Inspection on 20/09/05 for Kirby Close (10)

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kirby Close (10) 15/12/08

Kirby Close (10) 07/03/07

Kirby Close (10) 17/01/06

Kirby Close (10) 15/03/05

Kirby Close (10) 05/10/04

Similar services:

Park View (15)

Craigmore House

1 Lanark Close

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

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

CARE HOME ADULTS 18-65 Kirby Close (10) South Shields Tyne And Wear NE34 9QF Lead Inspector Miss Nic Shaw Announced Inspection 20th September 2005 09:00 Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 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 Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 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 Adults 18-65. 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. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kirby Close (10) Address South Shields Tyne And Wear NE34 9QF 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) 0191 454 5527 0191 454 5527 United Response Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2005 Brief Description of the Service: Kirby Close provides ordinary housing for two people who have a learning disability. The service cannot provide nursing care. The home is a three bedroomed semi detached house situated in a residential area. There is a lounge, kitchen, three bedrooms, (one of which is a sleep-in room/office), and a bathroom/WC located on the first floor. There is a lawned garden to the rear of the home and off road parking facilities to the front of the house. The home is situated in South Shields within close proximity to a range of community facilities such as shops, public houses and places of worship. There are bus stops nearby which link with the main regional centres. The home also has its own transport. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours in September 2005 and was a scheduled announced inspection. The inspection process involved observing interactions between the staff and the people who live in the home as well as talking to the manager and staff. Feedback was also obtained from questionnaires completed by relatives which were sent to the Commission prior to the inspection. A sample of records were examined including care plans, staff files, accident book and fire log book. A tour of the building took place which included all communal areas and both the service users bedrooms. The judgements made are based on the evidence available on the day of the inspection What the service does well: What has improved since the last inspection? Improvements have been made to the Statement of Purpose. This tells service users about the services and facilities available in Kirby Close and a copy of this has been given to each of the service users. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 6 The manager has looked at ways of changing the staff rota so that more staff hours are available during the evening to enable the service users to take part in more leisure activities. The bathroom has been re-decorated and a new bath panel and blind have been fitted in this area. The manager has started to introduce ways of monitoring the quality of care provided, for example unannounced “observations” of staff practices. 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. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&5 Information is available to inform service users that the service will be able to meet their needs. Service users have been issued with a contract, therefore, their rights as residents are protected. EVIDENCE: The standard Statement of Purpose and Service User Guide documents produced by United Response have now been completed for the services offered within Kirby close. An examination of the Statement of Purpose confirmed that it contains the information as required by the Care Homes Regulations 2001. Records examined confirmed that the service users have been issued with a “service user agreement” and “individual charter” which includes details of the terms and conditions of residency. Due to the communication needs of the service users it would not be possible for them to understand the contents of this document, therefore, their relatives, as their advocates, need to sign this on their behalf. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 The health and personal care needs recorded in the care plans generally reflect the service users physical, emotional and social care needs. However, these need to be further developed to ensure that the service users welfare is fully promoted. Service users are supported to take risks and make decisions. This means that they can enjoy a range of activities as part of living an independent lifestyle. EVIDENCE: Discussion with the manager indicated that since managing the home she has carried out a review of the care plans and has identified a number of shortfalls. For example: there is much information contained within the care plans, however the sheer volume of this makes it difficult to access current up-todate information in relation to the service users daily care needs. Some of the positive interventions observed in practise had not been documented in the care plan and the manager agreed that these were areas for future development. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 10 A review of the care plan consists of a written acknowledgement that it has been reviewed together with the date and a recording to indicate that there has been no change. However, no details as to who was involved with the review or what evidence was used to support the decision that there should be no change to the care plan was available. Due to the communication needs of the service users their relatives are involved with the decision making process and invited to attend person centred planning meetings as advocates on their behalf. None of the service users are able to look after their finances independently. One service user’s relative looks after this on their behalf whilst staff support the other service user through the home’s financial policies and procedures. The philosophy of the home is that of “Active Support”. The service users are encouraged to take part in day to day activities within the home as part of leading an independent lifestyle. Service users were observed to be encouraged to make hot drinks for themselves, with support from staff. However, the risk management strategies observed in practise to promote the service users safety whilst carrying out this activity, had not been recorded in the care plan. Risk assessments, however, had been carried out for a range of other activities including travelling in the car, going to the local pub and going on holiday. Strategies to reduce the risks were recorded and regularly updated, particularly in relation to going on holiday. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 16 Service users are supported by the staff to take part in leisure activities with their rights as individual’s being respected. EVIDENCE: One of the service users had just returned from a holiday abroad whilst the other service user had been supported by staff to have a short break holiday at Whitby. The manager confirmed that the organisation pays for the cost of the staff to support the service users on their holidays. Form October 2005 additional staff hours will be provided two evenings during the week. This is to enable each of the service users to take part in a leisure activity on a one to one basis. Examples of activities include shopping, going to the pub, going for walks and drives out in the home’s transport. On week days the service users attend a day service run by United Response where further opportunities are provided for them to engage in leisure activities such as swimming and going to the cinema. In house activities include aromatherapy. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 12 The staff no longer hold a key to the house. The service users have been provided with a front door key and staff are not able to enter the house unless the service users are present. The service users are encouraged and supported by the staff to take responsibility for some of the daily household duties including mopping the floor and putting the bins out. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 The service users are assisted by staff to maintain good quality health and receive personal support in a way that they prefer. The health of the service users is protected by the medication policies and procedures, however, some improvements need to be made to the record keeping processes. EVIDENCE: Care plans examined confirmed that detailed records are in place which describe how service users personal care needs are to be met. Discussion with the manager indicated that all service users have access to NHS healthcare facilities and specialists who can contribute to the home’s care planning process when required. Medication policy and procedures are in place, which covers the storage, handling and administration of medication. However, not all prescribed items, such as a shampoo, had been signed for on the Medication Administration Record. Two tablets were found in an unlabelled container in the medication cupboard. In order to minimise the risk of medication errors occurring all medication must be stored in the original dispensed pharmaceutical container. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 14 Paracetamol has been prescribed for the service users with the instruction to administer one or two tablets as required. Records confirmed that on occasion this had been administered to the service users, however, it was unclear whether one tablet or two had been given. As such it was not possible to determine whether the paracetamol held in stock accurately reflected the number of tablets which has been administered. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Whilst service users communication skills are very limited, arrangements are in place through the complaints process to promote their safety and offer protection. Appropriate policies and procedures are in place which ensure that service users are protected from abuse and neglect, however, not all staff have received training in relation to this. EVIDENCE: The homes complaints procedure is available in large print and picture format. Due to the communication needs of the service users it would not be possible for them to formally make a complaint. However, discussion with the manager confirmed that if the staff felt a service user communicated that they were concerned about something they deal with it there and then. There were no recorded complaints, however, a discussion took place with the manager in relation to a recent concern raised by a relative. This is being addressed by the manager, however, as it was not raised as a formal complaint has not been recorded. It was advised that it would be good practise to record all issues of concern together with any action taken as further evidence that the views of relatives are listened to and acted upon. The home has its own policy and procedure documents relating to abuse which are available to staff to guide them if they have any concerns in this area. In order to raise staff awareness of such issues the manager has discussed the home’s whistleblowing policy in a recent team meeting. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 16 Discussion with the manager and staff confirmed that some of the staff have not received training on how to follow the Local Authority’s protection of vulnerable adults procedures (POVA). Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The service users are provided with a clean comfortable generally well maintained environment in which to live. EVIDENCE: The home was found to be clean and tidy. Service users each have their own bedroom and one service user’s bedroom is soon to be re-decorated. The stairs leading to the first floor of the house, where the bedrooms and bathroom are located, are quite steep in gradient. Discussion was held with the manager in relation to the mobility needs of one service user. Concern was expressed in relation to how appropriate the environment would be to the future needs of this service user and the manager confirmed that this matter has been raised with Social Services. The kitchen area is starting to show signs of wear and tear. For example: a piece of wood is missing from the bottom of a cupboard and the handles are chipped and worn. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 The service users welfare is promoted and protected by a well trained staff team, however, some of the staff need NVQ level 2 training in care. Staffing levels during the night may not be sufficient and a review of this must be carried out in order to ensure the welfare and safety of the service users is protected. Staff recruitment procedures are robust, however, the organisation does not obtain the correct level of Criminal Records Bureau Disclosure check, which may compromise the protection of the service users. EVIDENCE: It was evident that the manager has spent time re-organising the staff files. This process has involved the completion of a training needs analysis from which it has been identified where there are gaps in training which need to be addressed. Information provided within the pre-inspection questionnaire confirmed that only 37.5 of the staff have achieved an NVQ level 2 qualification in care which falls short of the required 50 . Discussion with staff confirmed that they had completed induction training, which they found to be interesting and beneficial to them. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 19 The minimum staffing level for the home is 2 staff on duty during the day when the service users are at home and records examined confirmed that this has been maintained. As has been mentioned earlier in the report additional staff hours are to be provided so that the service users can take part in leisure and community activities independent of each other. Discussion was held with the manager in relation to staffing levels during the night, which currently consists of one sleep-in member of staff only, and whether or not this was suitable to the needs of the service users. Discussion was also held in relation to arrangements in place should the sleep-in member of staff or one of the service users become ill during the night or should there be a fire. These issues need to be addressed and form an integral part of a staffing level review. Staff files examined confirmed that the organisation carries out a thorough recruitment process which involves a face to face interview and obtaining suitable and appropriate references, one of which is from the last employer. However, only a standard Criminal Records Bureau disclosure check, not the higher level of check, which is a requirement for all staff working with vulnerable adults, had been obtained. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Although the home continues to operate without a registered manager the service users health and safety is promoted and protected by a well managed service. Arrangements to make sure that the service continues to improve have begun to be introduced. However, in order to safeguard the best interests of the service users, this must include a monthly unannounced visit from a person who is not employed to work in the home. EVIDENCE: The home has been without a registered manager for over one year now and United Response must address this issue without further delay. The current manager is responsible for managing a day service also belonging to United Response. As such she has been employed to manage Kirby Close on a part time basis. The CSCI have not agreed to such arrangements and this issue will be addressed outside of the inspection process. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 21 The job description for the manager was discussed. This makes no reference to the role and responsibility of the registered manager in line with the Care Standards Act 2000, Care home Regulations 2001 and National Minimum Standards. The current manager has a number of years management experience and is currently completing the Registered Managers Award. Discussion with her confirmed that she has begun to introduce a number of processes to monitor the quality of service being provided. One such process is a “formal observation”. This involves visiting the home unannounced spending time observing interactions between the staff and service users. Feedback is then given to staff on their performance and findings used to improve the service. The manager confirmed that a monthly audit is carried out under the requirements of regulation 26 of the Care Homes Regulations. However, copies of these have not been forwarded to CSCI in accordance with this regulation. In addition to this the manager said that she had recently completed this audit check herself. Discussion was held with the manager in relation to the requirements of regulation 26 in which it clearly states that a person external to the home must carry out such a visit. Discussion with staff confirmed they have received training in relation to health and safety issues such as moving and handling, food hygiene and fire safety. Appropriate records are held in relation to accidents. The fire log book examined confirmed that fire fighting equipment and the smoke alarms are regularly checked as recommended by the fire authority. All staff have recently received fire instruction and this is repeated each month. However, a detailed risk assessment needs to be completed in relation to fire safety. Bathwater temperatures were tested and found to be 45 degrees centigrade. The manager has since informed the CSCI that these have been adjusted so that the bathwater is maintained at 43 degrees centigrade. In order to promote the safety of the service users the bathwater is tested each time a service user has a bath. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X 2 Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 2 2 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kirby Close (10) Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 X DS0000000263.V250485.R01.S.doc Version 5.0 Page 23 No 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 YA6 Regulation 15(1) Requirement Care plans must continue to be developed. Records must also be maintained of who has been involved with the review of the care plan and on what basis the decision has been made for there to be no change made to these. Risk management strategies must be clearly documented for all activities the service users are involved with which involve a degree of risk. Medication Administration Records must be completed by staff for all prescribed items administered. Medication must be stored in the original dispensed pharmaceutical container. Medication Administration Records must be completed accurately to reflect whether one or two tablets have been administered. All staff must receive training in relation to the Local Authority’s adult protection policy and procedure. The kitchen units showing signs of wear and tear must be DS0000000263.V250485.R01.S.doc Timescale for action 31/12/05 2 YA9 13(4)(b) 31/12/05 3 YA20 13(2) 31/10/05 4 YA23 13(6) 31/03/06 5 YA24 23(2)(b) 31/12/05 Kirby Close (10) Version 5.0 Page 24 addressed. 6 7 YA32 YA33 18(1)(i) 18(1)(a) 50 of staff must have a care NVQ level 2 qualification. Staffing levels during the night must be reviewed and a copy of the review together with any action taken must be forwarded to the CSCI. CRB checks must be at the Enhanced Level. A registered managers application must be forwarded to the CSCI without further delay. The registered provider must arrange a monthly unannounced visit to the home in accordance with regulation 26. Bath water temperatures must be maintained at 43 degrees centigrade. A fire risk assessment must be completed. 31/12/05 31/12/05 8 9 10 YA34 YA37 YA39 19 8(1) 26 31/12/05 30/11/05 31/10/05 11 12 YA42 YA42 13(4)(c) 23(4)(a) 21/09/05 30/11/05 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 YA5 YA22 YA37 Good Practice Recommendations The contract should be signed by the service user’s relative on behalf of the service user. All issues of concern should be recorded with any action taken by the manager to address the issues. The registered manager’s job description should be reviewed to include the responsibility of ensuring the home’s compliance with the Care Standards Act 2000. Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Kirby Close (10) DS0000000263.V250485.R01.S.doc Version 5.0 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. 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. 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