Inspection on 21/11/05 for Glenholme Oakdene Psychiatric Residential Care Home

This inspection was carried out on 21st November 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glenholme Oakdene Psychiatric... 20/11/07

Glenholme Oakdene Psychiatric... 31/07/07

Glenholme Oakdene Psychiatric... 31/07/06

Glenholme Oakdene Psychiatric... 27/06/05

Glenholme Oakdene Psychiatric... 24/01/05

Glenholme Oakdene Psychiatric... 02/08/04

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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 Glenholme Oakdene Psychiatric Residential Care Home 30-32 Woodside Park Road North Finchley London N12 8RP Lead Inspector Anthony Lewis Unannounced Inspection 09:00 21 November 2005 st Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.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 Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.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. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Glenholme Oakdene Psychiatric Residential Care Home 30-32 Woodside Park Road North Finchley London N12 8RP 020 8446 3401 020 8446 9476 Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr George Pirrie Macalister Mrs Elaine Alice Macalister Mr Andrew Kenneth Knight Care Home 18 Category(ies) of Learning disability (18), Mental disorder, registration, with number excluding learning disability or dementia (18) of places Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.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: Glenholme/Oakdene is an independent residential care home that is part of the Woodbury Group, which includes another residential care home and a supported living housing group. The home provides residential care for up to eighteen residents, of either gender, who have mental health and support needs. The home is not purpose built and consists of two houses converted and joined together, with interconnecting doors and halls. Each has a lounge, dining room and kitchen. All residents have their own individual bedroom. The homes stated purpose is to support service users to gain sufficient life skills and confidence to eventually move into semi-independent or independent living accommodation. The aim is to achieve this by empowering residents to make their own decisions and take responsibility for their own actions, by operating a network of staff and fellow residents support in a homely, domestic environment. Part of the life skills development is centred on residents using local amenities, with support if required, in order to develop contact and equip residents to live within the community. The home is located within a short walk of Woodside Park underground station, bus routes, North Finchley High Road and Tally Ho Corner and local shops and supermarkets. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on Monday 21st November at 09:20am and was completed at 3:10pm. The registered manager was available throughout the inspection process and the registered provider was available for part of the inspection. Evidence was gathered for this inspection by viewing various records and files, including six residents, six staff files and nine service users comment cards and the pre-inspection questionnaire. Three residents were spoken to individually in private and two were spoken to informally. Evidence was also gathered by speaking to five support staff as a group and one in private. An internal and external tour of the home was conducted with the registered manager. On the day of the inspection, the hallways, stairs, landings and wall walls were being painted and the flooring was being prepared for re-carpeting. What the service does well: What has improved since the last inspection? What they could do better: Six requirements were made at this inspection one of which, was restated. A review to the care needs to an identified resident must be undertaken to establish if the home can continue to meet the resident’s needs. To ensure that health and safety is adhered to, all fire extinguishers must be kept on their Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 6 wall bracket. The oven knob and internal oven door glass must be repaired or replaced and the kitchen dustbin must be replaced to ensure that residents and staff can use the equipment safely. If residents are to be as independent as possible with the aim of moving into semi or independent living in the future, staff must support them in improving their domestic skills. All staff working in the home must receive formal recorded supervision at least six times a year to ensure that their personal development is being monitored and to ensure that they are being supported. To ensure that resident’s views are used to continually develop the service an anonymous and objective quality assurance monitoring system must be established. 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. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.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 Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.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 and 3. Robust assessments are being carried out by the staff team to ensure that they can meet the needs of prospective residents and that prospective residents receive accurate information about the service. EVIDENCE: A requirement at the previous inspection that the registered persons must ensure that the information contained in the statement of purpose reflects the present situation in the home has been met. Assessments of prospective residents are thorough. Of the five residents files viewed, all contained an assessment of the resident and the homes ability to meet their specific needs. The assessment of the most recent resident to the home was seen. It contained an up to date risk assessment, past mental health history, recommendations on tenancy and how the home will meet the resident’s personal, social and domestic needs. Staff were observed and listened to communicating with residents in a professional, helpful and courteous manner at all times. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 9 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 and 10. The staff team are not ensuring that all residents are fully empowered to be as independent as possible in order to eventually live semi or independently in the community. This has resulted in some residents becoming dependent on the staff team and being able to live permanently in the home. EVIDENCE: The stated purpose of the service is to support residents to gain sufficient life skills and confidence to eventually move into semi-independent or independent living accommodations. However, according to the registered manager, one resident has been living in the home for many years and has become dependent on living in the home permanently and lacks motivation. Another resident spoken to said that he has lived in the home for many years and does not want to leave. Of the nine service users comment cards received, six indicated that they enjoy living in the home, one sometimes and two that they did not like living in the home. A requirement is made that the registered manager reviews the care needs and appropriateness of the two identified residents continuing to live in the home and whether the home can continue to meet their needs. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 10 A resident who was spoken to at length said that he would like to receive all of his personal allowance at once, rather than a specified amount each day. When this was discussed with the registered manager, he stated that an assessment was carried out with the resident, who agreed to receive a specified amount of his personal allowance daily due to his risk of over spending. The assessment was seen in the resident’s care plan. The home’s confidentiality policy and procedure was viewed. It contained information on reasons for confidentiality and when it might be broken and persons who might be allowed access to confidential information. All confidential information especially resident’s personal information is kept in lockable cupboards in the office, which is locked when not in use. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 11 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): 11, 14 and 17. Residents who wish, are confident that the staff team will support them in everyday household living skills and encourage them to engage in their hobbies and interests. EVIDENCE: The staff team have ensured that residents, who wish, are supported to enhance their personal development through engaging in everyday living skills and hobbies/interests such as cultural cooking in the home, playing their instruments, shopping and household chores. Three resident’s care plans and the pre-inspection questionnaire contained evidence that they attend classes at college and that one resident has a part-time paid job. One resident’s care plan stated that he did not wish to participate in his religious beliefs. Residents are able to engage in a range of activities such as drama classes and group trips. One resident spoken to said that he likes going to the pub on his own and sometimes with another resident. Staff recently supported five residents on a trip to the BBC to witness the recording of a new show. Resident’s care plans contained information on their hobbies and interests. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 12 The menu for the past two weeks was viewed. The staff are ensuring that residents are supported to buy and eat healthy and nourishing meals. Three residents spoken to said that they enjoy the meals in the home. The preinspection questionnaire indicates that residents have a choice of menu. Two said that they sometimes go shopping and help to prepare the meals. The menu also contains information regarding which resident will be preparing the dinner for the day, with staff support if required. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 13 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): 18 and 20. Residents are confident that they will be supported by the staff team to be as independent as possible and that staff will respect their choices with minimal intervention. EVIDENCE: All residents are independent in all areas of their personal care and do not require any special equipment in the home, except the occasional prompting. The registered manager said that staff will support residents if requested by the resident and give advice when required. Two residents spoken to said that they go to bed and get up when they wish. The registered manager stated that staff will sometimes have to wake up a resident to remind them that they have an appointment. Whenever possible, the home will encourage residents to administer their own medication. Residents who administer their own medication, keep them in a locked cabinet in their bedroom. Resident’s care plans contain information on residents who self administer their own medication. The staff are ensuring that medication administered is correctly recorded on resident’s administration record sheets. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 14 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): 22 and 23. The home is ensuring that residents have the necessary information in the event of them wishing to make a complaint. The registered providers are proactive in ensuring that residents are protected from abuse by ensuring that all staff have the skills and experience to identify all forms of abuse. EVIDENCE: The home has a complaints policy and procedure file and a complaints book. All complaints are recorded appropriately and investigated by the registered manager. The service users guide contains information on making a complaint and also the Commission’s details. Two residents spoken to said that he would speak to the manager if he wanted to make a complaint and all service users indicated on their comment cards that they know who to speak to if they are not happy. The home has the London Borough of Barnet’s Multi Agency Protection Policy and Procedure file. The registered manager said that the registered provider and himself, conduct level 1 protection of vulnerable abuse training with staff. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 15 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, 25, 26, 27, 28 and 29. The registered providers are not ensuring the health and safety of residents, staff and visitors to the home by providing adequate facilities and ensuring that such facilities and their accommodation are clean and safe to use. EVIDENCE: Most internal areas of the home are being refurbished with new carpeting and some areas are being painted. It was noticed that a number of fire extinguishers were not on their wall bracket and some were propping doors open making it unsafe for residents, staff and visitors. A requirement is made that the registered persons ensure that all fire extinguishers are kept on their wall bracket. The tour of the home revealed that although most areas are clean and tidy, some areas are not being well maintained. For instance, in the kitchen, an oven knob and the internal oven door glass was missing. The inside of the oven was dirty as was the outside top of the kitchen dustbin, which residents and staff are using their hand to open, which may result in cross contamination occurring. A requirement is made that the registered persons ensure that the oven knob and internal oven door glass is repaired or replaced and the kitchen dustbin is replaced with a foot operated bin. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 16 All residents have a single bedroom. Three resident’s bedrooms were viewed and all were suitable to meet their needs. Two residents said that their bedroom is comfortable. The loft extension to provide two further bedrooms in the home has been completed and two existing residents are accommodating the rooms. Both rooms were viewed and have been built to a good standard. Although the three bedrooms viewed all contained sufficient furniture and fittings to meet the needs of the residents, two of the bedrooms were very untidy, with clothes and other items strewn about the room. This meant that people have to step on or over clothes and other discarded items left on the floor, which poses a potential risk to the resident, staff and visitors. One resident had spilt tobacco on his bedroom floor. A requirement is made that the registered persons ensure that all resident’s bedrooms are kept clean, tidy and safe at all times. The home has sufficient bathrooms and toilets throughout the home, which meet the needs of the residents living in the home and are lockable to provide privacy. The home has two conservatories where residents and staff are able to smoke. Some residents spend a large amount of their time in the smoking room, where they relax and socialise with other residents and staff. All of the residents are physically independent and do not require any specialist equipment in the home. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 17 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): 33 and 36. Although the home has an effective and skilled staff team with the experience and skills to meet the resident’s needs, they are not being adequately supervised by the management to ensure continuity in monitoring and supporting their personal development. EVIDENCE: The staff rota was viewed for the month of November and there is usually two or three support staff on the early and late shifts and two wake-night staff and an on-call person for emergencies. The registered manager and provider are on usually on the premises Mon-Fri 9-5pm. Many of the staff have worked in the home for a number of years ensuring that there is an effective staff team to meet the needs of the residents. Staff turnover is low and according to the pre-inspection questionnaire, only two staff have left since the last inspection. The staff team have a good working relationship. Staff were observed throughout the day interacting with each other in a professional, supportive and courteous manner. Five staff were spoken to as a group. All have a good understanding of their roles and responsibilities and of the associated needs of the residents. However, on looking through six staff files, supervision is not consistent. One member of staff has not received formal supervision since May 2005. A requirement is made that the registered persons ensure that all staff receive formal recorded supervision at least six times a year. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 18 Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 19 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): 39, 40 and 43. The registered providers have ensured that the business is viable and that there is a business plan that covers future development of the service but residents, their relatives and representatives are not being given adequate opportunity to objectively comment on the quality of service provided. EVIDENCE: There is a service users audit questionnaire in place but the registered manager stated that this is filled in by the residents with staff support and is therefore not objective neither is it anonymous. A requirement is made that the registered persons ensure that an anonymous and objective quality assurance monitoring system is in place to ascertain the views of residents, their family and representatives to the quality of service being provided. The home has a variety of policies and procedures, which ensure the rights and best interests of the resident. The registered manager said that residents and staff have access to all policies and procedures. One member of staff was observed using some of the policies and procedures for her National Vocational Qualification (NVQ). Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 20 The registered provider has produced a comprehensive business plan for 2005, which sets out the Home’s vision statement and strategic aims for the near future, including how the business intends to expand and grow and continue to provide a quality service to the residents. Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 21 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 3 X x Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 3 X LIFESTYLES Standard No Score 11 3 12 x 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 x Standard No 37 38 39 40 41 42 43 Score X X 2 3 X X 3 Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 22 Yes 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 YA6 Regulation 24(1)(a) (b)(2)(3) Requirement Timescale for action 23/03/06 2. 3. YA24 YA24 4. YA26 5. YA36 6 YA39 The registered persons must ensure that they reviews the care needs and appropriateness of the two identified residents continuing to live in the home and whether the home can continue to meet their needs. 13 (4) (a) The registered persons must (c) ensure that all fire extinguishers are on their wall bracket. 16(2g,h) The registered persons must 23(2c) ensure that the oven knob and internal oven door glass is repaired or replaced and that the kitchen dustbin is replaced with a foot operated dustbin. 23(2)(d) The registered persons must ensure that all resident’s bedrooms are kept clean, tidy and safe at all times. 18(2) The registered persons must ensure that all staff working in the home receive formal recorded supervision at least six times a year. (Timescale of 11/07/05 not met). 24(1)(a)(b) The registered persons must (2)(3) ensure that an anonymous and objective quality assurance monitoring system is in place to DS0000010445.V265148.R01.S.doc 23/12/05 23/12/05 23/12/05 23/03/06 23/03/06 Glenholme Oakdene Psychiatric Residential Care Home Version 5.0 Page 23 ascertain the views of residents, their family and representatives to the quality of care being provided. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Glenholme Oakdene Psychiatric Residential Care Home DS0000010445.V265148.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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