Inspection on 05/11/08 for Grove Park Nursing Home

This inspection was carried out on 5th November 2008.

CSCI found this care home to be providing an Good 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 Park Nursing Home 21/11/07

Grove Park Nursing Home 22/02/07

Grove Park Nursing Home 03/02/06

Grove Park Nursing Home 30/09/05

Grove Park Nursing Home 10/11/04

Grove Park Nursing Home 13/04/04

Grove Park Nursing Home 18/12/03

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Grove Park Nursing Home 9 Plymouth Grove West Manchester M13 0AQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Steve OConnor     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Grove Park Nursing Home 9 Plymouth Grove West Manchester M13 0AQ 01612734557 01612738456 gillespie170@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Thomas Collins Gillepsie Type of registration: Number of places registered: Roja Limited care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users requiring nursing care by reason of mental disorder or dementia shall be 20 aged 50 years and over. Two named service users currently accommodated require nursing care by reason of mental disorder but are below 50 years of age. Date of last inspection Brief description of the care home Grove Park Nursing Home is registered to provide nursing care for up to 20 residents with enduring mental health problems and alcohol related issues. Accommodation is situated over three floors and comprises of 18 single rooms and one double room. One single room has en-suite facilities and all other rooms have wash hand basin facilities. There is a smoking lounge and a seperate lounge/dining room situated on the ground floor. There is a passenger lift to the first and second floors of the home. There is a large garden area to the back of the building and parking facilities at the front of the property. The home is situated in Plymouth Grove West in the Longsight area of central Care Homes for Older People Page 4 of 30 Over 65 20 20 0 20 Brief description of the care home Manchester close to local shops and amenities. The home is close to public transport routes to the City Centre and South Manchester areas. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection report is based on information and evidence we (the commission) gathered since the home was last inspected in November 2007. Before visiting the home, we asked the manager 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 helped us to determine if the management of the home viewed the service they provide the same way that we assess the service. Additional information used to complete the inspection report may include incidents notified to us by the manager of the home and information provided by other people and/or agencies, including any concerns and complaints. Care Homes for Older People Page 6 of 30 Surveys were sent to people living at the home and to members of staff to find out their views of the service. Nine people and eight members of staff returned surveys. During the inspection visit time was spent talking to three people, observing how staff work with people and talking to the management and staff on duty. Documents and files relating to people and how the home is run were also seen and a tour of the building was made. The inspection was an opportunity to look at all the core standards of the National Minimum Standards (NMS) and was used to make a judgement on the quality of the service and to decide how much work we may need to do with the home in the future. The manager stated that the current fees for the home ranged from 412 to approximately 900 pounds depending on the level of support a person needs. Information and the previous Key Inspection reports could be found by calling the home direct and speaking to the manager. What the care home does well: What has improved since the last inspection? What they could do better: There was no requirements made during this key inspetion. Care Homes for Older People Page 8 of 30 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were assessed prior to admission so that the management of the home could decide whether they could support those needs. Evidence: The manager described the referral and initial assessment process. On receipt of a referral they would visit a prospective person and carry out an assessment of their needs to determine if they can be supported by the staff and management team. Where possible people were encouraged to come and visit the home and to meet other residents and staff to help them make a decision on whether to come and live there. Referrals were received mainly through local authority mental health services and Primary Care Trusts (PCT) who provided information about peoples mental and general health needs. Examples of the different types of assessment provided were seen in peoples files. They contained comprehensive information in relation to Care Homes for Older People Page 11 of 30 Evidence: peoples emotional and mental health. Intermediate care was not provided by the home. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples general and mental health needs were known and they were supported to access the relevant services. The medication administration system made sure that people had taken the medication they require to stay healthy. Evidence: Each person had their own individual file and care plan that was based on information gathered from the relevant assessments and through knowledge gained by staff as they got to know the person. The care plans concentrated primarily on peoples emotional and mental health, interventions to reduce risks and general health and personal care. From talking to the manager, staff and observing how staff work with people it was shown that the knowledge that staff have in how they work with and support people was not being fully reflected in individual care plans and support interventions. It is recommended that care plans reflect more fully how staff actually support people to meet their needs and maintain their health and wellbeing. Care Homes for Older People Page 13 of 30 Evidence: Care plans sampled showed good examples of risk assessments with clear and comprehensive support guidance and interventions to reduce the identified risk such as alcohol use, personal finances or behaviour. The manager had taken into account the recommendation made at the last key inspection and had looked at a wider range of issues that could pose a risk to peoples safety and wellbeing. An example was found where in the few months that a person had come to stay at the home the risks first identified had reduced or were not present. Also the way that staff worked with this person had moved on and was not the same as described in the risk assessment. It is recommended that changes in risk and the support provided be clearly reflected in risk assessments. Care plans were being reviewed on a monthly basis. Records of these reviews were maintained and a system was in place to make sure that all nurse staff had read the review and passed on any relevant information to the support staff. Examples were also seen of the formal review process of purchasing authorities through the Care Programme Approach with the majority of people having the opportunity to see their psychiatrist at least every six months. Peoples files contained information about their mental and general health needs and also recorded the interventions from specialist and general health providers. The majority of people still had access and contact with local mental health services. The medication administration system was assessed and found that records of deliveries and returns were being maintained. A contractor was being used to dispose of medication. The medication administration records (MAR) were sampled and found to be signed and audited to show that all the required medication had been administered. In response to requirements made in the previous inspection report the manager had developed medication as required (PRN) profiles and administration details and records for when PRN medication was administered. Privacy for people sharing a bedroom was provided through curtain screens. All bedroom doors had privacy locks and people had their own bedroom key if they requested one and it was safe. Staff members were observed to treat people in a respectful manner. Interactions between staff and people were observed to be positive. Care Homes for Older People Page 14 of 30 Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported to make choices and maintain control over their own daily routines and activities. Evidence: Breakfast was served from around 8:00 until 10:00 am with people free to get up as they wished at different times. Lunch was served between 12:00pm until 1:00pm, which was a light meal, soup and sandwiches. The main meal of the day was served around 5:00pm with a light snack provided at suppertime. Tea and coffee were available throughout the day. In addition to the main kitchen there was a small kitchenette where people and staff could make refreshments and light snacks. People commented on the surveys and when spoken to that they were happy with the meals and residents meetings were used to talk about the menus and what people wanted including or changing. The chef carried out monthly questionnaires asking people about the quality and choice of meals. They held information about what people liked and disliked and any dietary needs. There were sufficient supplies of fresh food and the majority of meals were home-cooked. Care Homes for Older People Page 16 of 30 Evidence: During the site visit a person was seen preparing and cooking their own evening meal in the kitchenette. They were provided with a budget to purchase their own food and could access the kitchenette whenever they wished. A number of people were independent in the community and came and went as they pleased according to their own preferences. Social and leisure activities were discussed at residents meetings and people made suggestions of what they would like to do. A record of the social and leisure activities that people enjoyed and took part in was being maintained. Several people were supported to visit local leisure amenities and a computer was available for people to use. A number of people commented on the activities that they enjoyed, particularly when going out into the community and social evenings, such as a karaoke event at Halloween. People were encouraged and supported to keep contact with their families. Visitors were encouraged although it was preferred that they do not come over mealtimes, unless prearranged. Peoples religious needs were met through visits to the home by church members and people attended services at local places of worship. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The policies, procedures and staff practices were present to protect vulnerable people from abuse and protect their wellbeing. Evidence: The formal Complaint Procedure set out the stages, timescales and the procedures for people to follow if they wanted to make a formal complaint. The procedure was made available to people and was also on display in communal areas. No formal complaint had been made since the last inspection report in November 2007. Any informal concerns and worries that people raised would be dealt with by the staff at the time. Comments from surveys and people spoken to during the visit suggested that they were aware of the complaint procedure and who they would speak to if they had any concerns. An Adult Protection Policy and procedure set out the role of the management and staff in protecting people. The manager and deputy were aware of the procedures to follow in the event of an allegation or incident of abuse. Staff spoken to were also aware of their role in protecting people and what they would do if they had any concerns. The manager had discussed the adult protection procure with staff during staff meetings and had made the policy available for them to read. Care Homes for Older People Page 18 of 30 Evidence: The procedures and recording systems for supporting people with their personal finances and spending were in place. This was looked at further in the Management and Administration section of the report. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises were safe, clean and offered enough space and flexibility to meet peoples needs. Evidence: Accommodation was spread over three floors in a large detached house. The main kitchen, staff room, office, laundry and storage facilities were located in the basement. On the ground floor there was a smoking and no smoking lounge/diner, a kitchenette, toilets, bathrooms and bedrooms. Further bedrooms, bathrooms and toilets were located on the other floors. A passenger lift provided access to the upper floors. Bedrooms on the ground floor and communal areas had been decorated since the last inspection. At the time of the visit the maintenance worker was decorating a bedroom. The manager stated that this decoration programme was an ongoing plan for all the bedrooms and communal areas on the other floors. A large number of people smoked and the smoking lounge was well used. Ventilation was efficient but it was difficult to keep the doors shut with people coming and going into the room. It is recommended that the manager seeked guidance on how the smoking legislation must be applied within the home. Care Homes for Older People Page 20 of 30 Evidence: Due to the number of people who smoked the manager stated that there were plans for decorating the smoking lounge every twelve months. There were also ongoing problems with cigerette burns to flooring in bathrooms, toilets and peoples bedrooms, which had to be frequently replaced. Water damage to areas of the home found during the last inspection had been decorated. Cleaning staff worked part time hours during the week and support staff would carry out ongoing cleaning and laundry duties. The laundry facilities were sufficient to meet peoples needs. The manager had sought guidance from the local PCT regarding updating the infection control measures and, as a result, had re-sited the storage of the disposable gloves and aprons in the bathrooms. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were being support by sufficient numbers of appropriately qualified and experienced staff. Evidence: The manager and deputy manager were both registered nurses and covered the management of the home across the week. The home had access to registered nurses who provided the nursing cover during the night, at weekends or if both the manager and deputy were not available. The staff cover consisted of two nurses and three support staff on duty between 8:00am and 2:00pm and one nurse and two support staff between 2:00pm and 8:00pm. This level of staff cover was maintained through the night. There was also a chef employed throughout the week and domestic staff who provided part-time cover during the week and one at weekends. An administrator supported the manager in the operational and financial aspects of running the home. Information provided by the manager in the AQAA stated that out of 17 permanent care staff seven had gained the NVQ Level 2 or above. Samples of files for staff employed since the last inspection were seen and it was Care Homes for Older People Page 22 of 30 Evidence: found that they all contained the required documentation and checks including references and Criminal Record Bureau certificates. Prospective staff were interviewed by the manager and administrator. They confirmed that interview notes were not kept after the event. The references from previous or current employers had no evidence to show that they actually came from an employer. It is recommended that interviews notes be retained after the event and that references from previous/current employers were asked to supply a company stamp or letterhead as proof of authenticity. Evidence was seen that the most recent members of staff employed were in the process of undertaking the Skills for Care Induction modules based on the Common Induction Standards. A log of the training that staff had undertaken showed that a range of core training had been identified. The manager had access to a range of training materials that had been purchased around issues such as Health and Safety, Adult Protection and the Mental Capacity Act 2005. Staff surveys sent to us commented that they had received training to meet peoples needs such as working with challenging behaviour. The manager stated that a lot of training, awareness raising and information sharing with staff occurred on an informal basis but there was no recorded evidence of this. It is recommended that all forms of staff training, awareness raising and information sharing that maintains and/or improves staff skills and knowledge be clearly evidenced and recorded. It is also recommended that a system be implemented that assesses the competence of staff to show that the knowledge and skills that they have acquired through training was being put into practice in supporting people. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management, policies and procedures for the operation of the home were in place and supported peoples best interests. Evidence: The manager was a registered nurse and had achieved the Registered Managers Award. They were part of the working rota and worked different shifts during the week. They also gave themselves supernumerary hours to work on operational management tasks. The deputy manager was also a registered nurse and provided cover when the manager was not on duty. The manager and deputy were also on-call for staff to contact by phone if they required help or guidance. Since the last Key Inspection the manager had applied for and been confirmed as the registered manager. Care Homes for Older People Page 24 of 30 Evidence: People meet on a regular basis for residents meetings. This was an opportunity for people to talk about any concerns and raise any issues. These usually consisted of discussions around activities and meal choices. The manager had also asked people and supported them to complete questionnaires to seek their views of the service they received. The manager was aware that the views from other professionals and also from peoples families would help in establishing how well people were being supported. Information in relation to health and safety issues was gathered on site and via the AQAA provided by the home. Evidence was seen of the passenger lift and hoist being serviced, up-to-date gas and electrical equipment checks, water and legionella testing. The hot water sources that were controled by thermostatic values were not being checked or recorded. It is recommended that the temperature of all hot water sources controlled by thermostatic values be checked on a regular basis. A fire risk assessment had been carried out that made a number of recommendations. The manager stated that these had been addressed. Visual checks were made of fire equipment, means of escape and the fire alarms were regularly checked. Fire drills were being carried out. The majority of people had their individual benefits paid to the local authority who acted as the corporate appointee. Only three people still had money in a pooled bank account operated by the owner of the home. Personal allowances and funds were requested from the local authority and stored securely at the home. A record was being maintained of all the monies paid to people and of their spending on personal items. Receipts were being kept for all transactions. Staff were both supporting people to go shopping for personal items such as clothes and also, at times, shopping for them. It is recommended that written agreements were gained from people if staff were shopping for them and spending their money. Some people had restrictions placed on the amount of money they can be given in a certain period of time. It is recommended that placing restrictions on peoples access to money should only be agreed with the persons permission or through the application of the Mental Capacity Act and the risk assessment process. Care Homes for Older People Page 25 of 30 Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that care plans reflect more fully how staff actually support people to meet their needs and maintain their health and wellbeing. It is recommended that changes in risk and the support provided be clearly reflected in updated through risk assessments. It is recommended that the manager seeks guidance on how the smoking legislation must be applied within the home. It is recommended that interview notes be retained after the event and that references from previous/current employers are asked to supply a company stamp or letterhead as proof of authenticity. It is recommended that a system be implemented that assesses the competence of staff to show that the knowledge and skills that they have acquired through training is being put into practice in supporting people. It is recommended that all forms of staff training, awareness raising and information sharing that maintains and/or improves staff skills and knowledge be clearly evidenced and recorded. It is recommended that placing restrictions on peoples Page 28 of 30 2 7 3 19 4 29 5 30 6 30 7 35 Care Homes for Older People access to money should only be agreed with the persons permission or through the application of the Mental Capacity Act and the risk assessment process. 8 35 It is recommended that written agreements are gained from people if staff are shopping for them and spending their money. It is recommended that the temperature of all hot water sources controlled by thermostatic values be checked on a regular basis. 9 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!