Inspection on 21/01/09 for Erith House

This inspection was carried out on 21st January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Erith House 20/01/10

Erith House 09/07/09

Erith House 30/01/08

Erith House 21/03/07

Erith House 07/02/06

Erith House 23/08/05

Erith House 07/01/05

Erith House 15/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Erith House Lower Erith Road Torquay Devon TQ1 2PX     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Finniear     Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Erith House Lower Erith Road Torquay Devon TQ1 2PX 01803293736 01803211311 janehannaby@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Erith House Management Committee Name of registered manager (if applicable) Mrs Jane Hannaby Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Erith House provides residential care for up to twenty older people, who may also have physical disabilities. The house was purpose built in Victorian times, and was solidly built, with gothic archways and fine windows. It is set in a large attractive garden in a quiet residential area in Wellswood, between Torquay and Babbacombe. There is level access throughout, with a shaft lift, and wide doors and corridors. Flagstones have been laid along the garden paths to make walking easier. There are raised toilet seats and two specialised baths to support residents with mobility difficulties or frailty. As well as a large lounge and dining room there is a library and a kitchenette for the use of residents. All bedrooms are single, with en-suite facilities. Several are large with lovely views over the town of Torquay and gardens. There is parking available in the Care Homes for Older People Page 4 of 27 care home 20 Over 65 20 20 0 0 Brief description of the care home grounds or on local roads. Erith House is a registered charity with the Charity Commission. It has a board of trustees which meet quarterly at the home. Fees are Individually based. Copies of Inspection reports are available in the home or from CSCI. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: To complete this inspection we received information about the home in an AQAA or Annual Quality Assueance Document completed by the home; we sent questionnaires to the people who live at the home, local GPs and district nurses asking them about the service; we sent questionnaires to the staff at the home asking them about what it is like to work there; we did a site visit to the home of 6 1/2 hours looking at how the home runs; we spoke to people who live and work there; we spoke to visitors who were at the home on the day of the inspection site visit; we spoke to staff on duty; we looked at the records the home keeps and we looked around the building. We also selected some people living at the home to reflect a range of need and followed their care throuh a series of documents to see how well the home meets their Care Homes for Older People Page 6 of 27 needs. One of these was then discussed with a member of staff in detail to check how well the records reflected the care being delivered. Taking information from all of these sources helps us to get a good picture of what it is like to live at the home. What the care home does well: What has improved since the last inspection? Since the last inspection the care plans have been greatly improved. Care plans detail the support people need and how they wish this to be given. These are now being dealt with by two senior care staff who have been developing them to best reflect the individual needs of people accommodated. Medication is being recorded more accurately than on the last visit. This helps to reduce the risk of errors. The home has reduced staff turnover which means they are having to rely less on Agency staff. Risk assessments have been completed for the bannisters and work carried out to safeguard people as a result. The risk assessment for the hot towel rail has also been completed. Care Homes for Older People Page 8 of 27 The windows previously in a poor state of repair have been repaired/replaced where necessary. This helps to ensure people live in an attractive and comfortable home. Training has been enhanced and now a high number of staff are working on senior and management levels of National Vocational Qualifications. This is commendable. Work has been done on the homes roof to ensure it does not leak. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission processes help to ensure that people have enough information about the home before they make a decsiosn to move in. The homes pre-admission asessments help to ensure the home can meet peoples needs. Evidence: Erith House has a service user guide avilable to people thinking about moving to the home as well as current occupants. The guide is updated annually which helps to ensure the information is accurate, and contains information on services and facilities at the home. It also contains information on terms and conditions of residency and periods of notice required in the form of a contract. People who completed questionnaires said that they had not received contracts from the home, but signed copies were seen in the homes office. People living at the home might benefit from having their own copy of the contract they have signed. Care Homes for Older People Page 11 of 27 Evidence: The records for the last two admissions to the home were seen and discussions were held with the manager about the admission process that had been followed. In one instance this had involved the person attending for Sunday Lunch regularly, followed by a period of respite care and then a final permanent admission. Assessments of need are undertaken which helps the homes staff identify the support people need and that those needs can be met at Erith House. The homes manager stated that they encourage people to come and spend time at the home before making a decision about moving in. People do not sign contracts of residency until they have made a decision to stay pemanently. The home does not cater for intermediate care. This means they do not provide specialist services for intensive rehabilitation with a view to returning people to their own home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are thorough and identify peoples support needs. Evidence: Each person living at Erith House has a plan of care, developed from an assessment, which looks at the support they need and how that support is to be given. Staff spoken to had been involved in the drawing up of the care pans and were keen to develop them further to include more information on how people like their support to be given. Care plans were thorough and were being regularly reviewed. Discussions were held with staff about the care given to one person who was frail and their care was reflected well in the care plan. This helps to demonstrate that the plans were an accurate reflection of the care delivered. Some people at the home have hearing or visual impairments which create problems with communication or with them being able to join in the activities on offer. This is particularly difficult for people with both hearing and visual impairments. The manager Care Homes for Older People Page 13 of 27 Evidence: confirmed that people who need to have their televisions on very loud can have headphones and hearing aid tests and batteries were available in the home, from the local GP practice or from the local hospital. Staff were said to have received training in the management of hearing aids. Aids and adaptations for mobility were available including raised toilet seats, grab rails and asisted bathing including a Parker bath, which is a specialist tilting bath. Evidence was seen of recent visits from community services to advise on the use of stand aids and hoists for one person. The home is said to have good relationships with local community medical and nursing services, and questionnaires completed by local general practitioners showed a high level of confidence in the service. One wrote I have always felt they were a well run home. The medication systems in use were seen. The homes staff sign administration sheets for all medication given to people and these were completed appropriately. Some people chose to deal with their own medication. The home orders this for them, and they can keep it in safes in their rooms. All medication other than that for self administration is supplied by the pharmacy in a series of blister packs. These help to reduce the risk of errors and help ensure staff can easily check that medication has been given out. Controlled medication which is medication needing special precautiosn due to its strength or effects was being recorded in a separate book as required. Senior staff are trained to give out medication as are the night staff. One prescription for as required medication needed reviewing as there was no indication as to why it was being given, under what circumstances or how frequently. People said they had their privacy and dignity respected. Some people felt that not enough attention was paid to how they wanted to do things at the home. The home does have a residents meeting and members of the Friends of Erith House visit people regularly to enable them to air any concerns or worries they may have. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to influence the way the home is run. Activities are provided but could be made more person centred or suitable for people with impairments. Meals are of a high standard. Evidence: Erith House has a programme of activities each month which is on display in the hallway. Care plans did not contain much information on peoples hobbies and interests but there are residents meetings where people can raise any requests. The home told us that many activities are arranged and residents are informed of them in advance. On the day of the visit there was an afternoon entertainment and tea party, organised by the Freinds of Erith House. It was also one persons birthday and there was a small celebration of the event with a cake. Some people at the home may find they are excluded from the mainstream activities due to hearing or visual impairments or some frailty, either mental or physical. The home may beneift from a more person centred approach to activities tailored to meet individual needs. Care Homes for Older People Page 15 of 27 Evidence: Religious services are provided in accordance with peoples wishes. Visitors are encouraged and were much in evidence of the day of the site visit. One visitor spoken to said Erith House was a lovely home. Mum is very happy here - it couldnt be better. The manager and a person living at the home confirmed that the home is using IT to help people living at the home keep in touch with relatives living abroad via email, which the person spoken to really valued. Meals are home cooked and of a good quality. Supplementation is available if needed for people with small appetites or problems with eating. The meal being served on the day of the site visit was Roast Gammon, roast potatoes, braised red cabbage, carrotts and home made cheesecake. Other choices were also available. One person spoken to said that the braised rad cabbage had been their suggestion and so were pleased that people had enjoyed it. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home and staff have information available to help them raise complaints appropriately or respond to allegations of abuse. Evidence: The home have told us they have received no formal complaints in the last year. There is a complaints policy and procedure in the home which is given to each person in the Residents handbook and is on display on the noticeboard in the hallway. People can speak to any member of the homes management or staff team, visitors from the Friends of Erith House who visit each person individually or raise concerns in a residents meeting. There is also a whistleblowing policy and business conduct policy which covers areas such as gifts to staff. Staff have received training in protection of vulnerable adults, including the identification and reporting of abuse. This helps to protect people from abuse or abusive practices. Staff have not yet had training in the Mental Capacity Act. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and attractive. Some attention is needed to the central heating system to ensure all areas of the home are warm enough for people, and some risk assessments need to be reviewed to ensure all areas of the home are safe. Evidence: The property is very substantial, attractive and well maintained. The corridors are wide; Communal facilties are attractive and comfortably furnished. Bedrooms vary in size from some which are compact to others which are large bed-sitting rooms. All have en-suite facilities. People have been able to furnish these as they wish, which has led to them being very individual and attractive. All areas seen on this visit were warm, although some people have had to provide additional heating to their rooms in the form of oil filled radiators or fan heaters. The manager confirmed these are rooms at or near the corners of the building. Attention has been paid to the boiler system to ensure it is capable of meeting the needs of the building and now attention needs to be paid to the radiators in these rooms to ensure they can sustain a comfortable temperature without supplementary heating being required. All areas seen were clean, comfortable, and free from odour. The home has adapted Care Homes for Older People Page 18 of 27 Evidence: bathing facilities such as a specialist Parker bath and bath hoists. There is level access around each floor and a passsenger lift between floors so that people with mobility difficulties can have relatively easy access around the building. The home has attractive and extensive gardens which are very well maintained and safe. There is a valued summerhouse with handrail/path access, and people spoken to said how much they were looking forward to getting outside when the weather improved. Since the last inspection the home have undertaken risk assessments of the hot towel rail and the low bannisers which have been addressed. They have also repaired windows on the first floor and repaired the roof. The homes AQAA states that people living at the home all participate in an annual training seminar on fire prevantion and precautions. Some communal area carpets are due for replacement in 2009. The laundry arrangements appearred satisfactory and there are appropriate arrangements for the disposal of clinical waste. Some risk assessments for the environment need to be reviewed as they were dated 2003. Hoists are serviced regularly and certification was available for gas safety and servicing of the lift. The Environmental health officer last visited in 2005, so an inspection is due. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are being well trained bu there are gaps in the recruitment process that may put people at risk. Evidence: On the site visit to Erith House time was spent looking at the recruitment systems the home uses, training provided for staff and the numbers and skills of staff members on duty. The homes recruitment processes were looked at for the three most recent members of staff appointed. Their files showed evidence of a recruitment process but the information kept was inconsistent between files and some areas were missing, such as references and a criminal records bureau check for one person. If a criminal records bureau check is not returned before the person starts working they should only be working in a supervised capacity until it arrives. This is to ensure that people are protected from being cared for by people who may later prove to be unsuitable. Files did show evidence that an Induction procedure was followed through for staff, which helps to ensure staff understand their role and are working consistently. The home has significantly reduced the staff turnover and reliance on agency staff in the last year which has improved consistency of care for people living at the home. Care Homes for Older People Page 20 of 27 Evidence: Staff training has also improved in the last year with four staff currently undertaking their NVQ level 4. National Vocational qualifications are awards reflecting the competence of a worker in their role. Level 4 is a management level qualification. Some staff are also undertaking level 3 which is a senior level award. Other training has been undertaken in core subjects such as medication managment and administration at basic and foundation level, moving and handling and protection of vulnerable adults. Training was booked for first aid and fire prevention. On the day of the unannounced site visit there were sufficient staff on duty to care for the people accommodated at the home. The rota supplied showed the staffing picture was typical of the working week pattern. People living at the home were compliemtary about the care and support staff. People said the staff are lovely. They bend over backwards to help and They try their best to help me. Staff spoken to were knowledgable about the people they were caring for and keen to develop their skills. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being well run, however work is still required to management systems. Evidence: On the site visit, time was spent talking about the homes quality assurance processes, staff supervision systems, health and safety issues and the way in which the home manager deals with small amounts of money held on behalf of people living at the home. Erith House has commenced a system for Quality assurance and a series of questionnaires have been sent out and returned from stakeholders about the way in which they percieve the home and on how they feel it could be improved. These will be incorporated into a business and develpment plan for the home for the coming year. A copy of this is to be supplied to CSCI. Discussion was held on health and safety prctices at the home. The risk assessments Care Homes for Older People Page 22 of 27 Evidence: shown for the environment were considerably out of date in some cases and need reviewing. Risk assessments also need to be undertaken for safe working practices. This was also identified at the last inspection. Staff receive some training in health and safety practices and there is a health and safety policy available. The hot water supply is said to be regulated to all baths and showers, which means that people should be protected from any risks of scalding. Window openings above the ground floor were said to be restricted, to prevent people accidentally falling from windows. Staff supervision systems are in place, but have slipped from their planned timescales. Supervision is a system for ensuring that staff spenf time with their supervisior on a regular basis (six times a year) looking at their performance and any obstacles that are impeding their work. It also looks at training needs. The manager was to check that an audit system for the safe management of food has been implemented by the homes cook. The arrangement for the management of small amounts of money held in trust by the home was seen, and found to be satisfactory. A small amount of cash is held by the manager for two people and each item of expenditure or transaction is recorded and reciepted. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 29 19 The registered person shall 15/02/2008 not employ a person to work at the care home unless - he has obtained in respect of that person the information and documents specified. (References, Criminal records bureau or POVA first checks Supervision, proof of identity, evidence of fitness and evidence of qualifications must be obtained before a member of staff commences employment at the home.) Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 13 Risk assessments for the 24/04/2009 environment and safe working practices need to be updated. This is so that the management can be sure that as far as possible the home is safe to live and work in. 2 24 23 Heating systems at the home must be suitable for peoples needs. This is so that people can be kept warm and control the heating in their own rooms. 24/04/2009 3 29 19 A full recruitment procedure including the obtaining of the required documentation must be followed for each person employed. This is to ensure people employed are suitable to be working with people who may be vulnerable. 20/02/2009 Care Homes for Older People Page 25 of 27 4 38 13 Risk assemments must be 17/04/2009 undertaken to ensure the home and the staffing practices are as far as possible free from forseeable risks. This is to help ensure the home is a safe place to live and work in. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 People living at the home should receive a copy of the contract or statement of terms and conditions in relation to their care. As required medication should have a protocol identifying when it is to be given, under what circumstances and how frequently. People living at the home may benefit from a more person centred approach to activities. Staff should receive training in the Mental Capacity Act. A copy of the homes quality assurance report/business plan should be supplied to CSCI when completed. 2 9 3 4 5 12 18 33 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!