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Inspection on 02/10/08 for Jubilee House Jonquil Close

Also see our care home review for Jubilee House Jonquil Close for more information

This inspection was carried out on 2nd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Jubilee House Jonquil Close 29 Jonquil Close Panshanger Welwyn Garden City Herts AL7 3HX 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: Julia Bradshaw Date: 0 2 1 0 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Jubilee House Jonquil Close 29 Jonquil Close Panshanger Welwyn Garden City Herts AL7 3HX 01707391113 01707393529 michael.oconnell@jubileehouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Jubilee House Care Trust Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 6 6 0 0 learning disability physical disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Jubilee House, Jonquil Close, is a 6-bedded purpose-built bungalow for high dependency service users. Services are offered to younger adults with a learning disability, and those with an additional physical disability. The property is leased through a housing association. The home is situated in a residential area of Welwyn Garden City and the town centre, with its wide range of facilities, is about a mile away. There is ample car parking for the home and a minibus is provided for the service users to facilitate outings. The weekly placement fee for each service user is £198: 23. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home This report draws on information obtained from the recent Annual Quality Assurance assessment ( AQQA ) completed by the manager and from a full inspection visit carried out on the 2nd October 2008.The inspection process included speaking to people using the service, staff on duty and a full inspection of records relating to care planning, medication, health and safety, staff records and training and the general management of the service. Surveys from people who use the service and from staff are part of the ongoing inspection of a service and any issues arising from these surveys and other relevant information received by the Commission could then inform further regulatory visits by CSCI in respect of Jonquil close. Care Homes for Adults (18-65 years) Page 7 of 30 The home has a Service Users Guide and Statement of Purpose that are provided to prospective users of the service. These and copies of the latest report on this service from the Commission for Social Care Inspection (CSCI) are available in the home. What the care home does well The service provides a diverse range of support and care to people with both a learning disability and physical disability. There are various systems in place which reflect both professionalism and expertise in working practices. These were observed as appropriate to the needs of the people using this service. The service has produced detailed care plans, which give a comprehensive insight into to the needs of the individual. The service has a good assessment system in place, which is both detailed and comprehensive in its approach to identifying all the needs of new and existing users of the service. Jonquil Care Homes for Adults (18-65 years) Page 8 of 30 Close provides detailed information about the operation of the service to prospective and current residents. The staff team are both committed and enthusiastic in their approach to people living within this service. The people living at Jonquil Close appear to have some degree of involvement in their care planning and the service has started to produced a person centred plan that enables staff to create an individual service in order to meet each persons needs and aspirations. Bedrooms have been redecorated and re-carpeted and provide a well maintained and well presented private space for individuals which promotes peoples dignity and provides an acceptable level of comfort and individuality. The staff spoken with during the inspection appeared to have a clear understanding of their individual roles and responsibilities. The service has clearly defined job descriptions. Staff have received a series of Care Homes for Adults (18-65 years) Page 9 of 30 mandatory training in order to carry out their roles effectively and professionally. The registered manager left the service in September and the care manager is providing the management support to staff whilst recruitment takes place for a new permenant manager. This temporary arrangments appears to be effective in the running and managment of the service. What has got better from the last inspection Several areas of the service have been re-decorated since the last inspection was carried out, including, new laminate floors being fitted, the sittingroom re-painted, new curtains and new lounge furniture have been provided. A new kitchen has also been refitted. Care Homes for Adults (18-65 years) Page 10 of 30 What the care home could do better The service is running well considering the absence of a registered manager but the company must ensure they are providing the necessary support to the care manager whilst this post remains vacant. The last Regulation 26 visit recorded was on the 1st April 2008. These visits must be carried out on a monthly basis and a record of these visits should be held within the service. The current arrangement for the storage of medication within the kitchen area of the service shoud be reviewed in relation to the maintenance of certain medications at temperatures of 20 degrees, as the current temepratures recorded are too high. Care Homes for Adults (18-65 years) Page 11 of 30 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Julia Bradshaw 33 Greycoat Street London SW1P 2QF 02079792000 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 Adults (18-65 years) Page 12 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 13 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . Information about the service is kept up to date and provided for all prospective users of this service and everyone wishing to enter the home has a full assessment of need completed. This ensures that all parties can be sure the home can meet all individual needs and terms and conditions of the home are agreed in writing so that people are clear about the roles and responsibilities of all those in the service. Evidence: A total of two care plans were reviewed and evidence gained regarding the initial assessments that are carried out to access if the service can meet the needs of the person. Information is held regarding the persons history and current needs. An assessment of each persons needs and aspiration are made before the person moves into the home. Competent and qualified staff complete these assessments. The service also receives and seeks external specialist support to meet the individuals needs. Whole life reviews occur to support the service users in achieving and reviewing their individual needs, goals and aspirations. The assessment process includes the gathering of information from other professionals. The organisation has its own internal assessment forms. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: A tenancy agreement is then drawn between the service provider and the person using the service. The agreement includes the terms and conditions within the home and the rights of the people who live at Jonquil close. Care Homes for Adults (18-65 years) Page 15 of 30 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 . Care plans reflect a detailed and detailed record of peoples needs, which ensures that people using the service are assessed, reviewed and safe from risk. Evidence: Two care plans were inspected in detail and were found to provide an good insight into each individuals needs. Individual notes and guidelines for people were observed within the service. The manager and staff have worked hard to further develop these care plans into a person centred plan format which can be more easily understood by the people using the service. Everyone living at Jonquil Close is supported within the whole life review framework and regular reviews occur to ensure changing needs are continuously assessed and reviewed. Ranges of risk assessments are completed within the service and action points recorded. These risk assessments are detailed and contain all the required information. Activities and outings enjoyed by people living at Jonquil Close determine that people are supported to take risks as part of an independent life style. Risk assessments have been reviewed since the last inspection was carried out. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: Staff work with people to assist them to lead safe and enjoyable lives, consulting with them as appropriate, regarding decision making and offering guidance where needed.There was evidence to confirm that people had been involved in their care planning with signatures from either the person using the service or their representative. People spoken to on the day of the inspection and comments received by way of surveys were all positive about the way that care is received in terms of preserving rights and dignity. People spoken to stated, I like the staff here, they take me out. The Community learning disabilities team based in Stevenage provides health care support. Care Homes for Adults (18-65 years) Page 17 of 30 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 . Those who use the service have their health and personal care needs carried out effectively and respectfully, ensuring that their wishes and choices are promoted. Evidence: People attend Hornbeams day centre, which provides a variety of activities, suitable to peoples individual needs and aspirations. The initial assessment determines the programme of choice within the day centre. Access to transport is through the on-site minibus. Staff support and encourage people to maintain and develop social, emotional, communication. People living at Jonquil Close are encouraged and supported to maintain links to the local community. The manager and staff should be congratulated on providing a range of holidays and social outings for people, including taking two people to Butlins in Somerset, two people went to Centre Parcs and two people went to Lincolnshire during the summer months. People also enjoy regular trips to the local pubs, library, salvation army church in Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Welwyn Garden city and people also attend the local Gateway club on a Friday evening. The service also has its own sensory room, which is equipped with a range of both visual and sound equipment. People are also taken on regular shopping trips. Residents views are currently obtained from regular meetings held within the service and through visual communication methods. However this could be further developed through the introduction of pictorial questionnaires. The inspector also arranged for pictorial questionnaires to be sent from the Commission to be completed by the end of November. Menus were inspected and offer a range of diverse meals that are representative of the cultural needs and wishes of the people currently living at Jonquil close. The menus could benefit from being presented in a pictorial format in order for people to make an informed choice about what they would like to eat. Care Homes for Adults (18-65 years) Page 19 of 30 Personal and health care support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . Those who use the service have their health and personal care needs carried out effectively and respectfully, ensuring that their wishes and choices are promoted. However the current arrangement of the storage of medication could put people using the service at risk. Evidence: The medication cupboard is located within the main kitchen area of the service. However this arrangement is unacceptable in relation to the storage of medication as some medication is required by the manufacturers instructions be stored at 20 degrees or below to remain clinically effective. The temperatures recorded for the month of October ranged from 23 degrees to 26 degrees.This means the medication may longer work or may even be unsafe to use. Medication that had been received into the home has been recorded accurately. All staff have been trained and inducted in the administering medication. There is currently no controlled medication held in the medication cupboards, however there is a robust procedure in place for the administration of these medications, if required. all non- blister pack medication has date of opening recorded. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: Health records are maintained within the main care plan and ensure that peoples holistic care is being monitored and maintained. Files checked confirmed that everyone living at Jonquil Close has regular health checks including out patient appointments. All personal and health care support is well maintained ensuring individual needs, choices and preferences are met at all times. All non-blister pack medication has date of opening recorded. Care Homes for Adults (18-65 years) Page 21 of 30 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 living in this service can be assured that they will be protected from abuse and that they will be listened to if they raise any concerns or make a complaint about any aspect of their care. Evidence: The service has a detailed complaints procedure in place. A record is maintained in the service of any complaints made detailing actions and outcomes as necessary. One person spoken to stated that they knew who to talk to if they had reason to complain. The recent AQQA stated that no complaints have been received since the last inspection was carried out. A detailed procedure is in place to ensure that people using the service are protected from abuse and harm. Staff receive suitable and adequate safeguarding training. Staff employed within the home are all subject to enhanced Criminal Records Bureau disclosure. Care Homes for Adults (18-65 years) Page 22 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 service provides a safe, clean and well-maintained environment for those who live and work there and people who live at Jonquil close can be assured that they can personalise their rooms to reflect their own tastes and personalities. Evidence: Several areas of the service have been re-decorated since the last inspection took place. All communal areas of the service are brightly decorated with new furniture in the main lounge and several bedrooms have been re-decorated with new flooring during recent months. All health and safety monitoring was up to date, including fire records and hot water temperatures. Bedroom appear clean, bright and have been created to provide and reflect a very individual private space,with peoples hobbies and interests reflected throughout. There are adequate communal areas and the service also benefits from having a well equipped sensory room. The service has a variety of specialist equipment and all service records relating to this equipment were up to date. Care Homes for Adults (18-65 years) Page 23 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 . A loyal, experienced and well-trained staff team ensures people using this service are provided with levels of support that meet their individual needs and supporting documentation confirmed people are protected. Evidence: The previous registered manager left the service in September 2008 and the care manager is currently covering the majority of the managers responsibilities whilst a new manager is being recruited. The service appeared well managed in their absence. The rotas were checked and confirmed that the service provides adequate staffing throughout both the day and night, with the care manager working along side the care support staff. On the day of this inspection there were three staff on duty, which appeared adequate to meet the needs of the people using this service. Training records were inspected and confirmed that staff are receiving the mandatory training required. Recent training has included, fire awareness, mental capacity act safeguarding and rectal valium training. The care manager is currently providing staff supervision on a regular basis. Staff spoken to on the day of this inspection confirmed that they felt both well supervised and supported by the care manager. The care manager co-ordinates the staff meetings which are held monthly, to ensure that all staff have the opportunity to be involved in the running of the service. The staff team appeared loyal and committed and very caring in their approach to the people using Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: the service. The recruitment records of 3 staff including the latest recruit were viewed; evidence demonstrates that there are good recruitment procedures within this service, which means that people living at the Jonquil close can be reassured they are protected by the effective recruitment systems in place Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 living at Jonquil Close can feel confident that they are living within a service that is well managed and they are safeguarded from harm by effective policies, procedures and accurate record keeping. Evidence: The managers post is currently vacant and being covered by the care manager of the service who is a loyal and long standing employee of the company. However the senior management must ensure that the Regulation 26 visits are carried out on a monthly basis and these visits written up and a record kept within the service. On the day of this inspection several months had lapsed since a representative of the company had carried out these visits. This situation is unacceptable as the company representative must ensure that both people using this service and staff have the opportunity, as part of their quality assurance process to discuss issue relating to the service provided. Also the care manager should be provided with support from a company representative, particularly whilst the registered managers post is vacant. The administration and organisational skills of the care manager are effective in ensuring that all documentation relating to the health and welfare of the people using this service are accurate, up to date and reviewed regularly, to ensure people are kept safe and are Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: protected. All records relating to the health and safety are maintained and carried out effectively by the designated member of staff. People are safeguarded from harm by the by the services recruitment procedures, safeguarding training and complaints procedure. The care manager ensures that supervisions and staff training are held regularly and staff confirmed that they feel supported and respected by the care manager. People living within the service are provided with information that can easily be understood although this could be further developed throughout the service. The service should endeavour to finalise the service user questionnaires to ensure that people have the opportunity to be more involved in the running of the service. Quality assurance systems should be formalised and further developed before the next inspection takes place, to incorporate service user feedback and also to incorporate the views of outside professionals who are providing support to this service, families and carers. The service manages peoples personal monies effectively and appropriately. A random check of two peoples monies was found to be accurate and reconciled with the individual ledger. All records relating to health and safety standards are maintained and carried out effectively by designated senior members of staff. Quality assurance systems should be both formalised and further developed before the next inspection takes place, to include both service user feedback and also to incorporate the views of outside professionals, families and carers. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 28 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 Description 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 Description Timescale for action 1 39 26 To ensure that the service is 30/11/2008 running effectively the representative of the company must ensure that regulation 26 visits are carried out on a monthly visit and a record of these visits kept within the service. To ensure that the manager is supported and that the service is being managed effectively. 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 20 The storage of medication should be maintained within the manufacturers guidelines, in order to ensure the people using the service are protected. Care Homes for Adults (18-65 years) 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 © (2009) 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 Adults (18-65 years) 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!