Inspection on 17/01/06 for Fontburn Court (7)

This inspection was carried out on 17th January 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fontburn Court (7) 21/11/06

Fontburn Court (7) 27/06/05

Fontburn Court (7) 14/12/04

Fontburn Court (7) 06/07/04

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22 Sandown Road

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Dilston College Of Further Education

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Park View (15)

Craigmore House

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

CARE HOME ADULTS 18-65 Fontburn Court (7) Witherwack Sunderland SR5 5SP Lead Inspector Gillian McCabe Announced Inspection 10:00 17th & 18 January 2006 th Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fontburn Court (7) Address Witherwack Sunderland SR5 5SP 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) 0191 553 5440 0191 553 5440 Council of City of Sunderland Mrs Linda Margaret Gibson Care Home 6 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Fontburn Court is care home, providing personal care for up to 6 people with a learning disability. Nursing care is not provided, but District Nursing services can be arranged where necessary. It is a purpose built bungalow with level access to all of the accommodation. The home is suitable for people with a physical disability or frailty. There is an enclosed garden to the rear of the home. The home is situated in a suburb of Sunderland, and is a bus ride or car journey away from central Sunderland. The home is near to local public transport links and local facilities, such as a doctors surgery, pubs and places of worship. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one full day on January 17th 2006 and three hours in the afternoon on January 18th 2006. The inspection was announced and the views of tenants, relatives and other visitors to the home were gathered prior to the inspection. The inspection involved talking to the manager, 3 members of staff who were on duty about the running of the home and exploring the training and support they receive to help them to do their jobs. The inspector also spoke with one person who was visiting a relative during the inspection, as well as talking with all the tenants living at Fontburn Court. A sample of records was inspected. Two tenants files were looked at along with two members of staff files. Quality assurance records were looked at, training records, maintenance plans and records of meals. A tour of the premises looked at the standard of accommodation and facilities on offer, and arrangements in place for maintaining a safe living and working environment. Two tenants invited the inspector to have a look at their rooms What the service does well: The home has a warm and friendly atmosphere. The team at Fontburn Court are well experienced, well trained and very clear about their roles. The manager and staff put a lot of effort into making sure the home is run in the best interests of the tenants. The home has very good quality assurance systems in place to make sure the tenants are happy with the care they receive and the home is kept safe. Some comments from tenants and visitors include “ I like the staff here” “I would like to get out more” “I love my bedroom” “Staff really make you feel welcome” “Staff are always courteous when I visit my relative”, “Staff always offer me a drink when I arrive”, “I can call at any time to visit my relative”. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&5 Fontburn Court has a very clear statement of purpose which gives details of the range of information available to tenants. Each service user has an individual written contract, which clearly sets out what services they will receive in the home and any terms and conditions between the home and the tenant. EVIDENCE: Prospective tenants and their representatives have clear information in order to make a decision about whether Fontburn Court would be suitable for them. Information in the statement of purpose includes the homes aims and objectives, the services and facilities on offer, rights and responsibilities of tenants, any terms and conditions the home has and views from tenants. This information along with a visit to the home can help prospective tenants to make an informed choice about the suitability of Font burn Court. The ‘Service User Guide’ is available in pictorial format, which is accessible for people who may have difficulty in reading the written word. All tenants are issued with a contract/statement of terms and conditions in the form of a booklet known as ‘Your Home’. The contract is very detailed and informative. Information included in the contract is details of fees payable, what the fees cover and who pays the fees. All tenants are issued with a contract/statement of terms and conditions upon residency. The contract is very detailed and informative. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 9 Two tenants files were case tracked as part of the inspection. Both files contained a ‘Service User Guide’ and an individual contract. The manager confirmed that the information in the contract is explained to the prospective tenant to ensure that the person fully understands the context. The contracts are signed by the tenant and the manager, demonstrating that all parties are in agreement with the contract. People who have difficulty understanding the written word may not understand the document. Tenants would benefit from the contracts being developed in a more accessible version. This would assist prospective tenants further, to make an informed choice of their prospective home. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, & 9 Were all assessed and met at previous inspection, standard 10 was assessed at this inspection. The home has robust policies and procedures in place to ensure that service users information is handled appropriately. EVIDENCE: The home has a policies and procedure file containing the policy on Confidentiality and Data Protection which sets out the principles of sharing information. Members of staff have received training as part of the induction process around confidentiality, data protection and storage of tenant’s information. Tenants, relatives and members of staff have access to the homes policies and procedures. Staff demonstrated their knowledge of confidentiality by discussing the homes policy and explaining that tenants information would not be discussed outside the home. Members of staff confirmed that all tenants records are stored in a locked cupboard and all information concerning tenants is handled in the strictest of confidence. The manger confirmed that training around confidentiality and data protection would be updated when necessary. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 11 One tenant spoken with confirmed that they are confident that information concerning them is kept confidential. Care planning arrangements were not assessed during this inspection, however care plans were looked at during case tracking and were clearly documented identifying tenants needs and wishes. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 & 17 Tenants are promoted to have relationships with family members and friends. Intimate personal relationships will be supported thus promoting tenants rights. Tenants receive a well balanced diet in pleasant surroundings; records of meals are not always kept. EVIDENCE: Tenants are promoted to follow their own lifestyles and maintain contacts with family members, friends and partners. Friends and family members are encouraged to visit the home at any time, and tenants can chose where to see their visitors, for example, in the main lounge or in the privacy of their own room. The manager and staff confirmed that tenants can develop and maintain intimate personal relationships with people of their choice, however the home does not have any guidelines around supporting people to make appropriate decisions. This is important if people are to be protected. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 13 Two tenants spoken with during the inspection confirmed that friends and relatives visit on a weekly basis and they spend time in the privacy of their own room or in the shared lounge. One visitor that was visiting her relative during the inspection said “Staff really make you feel welcome” “Staff are always courteous when I visit my relative”, “Staff always offer me a drink when I arrive”, “I am encouraged to go in to the kitchen to make a hot drink whenever I want to”, “I can call at any time to visit my relative”. Mealtimes in the home are flexible and tenants have the choice of what to eat on a daily basis. The majority of tenants spoken with confirmed that the meals provided at Fontburn Court are “very nice”. Staff have supported tenants to devise an individual file containing a list of ‘likes’ and ‘dislikes’ their choices. All tenants choose what they want to eat for each meal. The tenants with staff support carry out weekly food shopping. The manager confirmed that menus are not produced, however staff do record what people have eaten on a daily basis to ensure that all tenants are having a wide variety of healthy and nutritious meals. The recording was not completed for every day. This is important to ensure that health and nutrition is maintained. The dining room is pleasantly decorated and seating is available for tenants and staff to sit and have their meals together. Tenants are encouraged to eat in the dining room, however if a person wants to take their meal to eat in a different room staff would support the person to do this. Staff support tenants during mealtimes giving assistance to people who needed it whilst also promoting independence. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 The manager and staff deal with ageing, illness and death of a tenant with respect and as agreed in the person’s plan of care. EVIDENCE: The manager and a member of staff were specifically spoken with about issues surrounding terminal illness and death. Although the home does not have any policies about caring for people who are terminally ill or dying the manager and staff were able to describe in great detail the care routines and support they would give to a person and their family members during this time. The manager and staff showed a very good understanding of the need to provide the right kind of care and support to people to ensure their wishes are carried out. The manager and staff spoke about involving other professionals when necessary to help with specialist care that may be needed, professionals such as Palliative Care Nurses, G.P’s etc to ensure continued pain management, dignity and comfort. Tenants closest family members, where wished are also invited to stay at the home to be with their loved one throughout their final days. Staff spoke about the difficulties that can be faced through this period and how as a team they would support other tenants and each other. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 15 Although no formal training has been given regarding care of the dying it must be acknowledged that the home’s practice in this respect is very good. Staff have a demonstrated a very good approach with regards to caring for someone with terminal illness. Staff would benefit from receiving training around care of the dying. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Fontburn Court works to strict policies and procedures to ensure that people living there are protected from all types of abuse. EVIDENCE: Sunderland Social Services has a policy called MAPPVA Multi Agency Panel for the Protection of Vulnerable Adults for ensuring the protection of vulnerable adults. The manager and senior care staff have completed responsible adult training and all support staff have completed training regarding MAPPVA procedures. MAPPVA procedures are displayed in the office for staff and tenants to see. Staff spoken with during the inspection demonstrated a good knowledge of the issues involved and the actions required of them should any concerns about tenant’s well-being come to light. The home has a guide for protecting yourself and others ‘What Is Abuse’, developed by Sunderland People First. The manager regularly discusses the guide at tenants meetings to ensure that all tenants are aware of abuse and what to do if they experience any type of abuse. One tenant spoken with during the inspection confirmed that she would “tell the manager or staff ” if she needed to. One relative spoken with during the inspection expressed confidence in the staff to handle any issues surrounding abuse. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Fontburn Court is comfortable, homely and decorated to a good standard. However, some repair works are outstanding that could compromise the health and safety of tenants and staff. EVIDENCE: Fontburn Court is pleasantly decorated and benefits from good quality furniture. A regular, planned cycle of cleaning is implemented ensuring that the property is kept clean and free from infection. This can help to promote a positive image for tenants and ensure, they remain comfortable and safe. Fontburn Court is a purpose built bungalow providing level access to all of the accommodation. Communal areas consist of a lounge, dining room, kitchen and dining room. The home is furnished with good quality furnishings and adaptations, such as handrails, have been installed in some areas of the home to assist with mobility and safety. As a result of wear and tear some redecoration and repairs are outstanding. The manager has contacted Cheviot Housing on a number of occasions regarding repair work that is needed and is awaiting a response. Since the previous inspection the home has a new cooker and cooking hood. The cooker is bigger than the previous cooker and has the capacity for a Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 18 couple of people to cook on it. This will benefit people that want to participate in preparing and cooking their own meals. The kitchen units looked to be worn and parts of one unit looked to be shedding material onto near by food preparation surfaces. There are areas in the main corridor that need painting. A safety rail in the shower room has come off the wall. This has been re fitted and has come off the wall again. The tenants use a near by sink as a support when transferring from sitting to standing position, which is proving unsafe. The flooring in the shower room has water continually seeping underneath it and as a result the flooring is lifting. It is important that areas of maintenance are dealt with quickly so that tenants independence is maximised as well as areas of safety members of staff’s safety are not put at risk. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 & 36 An effective staff team, who are experienced, competent and well qualified, provide support to tenants. The manager routinely supervises staff so that the skills they use to support service users can continue to be developed. EVIDENCE: The team is provided with regular training opportunities to better equip them to understand the needs of the tenants at Fontburn Court. The majority of the staff team (80 ) have attained an NVQ in care at level two or higher. The manager has a yearly training plan and nominates staff for various courses throughout the year. Staff have completed all mandatory training and additional training such as person centred planning, exploring discrimination, ageing and learning disabilities and visual impairment. Staff are well experienced, confident in their roles and work well together. The manager carries out supervision on a monthly basis with all members of staff. Reflective practice is encouraged during supervision for staff to further develop their skills. Discussion with staff and records indicate that supervision is carried out on a regular basis. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38&39 The manager at Fontburn Court is appropriately qualified and experienced and strives to ensure that service users benefit from a well run home whilst guaranteeing their health, safety and welfare is always promoted and protected. Staff work well together, are well organised and share information and views so that service users care is consistent and well thought out. EVIDENCE: The registered manager has worked with people with learning disabilities in a senior or management role for most of her career. She has Registered Managers Award and NVQ Level Four. It is clear that the manager has developed warm and trusting relationships with the tenants who live at Fontburn Court and the staff who work there. She always strives to promote a positive environment within the home to ensure it is a pleasant place to live and work. The manager and staff put a lot of effort into keeping up to date with current best practice as well as sharing knowledge and skills with each other to ensure that the home is run in the best interests of the tenants. The standard of care Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 21 offered to tenants since the previous inspection continues to be good. The home monitors the care provided by undertaking a number of quality audit checks on a regular basis. Tenants, relative and independent representatives are issued with an annual questionnaire to gain their views. Examples of questions included in the questionnaire are ‘Do you like the home that you live in?’ ‘Do you feel you have enough choice relating to food and drink?’ ‘Do staff help you with your personal plans?’ Due to the communication needs of some of the tenants living at the home, it may not always be easy to gain a clear understanding of tenants’ views. Staff take into account tenants’ observed preferences and document details, staff also use people’s gestures, expressions and behaviour to judge what it is they are communicating and whether they are happy or not with various aspects of the service. Staff confirmed that relatives are involved in monitoring quality and they will assist their relatives where possible to complete questionnaires. One tenant confirmed that they would get help to complete the questionnaire from staff or a friend if necessary. Staff carry out monthly house meetings for tenants to discuss any issues relating to the running of the home. The manager also completes regular health & safety audits eg Fire safety, Water temperatures and as a result of a previous recommendation, now includes bed rails as part of health & safety audit. The home is also subject to monitoring visits by Sunderland Social Services Performance and Governance. Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 4 X X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fontburn Court (7) Score X X X 3 Standard No 37 38 39 40 41 42 43 Score 4 4 4 X X X X DS0000032736.V266296.R01.S.doc Version 5.0 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Regulation 17(2) Schedule 4 (13) Requirement Records of the food provided for service users in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and other wise. The registered person must ensure that all parts of the home to which service user have access are so far as reasonably practicable free from hazards to their safety. All parts of the home are kept reasonably decorated. Timescale for action 19/01/06 2. YA24 13(4)(a) 23(2)(d) 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations The service user contract/statement of terms and conditions would benefit from further development to make it more accessible to people who may have difficulty understanding the written word. DS0000032736.V266296.R01.S.doc Version 5.0 Page 24 Fontburn Court (7) Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Fontburn Court (7) DS0000032736.V266296.R01.S.doc Version 5.0 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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