Inspection on 10/01/08 for Grove Lodge Care Home

This inspection was carried out on 10th January 2008.

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

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

Other inspections for this house

Grove Lodge Care Home 19/12/06

Grove Lodge Care Home 15/03/06

Grove Lodge Care Home 12/09/05

Grove Lodge Care Home 22/03/05

Grove Lodge Care Home 05/10/04

Grove Lodge Care Home 12/02/04

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

CARE HOMES FOR OLDER PEOPLE Grove Lodge Care Home 62 Buxton Road Hazel Grove Stockport Cheshire SK7 6AF Lead Inspector Jackie Kelly Unannounced Inspection 10th January 2008 12:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove Lodge Care Home Address 62 Buxton Road Hazel Grove Stockport Cheshire SK7 6AF 0161 483 8654 0161 456 5703 silklands@hotmail.com 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) Grove Lodge Care Home Limited Fay Cicelia Cameron Care Home 18 Category(ies) of Dementia (18), Dementia - over 65 years of age registration, with number (18), Mental disorder, excluding learning of places disability or dementia (18), Mental Disorder, excluding learning disability or dementia - over 65 years of age (18) Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No persons under the age of 50 to be accommodated. Date of last inspection 19th December 2006 Brief Description of the Service: Mr Robert Stokes has owned Grove Lodge since October 2001. Mrs Fay Cameron is the registered manager and in day to day control. The home is registered to take service users from the age of fifty years and upward who have or are recovering from mental ill health. The home also provided day care for up to three people seven days a week. The day care service was not registered with the Commission for Social Care Inspection. There were three single rooms on the first floor, which had an en-suite facility (there was no passenger or stair lift). The remaining twelve beds were on the ground floor. The communal space consisted of three lounge areas, two conservatories one of which is the dining room. There was a reasonably sized garden to the rear of the property with parking for between six and eight cars at the front of the house. The home is situated on the main A6 trunk road on the outskirts of the Hazel Grove area of Stockport. Hazel Grove railway station is within a short car ride and there is also a regular bus service to Stockport town centre and Manchester. There are shops, restaurants, post office, banks and churches within a twenty to thirty minute walk to the centre of Hazel Grove other local shopping areas are within the same distance. The fees ranged from £395.00 to £480.00 per week. A £40.00 top up fee for those people who were social services funded was required. There was a service user guide that provided information about the home and the inspection report was available on request. Grove Lodge had achieved the ‘Investors in People Award’. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use the service experience excellent quality outcomes. This was a key inspection to look at the service provided by Grove Lodge Care Home, which included an unannounced site visit to the home. Time was spent talking with the registered manager Mrs Fay Cameron, Mr Stokes the provider, care workers, residents and relatives. Service user files and care worker files were given to the inspector to look at. Before the inspection, we asked the manager of the agency to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This was to help us to determine if the management of the agency saw the service they provided the same way that we saw it. The information on the AQAA was sufficient to allow us to make the assessment confirming our agreement. At the time the AQAA was completed the home was full with eighteen residents. There were twelve care workers and three ancillary staff employed to care for the residents. There had been three complaints sent direct to us; two were referred to the provider and one to the contracts monitoring division of Stockport Social Services for investigation. The results were sent to the complainants; no further action was necessary. There had been no safe guarding adult referrals. We sent survey forms to the residents, relatives, and care workers asking for their views on the service. Those who replied said that they were happy with the service and care provided. The residents also said that their privacy, dignity and confidentiality were respected. Comments about the home and the care received were positive such as; ‘don’t ever want to move’; ‘happy’; ’very pleased with my mothers care’; the staff are extremely friendly and show a lot of concern for the well-being of my relative’; ‘I think the home is a caring and functional place, catering for most of the needs’; ‘the staff are competent, friendly and well managed;’ ‘lucky to have found somewhere so nice.’ Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 6 What the service does well: The owner had obtained the services of a quality assurance company, which entailed the home being assessed by the consultant. The next visit from the consultant is to be done late January 2008 from which a report would be written and published. A copy will be sent to us and one will also be available to residents and relatives. The home also sends out survey forms to residents and relatives around the months of December/January. These help the management to look at any areas, which the residents feel, can be improved upon. The manager and provider are present at the home most days. Health and personal care needs were met in a manner, which respected their privacy and dignity. All those who completed a survey form said that the care staff had the right skills and experience to meet the different needs of the residents. The residents were encouraged to use services in the community by visiting Stockport town centre for shopping, local snooker club, church on Sundays, attending day centres or taking part in any other activity of their choice. Trips had been organised throughout the previous twelve months to Blackpool, canal boat, restaurants, German market and theatre. Activities were also available in the home every afternoon, consisting of bingo, quizzes, games and professional entertainers. Six of the seven survey forms returned said that the residents felt that there were always enough activities arranged and one said usually. The home was comfortable, clean and hygienic with bedrooms reflecting the personalities of the residents. The garden to the rear of the building had been landscaped to accommodate the resident’s needs and requirements. Care workers had achieved National Vocational Qualifications Level 2 and Level 3. Other core training had taken place such as moving and handling, adult protection, fire safety, food hygiene, managing challenging behaviour, palliative care and first aid. There were a number of comments from the staff team around the training, which they all felt was very good. The care workers were well motivated and were eager for more training. The following were some of the comments received; ‘we are given up to date training, which is relevant to my job’; ‘training is ongoing; courses are very informative, I have developed a better understanding of care work, and what is involved as a carer.’ The residents and care workers were relaxed in each other’s company and those residents who were spoken with on an individual basis said that the care workers were ‘very good – very nice, very helpful’; ‘looked after very well’; ‘had no complaints’. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 7 The relative/visitor questionnaires received said that the staff/management made them welcome in the home at any time and that they could visit their relative/friend in private. On the day of the inspection visitors were provided with a tray of tea and cake. The visitors said that this was normal practice. The mealtime was unhurried and residents were allowed to take their time eating their meal. No one had any complaints about the food. What has improved since the last inspection? What they could do better: Whilst the care plans contained all the relevant information about residents care needs they could be better presented along person centred planning guidelines. It was recommended that the manager access some training on care planning. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 8 All staff received an induction, which was recorded through a checklist. It was suggested to the manager that some written evidence from the care workers that supported their understanding of the information and training they had received be introduced. The Annual Quality Assurance Assessment (AQAA) was sufficient to assist us in making a judgement about the care home when taken together with other information received during the inspection and receipt of survey forms. However the document could be improved on by being more explicit with the information provided. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3,6. Quality in this outcome area is good. Residents were assessed and provided with information to enable them to make a choice as to the suitability of the care home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of the people who completed a survey form said that they received enough information before they moved into the care home. Assessments of personal care needs, which included likes and dislikes, social interests and areas of risk had been done. The assessments ensured that the home could meet the needs of the residents and formed the basis of the care plan. Social work assessments were also available for those residents who were funded by social services. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 11 Prospective residents were given the opportunity to visit the home for a day or overnight stay before making a decision. Standard 6 did not apply, as the home did not have any intermediate care beds. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10 Quality in this outcome area is good. The health and personal care needs of the residents were met according to their individual needs and with respect for their privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of the last four people to be admitted were looked at and found to be satisfactory. They contained information about resident’s health and personal care needs. However they could be improved and it is suggested that some training be sought on care plans and person centred planning. The manager of the home ensured that residents had access to all the health care services that they required to meet their individually assessed care needs. Policies and procedures were in place to ensure that medication was administered and stored safely. Care workers received training during the Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 13 induction period and were also provided with a safe handling of medicine professional training course. None of the residents were responsible for their own medication. The residents who were spoken with or completed a survey form said that their privacy and dignity was respected. Others who completed survey forms said that the staff listened to them and acted upon what they said. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards12,13,14,15. Quality in this outcome area is excellent. The manager and care workers encourage and assist residents to take part in activities both inside and outside of the home thereby promoting their social needs and involvement in life outside of the home. Meals were served in a manner, which respected residents’ personal needs and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The routines of the home were flexible to allow residents to go to day centres, visit Stockport Town Centre for shopping, attend church on Sundays and play snooker at a local snooker club. The previous year the residents had also visited the theatre, had days out on a canal boat, a trip to Blackpool lights and been to a restaurant for Christmas lunch. Activities were organised in the home such as bingo, quizzes and outside entertainers. All of the residents who completed a survey form said that there were enough activities. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 15 Friends and relatives were welcomed at the home at all reasonable times of the day and evening. Christmas celebrations had been organised for all residents, relatives and any others who wished to join them. Visitors were given a tray of tea and cake as a matter of routine. The residents had a choice of whether to take part in activities or not and could spend time in their rooms if they so wished. Bedrooms had been personalised and all the residents or their families had control over finances. When necessary residents had an advocate or solicitor to assist them with their affairs and decisions. None of the residents had any complaints about the food. It was a set menu but should someone not like what was available they could have something else. The inspector was present during the mid-day meal, which was served in an unhurried manner with residents given sufficient time to eat at a pace, which suited them. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16,18. Quality in this outcome area is good. The arrangements in place provided protection for service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a complaints procedure, which was given to all residents and/or their relatives. The majority of those who completed a survey form said that they knew how to make a complaint and who too. No one who was spoken with had any complaints. There had been three complaints sent to us, two were referred back to the provider and one to the contracts compliance unit at Stockport MBC; social services division. The results of the investigations were sent to the complainants and no further action was required. The manager said that she had received no other complaints but the three as indicated. There were no safe guarding adult referrals. All care workers received safe guarding adult training as part of their induction and were informed of the relevant polices and procedures. They also attended the Stockport Training Partnership alerter training course. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 17 The majority of the residents who completed a survey form said that they felt safe and knew who to speak to if they were unhappy with their care. Two people out of the three relatives who completed a survey form said that their complaints were always responded to appropriately with one saying usually. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards19,26. Quality in this outcome area is excellent. There was continual improvement to make the home comfortable for the residents with very good quality decoration and furnishings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A second conservatory had been built which was set out as a dining room. New tables, chairs, curtains and lamps had been purchased making it a very pleasant, bright and airy room to eat in. This was a big improvement on the previous dining room as there was now more space for residents and care workers to serve the meals. Other areas had benefited from new carpets, decoration and new furnishings. The bathroom at the front of the house had been upgraded with the installation of an easy access shower, new tiling and bathroom fittings. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 19 Laundry facilities had been updated and infection control measures put in place such as antiseptic hand washes in bathrooms and entrance hall. Also new carpet cleaning equipment had been purchased to reduce infection and to keep the home free of unpleasant odours. The general appearance of the home was warm and friendly with different seating area’s allowing residents to have private visits with friends and family. The gardens are well maintained and have been designed to meet the needs of the residents. The front of the house had been improved to make parking easier for visitors. Information in the AQAA completed by the manager told us of all the improvements they have made this year, and all that they plan to do to further in the next year to continually ensure that residents have a nice and comfortable place to live. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30. Quality in this outcome area is excellent. The commitment of the manager to employ suitable staff and encourage training ensured that only capable and skilled care workers looked after the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were sufficient management, care workers and ancillary staff to ensure that the home was staffed adequately to meet the needs of the residents. The home had a very low staff turnover with just two part time staff having left over the past twelve months. The records of the one person who had recently been employed were looked at. They contained all the relevant information designed to ensure that only suitable people were employed. An induction programme was in place and recorded in the form of a checklist. It was recommended that the manager look at the Skills for Care Induction programme to provide written evidence that the new member of staff had understood the skills and knowledge required to carry out their role. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 21 Out of a care staff team of thirteen, eight had a National Vocational Qualification (NVQ) Level 2 or above with three others currently working towards a qualification. The manager had in place a training programme which covered all core skills such as; moving and handling, health and safety, safe handling of medicines, safe guarding adults and safe food practices. Other specialist training had taken place such as; caring for people with dementia, managing challenging behaviour and the new Mental Capacity Act. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,38. Quality in this outcome area is excellent. The manager of the home ensured that the home was run for the residents by a staff team who were experienced and were continually looking to improve the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager had the necessary qualifications and experience to provide direction and encouragement to both staff and residents in the day-today running of the home. As stated previously the manager ensured that only suitable people were employed with care workers encouraged to take training courses both in house and external to provide them with the knowledge and skills to care for and meet the residents needs. The support and training offered ensured that care workers and ancillary staff were retained. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 23 The manager was also the chairperson of the Stockport Care Training Partnership group. The provider had a contract with a Quality Assurance Consultant who visited the home and provided a report; a copy of which was available to the inspector and relevant others. The consultant’s visit for 2007/2008 was planned for January 2008. The manager also produced resident/relative survey forms, which were given out in the months December/January in order to gain feedback about the home. The results of the surveys and action to be taken should be included in the annual quality assurance report. The completion of the Annual Quality Assurance Assessment (AQAA) could be improved. All policies and procedures had been reviewed October 2007. The home was not responsible for any of the residents’ finances apart from a small amount of money for daily items such as hairdressing; a record was kept. The provider and manager ensured that the health and safety of the residents and care workers were part of safe working practices, which included written policies and procedures and training as and when required. Written risk assessments were in place as were records for the reporting of accidents. The home had received the Investors in People award, which will be ready for renewal 2009. Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 4 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 4 x x 4 Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Whilst the care plans were satisfactory and contained information about the residents needs they could be better presented. It is suggested that some training be sought on writing care plans and person centred planning. The induction record could be improved from the current use of a checklist only. It is recommended that some written evidence from staff to support their understanding of the training given be included. It is recommended that the Manager look at the Skills for Care documentation. The Annual Quality Assurance Assessment (AQAA) could be more explicit with the information provided. 2. OP30 3. OP33 Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Grove Lodge Care Home DS0000008589.V357571.R01.S.doc Version 5.2 Page 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. 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