Inspection on 12/06/07 for Hillersdon Court

This inspection was carried out on 12th June 2007.

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 but made no statutory requirements on the home.

Other inspections for this house

Hillersdon Court 01/08/06

Hillersdon Court 01/11/05

Hillersdon Court 11/07/05

Hillersdon Court 16/11/04

Hillersdon Court 17/06/04

Hillersdon Court 23/09/03

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hillersdon Court 18 College Road Seaford East Sussex BN25 1JD Lead Inspector June Davies Key Unannounced Inspection 12th June 2007 09:30 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 Hillersdon Court DS0000021137.V337180.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. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillersdon Court Address 18 College Road Seaford East Sussex BN25 1JD 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) 01323 897706 01323 898689 kwsussex@aol.com Mr James Lord Mrs Sylvia Lord Mrs Kathleen Waller Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That service users must be aged sixty-five (65) years or over on admission. That a maximum of twenty (20) service users are accommodated. Date of last inspection 1st August 2006 Brief Description of the Service: Hillersdon Court is registered to provide residential care and support for up to twenty older people. The premises comprise of a large detached house, which has been extended over the years. The home is situated close to the shops and railway station in Seaford town centre and within walking distance of the seafront. Service user accommodation comprises of seventeen single rooms and one double room, eleven of which have en suite facilities. All rooms are fitted with a call bell system. The proprietors of Hillersdon Court also own Bybuckle Court, another care home for older people situated in the Seaford area. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The range of weekly fees, as of 12th June 2007, is £358 - £395. Additional charges, not included in the fees, include hairdressing, chiropody, newspapers and holidays. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out on the 12th June 2007 over a period of six hours. During this time the inspector spoke with seven service users, two visitors to the home, three members of staff, the registered manager and acting manager as well as viewing all documentation relating to the key standards inspected. A tour of the home and garden took place. What the service does well: What has improved since the last inspection? All care plans contain good information to make sure that all staff are informed in all aspects of each service users care needs. Care plans and risk assessments are regularly reviewed and now reflect the changing needs of the service user. Staff training has improved since the last inspection with only a few members of staff still needing to complete all their mandatory training. Staff files show that recruitment practices have improved and staff now have two written references in place, but some further work needs to be done. The home is in the process of addressing the low percentage of staff with NVQ qualifications, and further staff are now in the process of working towards an NVQ qualification. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 7 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 Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 8 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 1, 2 and 3. Quality in this outcome area is good. The homes statement of purpose and service user guide provides prospective service users with the information they need to make a decision about moving into the home. Pre-admission assessments contain comprehensive information on which to base the service users care plan. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes statement of purpose and service user guide has now been reviewed and contains sufficient information to give prospective service users the choice of living in Hillersdon Court. Each service user is given a contract, which clearly outlines which room they will occupy and what fees they are being charged. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 9 A new pre-admission assessment has been produced for prospective service users, this gives very detailed information as to what care needs are to be met. Three pre-admission assessments were viewed these had been completed properly giving sufficient information on which to base a care plan. The home does not offer intermediate care. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. The care planning system is clear and consistent and provides staff with the information they need to meet service users needs. The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. Medication within the home while generally managed well but some improvements are needed to make sure the service users are not placed at risk. Staff respect the privacy and dignity of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans show that each service user has been individually assessed and give individualised information relating to their care needs. Also contained with care plans were individualised risk assessments and evidence of Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 11 regular reviews taking place. It was noted however that there was no evidence that service users and or their relatives had been involved in drawing up their care plan. There was no evidence that nutrition assessment was carried out regular basis, but through discussion with the registered manager, it became evident that some personal details were kept collectively in books in the office and this will be dealt with later in this report. Care plans did contain a personal care sheet but these were not always correctly completed for the tasks that had been carried out. One relative visiting the home at the time of this key inspection stated, “I am aware that my mother has a care plan, but neither my mother or myself were involved with it. The home does a grand job with my mother, I could not wish for better.” Through evidence seen in care plans it was obvious that service users are able to see health care practitioners at their request, or when the registered manager sees the need for referral to G.P.’s, district nurses, community matron and other external stakeholders. Two service users stated that they were able to see their G.P. as and when requested. The home has up to date policies and procedures for the receipt, administration, storage and disposal of medication. All the staff administering medication in the home have received the appropriately training. Generally medication was well managed but there is still room from improvement by ensuring that mid cycle medication and respite care medication is properly entered onto the MAR chart. From observation it was evident that staff respect the service users rights to dignity and privacy. Staff were also observed talking to service users in a kind and respectful way. One service user said, “The staff here are marvellous, we could not wish for better care.” Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. Activities and links with the community are good and support and enrich the service users social lives. The meals in the home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are able to make decisions relating to their day to day lives. Two service users said that they were able to get up in the morning when they wished to and that they had their breakfast in bed. Each morning service users are able to take part in an exercise routine in the main lounge. Two service users said, “We enjoy the daily exercises and do not like to miss them.” From the activities list service users are offered a variety of activities throughout the week, added to this there are visitors from local churches and lay visitors from the church. An entertainer visits the home every six weeks. Every month there is a bus outing for the service users to a place of interest. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 13 When the weather is nice staff walk along the sea front with service users or take them into town for a coffee. One service user said, “There is enough going on in the home to keep us occupied.” Several service users said that they could join in activities as and when they wished to. Visitors are made welcome in the home and support the home on special occasions or when there is a social gathering such as a garden party, at Christmas. Relatives also attend service users birthday celebrations. The registered manager has no involvement with service users finances with exception of personal allowances. One service users manages their own finances and another service user is in the process of appointing a solicitor as power of attorney, in other cases the relatives have control of finances. Advocacy services have been used for one service user in the home, and other relatives or service users would be able to contact an advocacy service if they wished to. As mentioned earlier in the report some personal information about service users is kept collectively in books in the office and this does not conform with the Date Protection Act 1998. The registered manager said that service users would be able to see their individual care plans if they wished to, and that she would address the personal information that is being kept collectively. The menus in the home were viewed and showed that service users are offered a variety and choice of nutritious, wholesome food. Drinks and snacks are offered between meals. The home would cater for specialised diets, but at the moment only caters for those service users who are diabetic. None of the service users are on liquidised diets. On the day of the key inspection the inspector witnessed that the lunchtime meal was served in an appealing way, and that the lunchtime meal was unhurried. Four service users said that the food in the home was very good; that there was always plenty to eat, and that they were able to have choices at each mealtime. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. Service users know their complaints will be listened to and acted on. Staff have a good knowledge and understanding of adult protection issues and this protects the service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedure has recently been reviewed and updated, this policy gives clear guidelines of how to make a complaints and the timescale in which a reply will be made. This complaints policy and procedure is displayed in the main hallway. Two service users said that they would know how to make a complaint, but they never had need to. At the present time Hillersdon Court has an Adult Protection issue, which is still being investigated, and another adult protection issue, which was reported to the Adult Protection Co-ordinator on the day of the inspection. The home has policies and procedures in place for the protection of vulnerable adults including East Sussex Brighton and Hove multi agency guidelines and protocols for the protection of vulnerable adults. Staff said they are aware of what constitutes abuse and the whistle blowing policy. All staff have received POVA training. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 15 Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 16 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): Standards 19 and 26 Quality in this outcome area is adequate. The home provides a pleasant environment for service users, but attention needs to be paid to maintenance, hygiene and infection control to make sure service users can live safely in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is suitable for its stated purpose, although no changes have been made to the physical environment since the last inspection; service users live in a comfortable and homely environment. Some carpets have been replaced. One bedroom did not have a lock fitted to the door. The back garden is accessible to the service users and there were no visible health and safety issues. The inspector did note that in the dining room an electrical socket was Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 17 cracked, one of the bedrooms has a badly cracked windowpane and a call bell needed attention in one of the ground floor toilets. On the day of the key inspection the home was clean and tidy with no unpleasant odours, with the exception of one bedroom. The inspector did note that in communal toilets terry towels were still being used, and these should have been replaced by paper towels to reduce the risk of cross infection. The laundry room is situated behind the kitchen, but laundry is passed through a hatchway so that it is not taken through the kitchen area. The laundry floor was impermeable to water, and contained an industrial washing machine, with a sluicing and disinfecting program; there was also an industrial tumble drier. The home has a clinical waste contract and all clinical waste is placed into the appropriate yellow sacks. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is adequate. There are sufficient staff on duty to meet the needs of the service users. Staff recruitment practice, mandatory training and job related training has improved since the last inspection but further improvement needs to be made to ensure that service users are not placed at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels at Hillersdon Court are good, with sufficient staff on duty for each shift, this was evidenced through staff rotas and observing the staff on duty during the course of two shifts. One member of staff said, “They did not feel rushed.” One service user said, “ The staff are always around when you want them, I do not have to wait long if I use my call bell.” Only 30 of the care staff are trained to NVQ level 2 or above, with two other staff in the process of obtaining NVQ. Through viewing three staff personnel file the inspector found that all files contained a completed application form with employment histories. It was found that one file contained a transferred CRB check; this was pointed out to Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 19 the registered manager, who said that she would ensure a new CRB was sent for. One file did not have any proof of identity. All files had two references. There was evidence in the files that staff have induction related to Skills for Care. Staff files also contained evidence of some staff training taking place. The staff-training matrix showed that many staff have completed mandatory training but there were still a few gaps, specifically for moving and handling, food hygiene and infection control. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 20 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 and 38 Quality in this outcome area is good. The registered manager has a good understanding of what needs to improve in the home, but planning needs to be in place to show how this will be resourced and managed. The quality assurance system needs to be developed further to ensure that service users are receiving the best quality of care. Generally health and safety procedures are good, but further work needs to be done to ensure that service users and staff live and work in a safe environment. This judgement has been made using available evidence including a visit to this service. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 21 EVIDENCE: The present registered manager is many years experience at management level and has a City and Guilds Advanced Management in Care qualification. At the present time she is overseeing another home owned by the registered provider. An acting manager has been recruited in Hillersdon Court and it is envisaged that she will be applying to be the registered manager once she has completed her RMA. The registered manager said that she is in daily contact with the home A member of staff said ‘The manager is very helpful, she has an open approach to management in the home, she is very caring to the service users in the home.’ Service users said – ‘The manager is very good, we can go to her for anything.’ ‘I could not wish to be in a better home.’ ‘The manager always has time to talk to us, and the staff are very caring.’ A relative said – ‘I could not wish for my mother to be in a better place, the manager and staff are very professional, and at the same time they are friendly and caring. I feel happy and relaxed that my mother is in Hillersdon Court.’ While some work has been done on drawing up a quality assurance system in the home this needs to be developed further, to provide stakeholder questionnaires, recorded monitoring of systems in the home, and that there are six monthly risk assessments for the whole building (internal and external) for health and safety and fire. As mentioned earlier in the report all staff must complete their mandatory health and safety related training. There are up to date maintenance certificates for all equipment used in the home. Fire point checks are carried out weekly and recorded and there are six fire drills per year. Hot water temperatures are regularly recorded and all hot water taps are fitted with water temperature control valves. Fire stops have been fitted to all doors in communal areas, and the home is now concentrating on fitted these fire stops to bedroom doors where the service users like to keep them open during the day. The registered manager said that all bedroom doors are closed at night. Radiators throughout the home are covered. All windows have windowopening restrictors fitted. There is not a comprehensive health and safety and fire risk assessments for all rooms in the home at the exterior of the building. A HSE accident book is in place and it was noted that staff complete these correctly. All staff have Skills for Care induction training and this covers topics on health and safety. Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 22 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 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13 (2) Requirement All medicines brought into the home must be properly recorded onto the MAR sheets. Any medication allergies relating to service users must be recorded onto the MAR sheets. The cracked windowpane in a bedroom must be replaced. Electrical sockets and call bells must be maintained to ensure they are kept in a usable condition. All parts of the home must be kept free from offensive odours. All communal toilets must have paper hand towels to avoid the risk of cross infection. It is required that a minimum ratio of 50 of care staff obtain NVQ level 2 in Care. This was a previous requirement that was not met by the timescale of 13/12/06 All staff must have CRB check. Previously obtained CRB are not transferable. DS0000021137.V337180.R01.S.doc Timescale for action 06/08/07 17(1)(a) 2. OP19 23(2)(c) 06/08/07 3. OP26 16(2)(k) 13(3)(4) (a-c) 06/08/07 4. OP28 19 (5) (b) 05/10/07 5. OP29 19(4)(c) Sched. 2 (5) 06/08/07 Hillersdon Court Version 5.2 Page 24 Sched. 2(1) 6. OP30 12(1)(a) (b) 18(1)(a) (c) 24(1)(a) (b), (2)(3) Staff files must include proof of identity including a recent photograph. All staff must receive and update their mandatory training and receive training relevant to the assessed and changing needs of the service users. The registered person must develop a full quality assurance system for the home, ensuring that stakeholders views are sought, that regular recorded monitoring of systems used in the home are carried out and that six monthly health and safety assessments are carried out for each room and the external building. 06/08/07 7. OP33 06/08/07 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. 2. 3. Refer to Standard OP7 OP8 OP14 Good Practice Recommendations Service users and or their relatives are involved in their care plans and sign to agree to the levels of care required. Personal hygiene charts are kept up to date and correctly reflect the personal hygiene that has been carried out for the service user. All personal details relating to the service user must be kept in individual care plans and not collectively in books so as to comply with the Data Protection Act 1998 Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hillersdon Court DS0000021137.V337180.R01.S.doc Version 5.2 Page 26 - 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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