residential Care Home for more information

This inspection was carried out on 8th August 2006.

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.

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

Each of the residents interviewed described their satisfaction with the service provided. Staff were said to be kind, gentle and approachable. Assessments and care plans are recorded to a good standard for each resident, detailing health and personal care needs. One resident stated that, "The staff are charming." There is an activities programme, which includes trips out for the more able. Information is provided to prospective residents in the form of a brochure. The environment is well maintained and the owners are committed to reinvestment and making improvements to the facilities. At the time of this visit work was in progress to complete a recreational facility, which will include a therapy pool with wave machine, and an additional lounge. The home is surrounded by landscaped gardens. Bedrooms are personalised with residents` own furniture and belongings, and several residents have their dedicated telephone line and cable television service. The home is well run with systems in place to ensure staff are trained and supervised, although a deficiency in the numbers of staff trained in first aid was noted. A quality audit system enables the providers to make sure the home is run the best interests of residents and that residents and their relatives are able to give feedback about the service they receive. Modern practices for palliative care have been incorporated into the home`s operation.

What has improved since the last inspection?

The home continues to review and improve its service provision e.g. the creation of a recreation building will be completed shortly.

What the care home could do better:

Whilst the home carries out its own assessments of need for each person referred for possible admission, the home needs to ensure it also obtains a copy of the care manager`s assessment where applicable. Staff recruitment procedures need to be improved particularly in obtaining 2 written references, one of which must be from the most recent previous employer. Feedback from relatives and staff indicates that residents` quality of life might be improved by more `face to face` interaction with staff. The numbers of staff receiving approved first aid training need to be improved.

CARE HOMES FOR OLDER PEOPLE Eastfield Nursing & Residential Care Home Hillbrow Road Liss Hampshire GU33 7PB Lead Inspector Mr Ian Craig Unannounced Inspection 8th August 2006 09:50 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 Nursing & Residential Care Home DS0000011499.V300673.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 Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastfield Nursing & Residential Care Home Address Hillbrow Road Liss Hampshire GU33 7PB 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) (01730) 892268 Wenham Holt Homes Limited Mr Dennis Anthony Greenwood Care Home 37 Category(ies) of Dementia (7), Dementia - over 65 years of age registration, with number (37), Old age, not falling within any other of places category (37), Physical disability (7), Physical disability over 65 years of age (14), Terminally ill (7), Terminally ill over 65 years of age (37) Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All Service Users in the DE, TI and PD categories must be 55 years old and over. 8th February 2006 Date of last inspection Brief Description of the Service: Eastfield Nursing and Residential Home provides care, or care with nursing, for service users over fifty-five years, including those who are terminally ill, have a physical disability or dementia. The home has thirty-five bedrooms. Twenty-nine of these are single and four shared. Communal space comprises a lounge, conservatory and lounge/dining room. The home has extensive landscaped gardens that service users are able to access. Eastfield is situated on a main road a short distance from Liss and is close to local amenities. The home is one of two family-run businesses. Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and consisted of a tour of the building, observation of staff and residents, interviews with residents and staff, examination of records, policies and procedures as well as discussions with the manager, Mr. Greenwood. ‘Comment cards’ were received from 4 relatives of residents who gave their views on the service provided by the home. What the service does well: What has improved since the last inspection? Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 6 The home continues to review and improve its service provision e.g. the creation of a recreation building will be completed shortly. 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. Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 Nursing & Residential Care Home DS0000011499.V300673.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prospective residents are given information about the service and are able to visit the home to check if it meets their needs. Whilst the home carries out its own assessments of need this needs to be improved to ensure only those whose needs can be met are admitted. EVIDENCE: A resident described how he was able to visit the home before deciding to move in, and that he was given literature about the home. The home’s brochure entitled, Statement of Purpose, was seen; this gives information about the home as well as the complaints procedure. The process of assessing prospective residents’ needs prior to an agreement to commence the placement was examined for 4 residents. The home completes its own assessment of need, which is recorded, as well as obtaining relevant hospital discharge details. Where residents are referred from social services a copy of the referring care manager’s assessment had not been obtained by the home. This was discussed with the manager and identified as a procedure that has not been implemented. Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 9 Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ health and personal care needs are met and are detailed in assessments and care plans. Residents’ dignity and privacy is promoted and those with a terminal illness are treated with respect and sensitivity. EVIDENCE: Care records were examined for 4 residents. These contain a variety of assessment tools, including health assessments, handling profiles, barthel assessments, pressure sore assessments, as well other personal and health care assessments of need. Care plans detail how personal care needs are to be met, including details such as teeth and denture care. Risk assessments are completed to help assess and prevent falls, and where there is a possibility of injury from falling from bed. Staff described how they record and update care plans as part of their responsibility for key residents. Daily running records were found to be well maintained. Records and discussion with residents confirmed that health care needs are addressed with regular appointments with health care professionals. At the Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 11 time of the inspection a local general practitioner was reviewing several residents, which occurs on a weekly basis. Where necessary, fluid charts are maintained to ensure that residents do not become dehydrated. Residents were observed having regular drinks. Fruit squash drinks were freely to hand in communal areas and in bedrooms. Residents stated that their care needs are met and that staff treat them with kindness and respect. Medication procedures were found to be satisfactory. Staff were observed dispensing medication. Records of medication administered were maintained, including controlled medication. Medication is only handled and administered by one of the home’s qualified and registered nurses. Medication is stored according to pharmaceutical guidelines. The home has policies and procedures for the care of those with a terminal illness. These are reviewed and updated to incorporate modern practices such as the Liverpool Care Pathway for the Terminally Ill. This pathway provides guidelines for palliative care developed by the Royal Liverpool University Hospitals and the Marie Curie Centre. This Pathway has been developed to transfer the hospice model of care into other care settings. The Liverpool Care Pathway (LCP) empowers doctors and nurses to deliver high quality care to dying patients and their relatives. Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 , 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents maintain contact with friends and family as well as the wider community. Residents’ social and recreational needs are met, although there is scope to review this. A wholesome and nutritious diet is provided. EVIDENCE: A Newsletter is regularly produced for the residents and staff, giving details of forthcoming events, day trips and other activities for the residents. Provision of these activities was confirmed by the residents themselves and includes the following: • Two trips out a week in the home’s transport to places such as Hayling Island, Goodwood Park and Petworth. • Music afternoons where a musician performs to the residents in the home. • Arts and crafts one afternoon a week • Multi sensory relaxation therapy • Barbecues • Hairdressing Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 13 • Religious services by a visiting priest • Exercise classes Each person’s care plan refers to the person’s social and recreational needs. Residents described how they join in with the activities or prefer to stay in their rooms reading or watching television. One resident was observed watching test match cricket on Sky Sports via his own digital service. It was identified that the provision of opportunities for residents to have time to talk to staff could be developed, particularly for those who spend a great deal of time in their rooms. This is based on comments from one resident, feedback on a comment card from a relative and from discussions with two of the staff. These all remarked that there was insufficient time for staff to spend time talking to residents on a one to one. The home’s menu plan showed a varied and nutritious diet. Residents are aware that they can choose a different meal from that on the menu. Comments made by the residents about the food were varied. One person stated it was “variable and sometimes insipid,” and another person described it as “good,” but that it could be more varied, another person remarked that “it is good home cooking,” and a fourth person said it is “reasonable.” The inspector observed the served of the midday meal, which looked appetising. Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has robust complaints procedure that enables residents to be confident their concerns will be listened to and addressed. Residents are protected from abuse by the use of training, policies and a robust employment procedure. EVIDENCE: The home has a complaints policy and procedure. The registered manager said a copy is given to everyone on admission. Residents stated that they would speak to the manager if they had any complaints. One resident stated that there is ample opportunity to raise any issues with the home via the residents’ meetings and the comments/suggestions book, which can resolve any matters without the need to resort to the complaints procedure. The home has a system for recording complaints. This showed that one complaint was made in August 2005,which had been dealt with using the complaints procedure. The Commission has not received any complaints in respect of the home. The home has an in house policy and procedure for the protection of vulnerable adults. The registered manager said it is based on the guidance given in Hampshire social services adult protection procedure. The home has a copy of this in the office. Training on adult protection procedures is included in Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 15 the training calendar and the majority of staff have attended. Two staff interviewed confirmed that they have attended this training. The home deals with any abuse matters in line with the local authority and the Protection of Vulnerable Adults register policies. Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides a clean, safe and well-maintained environment, including private and communal living areas. EVIDENCE: The inspector saw most areas of the home, which were all clean and free from any offensive odours. One resident stated that the home is “spotlessly clean and another remarked that the home is free from odours caused by incontinence. Bedrooms and communal areas are maintained to a good standard with bedrooms being redecorated when they are vacated. Residents were observed using their bedrooms to watch television, to read and to knit. Two residents commented on how much they like the view from their first floor bedroom window to the surrounding countryside. The gardens are extensive and colourful plants enhance the environment for residents and visitors. Residents have been able to personalise their rooms with furniture, books, pictures etc. Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 17 Communal and dining space will be extended with the completion of the lounge and therapy pool in the near future. A variety of specialist equipment is available for lifting residents and there is a recently installed lift. It was noted that where resident’s bedrooms have a fire exit escape door that risk assessments need to be carried out and recorded. The manager agreed with this and gave a commitment to carry this out. Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home deploys sufficient numbers of staff to meet the care needs of the residents, although the input of staff to residents regarding social needs could be improved. Staff receive regular training to meet the needs of the residents. Recruitment procedures need to be improved to ensure the safety of residents. EVIDENCE: The manager explained that the home operates with a minimum of eight care staff from 8am to 2 pm, and 6 care staff from 2pm to 8pm each day. At least 2 or 3 trained nurses are on duty at any given time. At nighttime there are 3 staff on duty. The staff rota and observation of staff at work confirmed that the home is maintaining these staffing levels. One resident’s relative, and some of the care staff interviewed on the day of the inspection, commented that residents would benefit from greater opportunities for face to face interaction with staff, especially those who tend to spend time in their bedrooms. Those residents interviewed were generally satisfied about the numbers of staff on duty, although one person stated that he/she had little to do for long periods. The home’s management should review this aspect of residents’ care. A training programme for staff was displayed on the office wall and included the following ‘in house’ training for staff over the summer period: care plans, pressure area care, communication, infection control, coping with Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 19 bereavement, good working relationships, continence and aggressive behaviour. Staff confirmed that they have access to a variety of training courses as well as having an annual performance appraisal, induction when starting work, and regular supervision. There is a structured induction booklet, but this was not available for the most recently appointed staff member. The manager telephoned this staff member at home as he was not on duty, and reported that he had taken the completed induction pack home. From a total of 27 care staff, 9 are trained registered nurses and 6 staff have NVQ level 3 with a further 5 staff currently undertaking NVQ 3. Staff record a signature each time a supervision session takes place confirming if they prefer individual or group supervision. Records of supervision are maintained. Recruitment procedures were examined for 4 staff including the most recent person to have started work at the home. Records showed that suitable checks in the form of references and criminal record bureau checks had been carried out with the exception that a reference had not been requested from one person’s most recent previous employer and only one reference had been obtained from the two referees given by the person. Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed with systems for obtaining the views of residents and relatives about the home. Health and safety is promoted although this needs to be improved regarding first aid training. EVIDENCE: The manager is a registered nurse with various qualifications in business management and is an NVQ assessor. There are systems to ensure that the views of service users and relatives are considered, including questionnaires being sent out to residents and relatives. There is a book in the entrance hall for residents to add any suggestions of how the home could be improved. A resident confirmed that he has made an Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 21 entry in the ‘suggestions’ book. There are relatives’ and staff meetings, which are recorded. An annual development plan is devised and a regular health and safety audit takes place. Residents’ finances and valuables are safeguarded with records maintained of any monies or valuables deposited for safekeeping with the home. Procedures for health and safety were found to be satisfactory with servicing and checks on all the appliances in the home. Staff receive training in infection control, food hygiene and moving and handling. Training for staff from approved first aid trainers needs to be improved, as there are only two staff members who have attended approved first aid training. Consequently, there are periods (e.g. night time) when there are no staff members on duty who have received first aid training. At any given time there must be at least one staff member on duty who has received training from an approved first aid trainer. Staff receive ‘in house’ first aid training from the nursing staff who are not approved first aid trainers. The fire logbook showed that the fire safety equipment is tested and serviced in accordance with fire safety guidelines. Eastfield Nursing & Residential Care Home DS0000011499.V300673.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 2 X 3 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 2 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 Nursing & Residential Care Home DS0000011499.V300673.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. 1 Standard OP3 Regulation 14 (1) Requirement For individuals referred through the care management system, the home must obtain a copy of the care manager’s assessment and care plan, which must form part of the assessment of whether or not the person’s needs can be met. Two references must be obtained, one of which must be from the most recent previous employer, prior to the person commencing work. There must be at least one member of staff on duty at any given time who has received training in first aid from a trainer approved by the Health and Safety Executive. Timescale for action 08/10/06 2 OP29 19 (1) Schedule 2 13 (4) 08/10/06 3 OP38 08/12/06 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 Good Practice Recommendations DS0000011499.V300673.R01.S.doc Version 5.2 Page 24 Eastfield Nursing & Residential Care Home 1. Standard OP27 The social needs of individual residents for ‘face to face’ contact with staff should be assessed and planned for. Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Eastfield Nursing & Residential Care Home DS0000011499.V300673.R01.S.doc Version 5.2 Page 26 - 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!