Inspection on 13/10/05 for Ingham Old Hall Residential Care Home

This inspection was carried out on 13th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ingham Old Hall Residential Care... 24/01/07

Ingham Old Hall Residential Care... 12/05/05

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Oak Ridge

Sun Court Nursing Home

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Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Ingham Old Hall Residential Care Home Sea Palling Road Ingham Norwich NR12 0TW Lead Inspector Linda Wells Announced 13 October 2005, 09:30am th 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 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. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ingham Old Hall Residential Care Home Address Sea Palling Road, Ingham, Norwich, Norfolk. NR12 0TW. 01692 580257 01692 580297 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ingham Healthcare Ltd Mrs Pamela Gibbard Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration other than those specified above. Date of last inspection 12th May 2005 Brief Description of the Service: Ingham Old Hall is a residential care home providing personal care and accommodation for up to twenty-five older people. It is a detached, two storey, period house that has retained many of its origional features and in parts dates back to the fourteenth century. There is a passenger lift to the first floor and residents have communal use of a lounge, entrance hall sitting area, conservatory and dining room. The home has twenty-four bedrooms, one of which is a double bedroom and all have ensuite or designated washing and toilet facilities. There is a communal toilet and bathroom on each floor with a shower facility on the first floor and an additional toilet on the ground floor. The home is privately owned and is situated in a rural setting in its own, large, well kept grounds with parking to the side of the building. The village of Ingham is approximately 1.5 miles from the small town of Stalham which offers shopping and health care amenities. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection undertaken on the 13th October 2005 over six hours and was carried out as part of a routine inspection plan. Prior to the inspection twelve comment cards were received from residents, eighteen from relative/visitors and two from healthcare professionals. All of those who returned the comment cards indicated that the home was friendly, always clean, staff members were caring and residents were well cared for. Residents wrote “the staff are very good and helpful” and “I feel secure in this home”. Relatives/visitors wrote, “since the new owner took over everything has improved” and “excellent staff”. On the day of inspection twenty-four residents were living at the home and residents were seen to be having a meal, sitting in the lounge, the sun lounge or their bedroom listening to the radio, reading or watching television. The inspection took the form of a tour of the premises, individual discussion with five residents, four staff members, a visitor, the manager and the proprietor, group discussion with two residents, examination of care plans, records, certificates and compliance of requirements and recommendations from the last inspection. What the service does well: The home has a friendly, relaxed atmosphere and the residents spoken to said that they liked living at the home, they were well cared for, staff treated them with respect and assisted them with all necessary tasks in a kind and considerate manner. Two residents said “I could not be anywhere better” and “staff are wonderful” and they all said that the routine of the home could be flexible and that the home was always clean and tidy. Staff members were well trained, enthusiastic and said that they put the needs of residents first. This was demonstrated in the records held and the comments received from residents and the visitor. The staff members spoken to said that they liked working at the home and that they were encouraged to promote resident choice and independence. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Residents said that they were happy living at the home, felt included and safe. However, the new proprietor and manager have inherited requirements and recommendations from the previous owners and although many have been complied with over the last six months there is still more to do. The following ten requirements and four recommendations were made to further improve the experience of living and working at the home for residents and staff. • • • • • • • • • • A continued plan of maintenance and redecoration is needed to ensure that residents are fully protected and the home is attractive in all areas. The Quality Assurance system produced is undertaken to ensure that the views and opinions of everyone are sought on the standard of care, service and facilities provided at the home. The target of 50 of staff completing training to NVQ2 be achieved to ensure staff are fully equipped to meet the needs of all residents. A review of the activities is undertaken with residents to ensure that they are of interest and stimulating. Residents to be given a contract of the terms and conditions of living at the home and a copy held, to ensure that they are informed. Staff member to be given a contract of employment to show agreement on the terms of their employment. Each resident to have their photograph held in their plan of care to aid identification. Each staff member to have their photograph held in their staff file to support their proof of identity. A key-worker scheme to be fully developed, to ensure residents have a member of staff to relate to and ensure their needs are fully met. The staff room to be redecorated and staff provided with lockers to ensure an attractive and safe place for staff to store their belongings. I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 7 Ingham Old Hall Residential Care Home • • • • • The arrangements at death to be recorded in the plan of care of each resident to ensure that their wishes are known and complied with. It is recommended that consideration be given to the provision of an Activities Co-ordinator to ensure activities are planned and organised. It is recommended that staff undertake training in the care of those with Dementia to ensure the needs of residents are fully met. It is recommended that residents be assisted to have contact with local voluntary groups to promote friendships and activities in the community. It is recommended that a review of the main meal choice be undertaken with residents to ensure their individual tastes are taking into account. 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. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 The admission procedure and written information available has been rewritten and fully enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: The homes Statement of Purpose and Service User Guide were seen and found to contain relevant information. The manager said that prior to admission as much information as possible was collected from a prospective resident, their family and other professionals. She said residents, their family or friends sometimes visited the home, that she often visited residents in their own home and that residents were admitted on a one-month trial basis. Residents had not been issued with a new contract of the terms and conditions of living at the home and a requirement was made that a copy of the signed contract be held in the plan of care of each resident to demonstrate agreement. A resident who had lived at the home for eight weeks said that she and her relative had visited the home prior to admission, had been given enough information about the home to help them make a choice, that staff had made her feel welcome and had helped her to settle into the home. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,11 The health, social and personal care needs of residents were met, they were well cared for but not all records were completed. EVIDENCE: Residents said they were well looked after and four individual plans of care were examined and found to contain relevant health, social and personal care information, care needs, weight records, reviews, daily records, risk assessments, choices, past history, interests and visiting professionals. However, they did not contain a photograph of each resident or the wishes of each resident upon death. Two requirements were made that a photograph is held in each plan of care and the wishes of residents at death be recorded in their plan of care to demonstrate identification of each resident and involvement, consultation and agreement of each resident on their funeral arrangements. Medication policies and procedures were seen, a member of staff was observed safely administering medication and the records held demonstrated that medication was administered, recorded and stored correctly. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,15 There are some social and creative activities and a choice of meals is available but they do not fully meet the interests and preferences of the residents. EVIDENCE: Residents said that their family and friends were always made welcome at the home and that staff assisted and encouraged them to make choices. They said that they were not aware of who their key worker was and were not fully stimulated by the activities provided daily in the home and some said that they would like to be more involved with community activities. Records were seen to demonstrate that some activities were provided and the manager said that consideration was being given to employing an Activities Co-ordinator. Staff said that they would like to provide more activities for residents but did not always have time due to the dependency of some residents. Therefore, two requirements were made that a review of the daily activities provided is undertaken with residents and the key worker scheme developed and two recommendations were made that an Activity Co-ordinator be provided and local community volunteer groups be contacted to ensure that residents are supported and offered a daily program of activities that is varied and meets their interests. The main meal and menus were seen and were balanced and varied. Records showed that residents were given a choice and an alternative offered. Residents spoken to said that in general meals were good but the main meal Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 12 was sometimes plain, limited and repetitive and a recommendation was made that a review of the main meal option is carried out with the residents. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: No complaints had been received about the home and the home’s records demonstrated that a new complaints policy and procedure has been put in place and that any complaints made to the home are investigated and the appropriate action taken. The residents spoken to all agreed that if they had reason to complain they would speak to staff or the manager and all felt confident that the problem would be resolved quickly and to the satisfaction of all involved. Residents are able to exercise their legal rights and are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home and records showed that staff have undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,22,23,25, The standard of the environment within this home is mainly good but does not fully provide residents with an attractive, safe and homely place to live. EVIDENCE: A tour of the building revealed that residents live in a home that is decorated and furnished to a reasonable standard. Residents said that they benefited from a home that was comfortable, clean and tidy and this was found in all areas during the tour of the building. The proprietor outlined his plans to gradually redecorate and refurbish all areas of the home and although improvements had been made to the home some of the bedrooms were in need of redecoration and the staff room was in need of refurbishment and redecoration. Two requirements and a recommendation were made that a continued plan of maintenance and redecoration is carried out, especially in some bedrooms, to ensure that residents are fully protected and the home is attractive in all areas and that the staff room is redecorated and staff provided with lockers to ensure that staff are provided with an attractive and safe place to sit and store their belongings. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 15 Residents were seen to have personalised their bedrooms, specialist equipment was provided and each floor of the home had adequate bathrooms and toilets that were adapted to suit the needs of the residents. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The needs of residents are met, staff members are competent and the procedure for the recruitment and training of staff provides safeguards to offer protection for the people living in the home. EVIDENCE: Residents said that they were well cared for and the staff spoken to said that there were enough staff on duty if all shifts are fully covered. The manager said that staffing levels had been revised and that she was in the process of undertaking a further review to determine if two staff on duty each evening was adequate. The four staff members spoken to said that they are supported by the senior care staff and the manager, handover, staff meetings and supervision and demonstrated that they were aware of their role and responsibilities. Records showed that residents were protected by the staff recruitment checks that had been carried out. CRB checks, references, personal details and proof of identity were seen and held in the file of each staff member but there was not a photograph of each staff member and staff had not been provided with a new contract of employment. A new employment contract was seen that had been produced by the proprietor and he said that he would be gradually discussing it with each staff member. Two requirements were made that a photograph of each staff member be held in their staff file to supplement proof of identity and that a copy of a signed contract be held in each staff file to demonstrate consultation and agreement on their terms of employment. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 17 Records demonstrated that staff members had a mix of experience and skills and the manager said that one staff member had completed NVQ2 and two were about to commence the training. Improvements had been made in the basic training of staff and certificates showed that induction, foundation and updated, training programs were, undertaken by all staff, with an emphasis on customer care. A recommendation was made that staff undertake training in caring for those with Dementia to enable them to gain the knowledge necessary for the range of needs of residents living at the home. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38 The manager is supported by the senior staff in providing leadership, guidance and direction to staff to ensure that residents receive a good standard of care. EVIDENCE: The manager has been in post for six months, is a trained nurse, has previous experience of managing a residential care home and training staff, has successfully completed a fit person interview with CSCI and holds qualifications in management. Residents and staff members said that the home was well run and that the proprietor and manager were approachable. Records demonstrated that the management, accounting and financial administration procedures carried out in the home offer safeguards and protect residents. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 19 A quality assurance system has been produced and a requirement was made that it be carried out to demonstrate the views and opinions of residents, staff and visitors on the quality of care, service and facilities provided at the home. Policies and procedures have been produced and were seen on all aspects of the home and service provided. The records held were found to promote and protect the rights and best interests of each service user. A new more robust system of supervision and record keeping has been put in place and the handover, staff meeting minutes and supervision records demonstrated that staff members worked as a team and were supported and regularly supervised by the manager to ensure that their knowledge of the needs of each resident, their work practice, commitment and training needs were identified, clarified and reviewed. The records seen showed that incidents of poor practise were identified, discussed with the staff member and monitored to ensure that a good standard of care was provided to residents. The servicing and testing of all equipment had been carried out and relevant and timely certificates were held to ensure that the health and safety of residents is protected. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION 2 3 x 3 3 x 3 x STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 3 3 3 3 3 Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 17.1.a Timescale for action The Registered person must 31st ensure that a photograph of December each resident is held in their plan 2005 of care. The registered person must 31st ensure that the arrangements December and wishes at death are 2005 recorded for each service user. The registered person must 30th ensure that a review of the daily November activities provided is carried out 2005 with service users. The registered person must 1st January ensure that a keyworker scheme 2006 is developed for each service user. The registered person must 30th ensure that a continued program November of maintenence and redecoration 2005 and is carried out in the home. ongoing The registered person must 31st ensure that the staff room is safe December for staff members to use, 2005 redecorated and that lockers are provided. The registered person must 1st ensure that a photograph of December each staff member is held in 2005 their staff file. The registered person must 31st ensure that all staff members January Version 1.40 Page 22 Requirement 2. OP11 12.3 3. OP12 16.2.m n 4. OP14 12.2 5. OP19 23.2.b 6. OP19 23.3.a 7. OP29 19.1 8. OP29 17.2.6 schedule Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc 4 9. OP30 10.3 10. 11. OP33 24.1-3 are given a contract of employment and a signed copy held in their file. The registered person must ensure that 50 of staff members commence NVQ2 training. The registered person must ensure that a quality assurance audit is carried out. 2006 31st December 2005 30th April 2006 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. 4. Refer to Standard OP13 OP13 OP15 OP30 Good Practice Recommendations It is recommended that consideration be given to the provision of an Activities Co-ordinator to ensure activities are planned and organised. It is recommended that residents be assisted to have contact with local voluntary groups to promote friendships and activities in the community. It is recommended that a review of the main meal choice be undertaken with residents to ensure their individual tastes are taking into account. It is recommended that staff undertake training in the care of those with Dementia to ensure the needs of residents are fully met. Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 23 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ingham Old Hall Residential Care Home I55 s63055 Ingham Old Hall v247321 AN 131005 Stage4.doc Version 1.40 Page 24 - 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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