Inspection on 24/02/06 for Lime House

This inspection was carried out on 24th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lime House 05/07/06

Lime House 26/10/05

Lime House 06/10/04

Lime House 07/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Lime House Newton Road Lowton Nr Warrington Cheshire WA3 1HF Lead Inspector Jeanette Ashcroft Unannounced Inspection 24th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lime House Address Newton Road Lowton Nr Warrington Cheshire WA3 1HF 01942 674135 01942 674135 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) Nugent Care Mrs Ann Hillidge Care Home 32 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (32) Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 32 service users to include:Up to 32 service users in the category of OP (Older People over 65 years of age) Up to 8 service users in the category of DE(E) (Dementia over 65 years of age) Up to one service user in the category of MD(E) (Mental Disorder over 65 years of age) The service should employ a suitably qualified and experienced Manager who is registered with the CSCI. The Registered Person must ensure that all staff working in the home have dementia awareness and dementia care training, which equips them to meet the assessed needs of the service users accomoodated, as defined in the individual plan of care. The service should at all times employ suitably qualified and experienced members of staff, in sufficent numbers, to meet the assessed needs of the service users with dementia. 26th October 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Lime House provides residential care for up to thirty-two residents who are elderly, of either sex. This includes up to eight residents over sixty-five with dementia and one resident over sixty-five with a mental disorder. The home is part of Nugent Care, whose head office is based in Liverpool. Lime House premises are leased from Wigan Council. Lime House is set within its own landscaped grounds in a residential area. The home has a main house and a lodge, which are connected by a link area. The majority of residents live in the main house, which has two lounge areas and a dining room with a sitting area. The lodge has a combined lounge and dining room. The home is in Lowton. There is a reasonable level of public transport, shops and local facilities in the area. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.30am and 2.45pm. At the time of the visit a Care Supervisor was in charge and she was present throughout. The Registered Manager retired on 23 March 2006 after 20 years at Lime House. An experienced Care Supervisor has been appointed as ‘Acting Manager’ until a permanent arrangement is made. The Acting Manager has worked at Lime House for several years and has NVQ Level 4 in Care. Support is provided from Head Office through regular visits and telephone contact to the home. The Inspector was satisfied with these temporary arrangements. An application for a new manager to be registered with CSCI is required. During the visit the inspector met several people who live at Lime House and was able to talk to them over lunch. Another resident gave the inspector a guided tour of the home. The inspector spoke to various members of staff including care support staff, the cook and a member of Head Office staff who was conducting an unannounced Quality Assurance visit. The inspector examined some records and documentation and observed practices and interactions between staff and service users at the home. What the service does well: All prospective service users and their relatives are given the opportunity to visit Lime House before making a decision to take up residence. Trail visits enable service users and their representatives to know that the home will meet their needs. Lime House supports its residents to lead active and interesting lives by providing a range of varied social and leisure opportunities both within the home and the community. The home is clean, pleasant, safe and comfortable and offers people a range of communal and private areas in which to spend their time. The atmosphere in the home was very relaxed and comfortable. Interactions between staff and residents were natural and warm. The menu provides a wide choice of varied, nutritious foods that reflect resident’s choices and preferences. There is a well-publicised and accessible Complaints Procedure. Residents and their representatives can be confident that their complaints will be taken seriously and acted upon. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 6 Service users are able to look after and administer their own medication if they choose to do so. An individually assessed level of support is provided to make sure that this is done safely. Safe practices for dealing with medication are in place as detailed in the home’s policies and procedures. Service users are supported and protected by the home’s recruitment practices. The staff team is static and stable with very low turn over. There is a good training programme in place for staff of all grades with regular updates of key subjects. The inspector was satisfied that the recruitment and vetting procedures described for both employees and volunteers meet the required standards. Service users’ finances are safeguarded. The home’s policy prevents staff from having any involvement in residents’ finances unless absolutely necessary. Any involvement is limited to a small number of senior staff members. The health, safety and welfare of service users and staff are promoted and protected. What has improved since the last inspection? What they could do better: At the time of the inspection two residents were looking after their own medication. An assessment is carried out with them to identify any risk factors that may be apparent. This is good practice. For purposes of accountability the inspector recommended that these assessments, along with outcomes and actions are clearly recorded and regularly reviewed. At the time of the inspection it was noted that the Emergency Lighting Inspection Certificate expired in December 2005 and the Periodic Inspection Report for the Electrical Installations was unavailable. Lime House has been asked to forward the current certificates to CSCI. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 7 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. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Lime House DS0000005746.V268707.R01.S.doc Version 5.1 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 the following standard(s): 4, 5, 6 All prospective service users and their relatives are given the opportunity to visit Lime House before making a decision to take up residence. Trail visits enable service users and their representatives to know that the home will meet their needs. EVIDENCE: The Care Supervisor confirmed that all prospective residents are encouraged to visit Lime House before deciding whether or not they wish to move there. If a visit is not possible then a member of the management team will arrange to visit the person in their current home environment. The purpose of this is to help the person to make an informed choice about moving to the home and to help them to understand what it will be like to live there. This is especially important if the person has not been in a residential care home before. Relatives or friends are encouraged to be involved in the decision making process. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 10 New residents move into Lime House for an initial four-week trial period, giving them a chance to really find out what it is like there. The trial period can be extended if a person needs more time to make a decision. The Care Supervisor gave an example of a previous resident who was able to keep extending their trial period for over a year before moving into the home permanently. This is good practice that helps to alleviate the pressure that people feel when they are faced with an important and life-changing decision. At the time of the inspection there had not been any recent admissions into Lime House. The inspector was therefore unable to discuss trial visits and admission-related practices with the people living there. At the last inspection it was recommended that the current contact details of CSCI’s local office was included in the Complaint Procedure and Service User Guide. This has been completed. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 9 Service users are able to look after and administer their own medication if they choose to do so. An individually assessed level of support is provided to make sure that this is done safely. The risk assessment process for each resident along with outcomes and actions should be clearly recorded and regularly reviewed. Safe practices for dealing with medication are in place as detailed in the home’s policies and procedures. EVIDENCE: The inspector discussed medication policies and procedures with the Care Supervisor and also observed medication being dispensed to several residents during lunch-time. Relevant records were examined. At the time of the inspection two residents were looking after their own medication. An assessment is carried out with them to identify any risk factors Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 12 that may be apparent. The inspector recommended that these assessments, along with outcomes and actions are clearly recorded and regularly reviewed. A lockable facility is provided in resident’s bedrooms in which to store their medicines safely. They are given a week’s supply of medicines in a ‘blister pack’ that they return at the end of the week. All staff that are involved with medication at Lime House have received relevant training. Training is organised and funded by Nugent Care and is updated at least two-yearly. It was positive to note that only a small number of designated staff are allowed to handle medication. Each person has provided a sample of their signature and initials so that medication records can be monitored and verified. Records for receiving, storing and administering medication were available and these appeared to be in order. Separate safe storage and recording systems are provided for Controlled Drugs. Lime House has regular contact with the local pharmacist for advice and information and medication checks. Records indicate that the pharmacist last checked the medicines in August 2005. Nugent’s Quality Assurance Team also carries out medication checks and audits. The next one is scheduled for 3 March 2006. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 12, 13, 14, 15 As was evident at the last inspection, Lime House supports its residents to lead active and interesting lives by providing a range of varied social and leisure opportunities both within the home and the community. The menu provides a wide choice of varied, nutritious foods that reflect resident’s choices and preferences. EVIDENCE: At the time of the inspection residents were observed to be enjoying their lunch in quiet and comfortable dining rooms. A choice of seating options are available - some people were sharing a dining table with two or three other people, others were eating their lunch in their bedroom and the lounge. The cook said that she plans the menus around the preferences of the residents and that she encourages them to give feedback so that she knows what they have enjoyed and what they would like in the future. This was confirmed in discussions with some of the residents. Take away meals are sometimes organised to ensure that variety is available and that interest in Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 14 food is maintained. During the visit one of the residents had been bought fish and chips from the local chip shop by her key-worker. Lime House has a designated Activities Co-ordinator who organises an ongoing plan of social activities and outings. Some of the residents had recently been to a Pantomime and were planning, amongst other things, to go ten-pin bowling next week. The inspector was impressed with the activities programme and the value placed on this by the staff and residents. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 16 There is a well-publicised and accessible Complaints Procedure. Residents and their representatives can be confident that their complaints will be taken seriously and acted upon. EVIDENCE: The Inspector examined the complaints procedure. It was positive to see that this is available in different formats, for example, in large print using easy words and on DVD. Various notices around the home remind people of their right to express dissatisfaction or to make complaints about the care that they receive. The contact details of a member of the Head Office staff are provided on the notices so that residents can to complaint to somebody outside of Lime House. One of the Care Supervisors is designated as the home’s Complaints Coordinator. The Co-ordinator reminds residents of the Complaints Procedure at the regular Resident’s Meetings. Notes of the last meeting confirmed this. Complaints made at Lime House are reported to Head Office who then monitors how they are managed. At the time of the inspection, a member of the Quality Assurance Team made an unannounced visit to Lime House to check the progress of a complaint that had been made at Lime House several Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 16 weeks ago. The complaint appeared to have been resolved to the satisfaction of both parties. As was the case at the last inspection, all staff continue to receive ongoing training in all aspects of care including the protection of vulnerable adults. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 20, 25 The home is clean, pleasant, safe and comfortable and offers people a range of communal and private areas in which to spend their time. The Inspector could not verify the effective working order of the emergency lighting in the home as a current inspection certificate was not available. EVIDENCE: At the time of the inspection the home was found to be warm and clean with a good standard of furnishings and decor throughout. The large grounds were attractive and well maintained. A local neighbour visited the home during the inspection to thank the gardeners for keeping the grounds tidy and attractive. Residents have their own bedrooms that are regarded by themselves and the staff team as private areas. One of the residents had recently had his room Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 18 decorated and he was pleased to have been involved in choosing the colour scheme. Within the home there are several communal and quiet areas that provide residents with a choice of whom to associate with. Some residents choose to spend their time in private in their own rooms. Throughout the home signs and symbols are used to remind people where toilets and bathrooms are located and bedroom doors have a photograph of the occupant on them. Notices are represented in colourful pictures to make them interesting and accessible to people. This is good practice and particularly important in a service where some people have signs of dementia. Emergency Lighting is provided throughout the home. At the time of the inspection the current inspection certificate was unavailable – the one shown to the Inspector showed that an inspection should have been carried out in December 2005. The manager has been asked to forward a valid certificate to CSCI. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29, 30 Service users are supported and protected by the home’s recruitment practices. The staff team is static and stable with very low turn over. There is a good training programme in place for staff of all grades with regular updates of key subjects. EVIDENCE: Training records indicate that a wide range of training courses is available to staff of all grades. Some training is mandatory for example, Moving & Handling, First Aid, Medication whilst other training is optional. There is a continuing commitment to NVQ training and two care staff are currently undertaking NVQ level 2. The inspector met one of them during the visit. The inspector was impressed with the range of training available and with the direct relevance to the needs of the people being offered a service at Lime House. Staff turnover at Lime House is very low suggesting that staff are well supported and happy in their role. The atmosphere in the home was very relaxed and comfortable. Interactions between staff and residents were natural and warm. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 20 Staff personnel files are held at the Head Office and therefore the inspector was unable to examine them during this visit. Recruitment procedures were discussed with the Care Supervisor but not with other staff members as no one had been employed for over a year. The inspector was satisfied that the recruitment and vetting procedures described for both employees and volunteers meet the required standards. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 38 The Registered Manager has recently retired. Satisfactory temporary management arrangements are in place. An application for a new manager to be registered with CSCI must be submitted. Service users’ finances are safeguarded. The home’s policy prevents staff from having any involvement in residents’ finances unless absolutely necessary. Any involvement is limited to a small number of senior staff members. The health, safety and welfare of service users and staff are promoted and protected. There are robust health and safety procedures and a general recognition that health and safety is everybody’s responsibility. The current Electrical Installation and Emergency Lighting Certificates were unavailable during the inspection visit. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 22 EVIDENCE: The Registered Manager retired on 23 March 2006. An experienced Care Supervisor has been appointed as ‘Acting Manager’ until a permanent arrangement is made. The Acting Manager has worked at Lime House for several years and has NVQ Level 4 in Care. Support is provided from Head Office through regular visits and telephone contact to the home. The Inspector was satisfied with these temporary arrangements. An application for a new manager to be registered with CSCI is required. Lime House encourages residents to manage their own finances with help from a representative if needed. A lockable facility is provided in all bedrooms for safe keeping of money and other valuables. The home’s policy is for staff to avoid becoming involved if possible and to discourage residents from keeping large amounts of money or valuables at the home. If help from staff is needed then appropriate records are maintained and receipts are kept. Rather than holding money for residents, staff purchase items on their behalf and provide an invoice for the full amount. Any involvement is limited to senior staff. It is generally regarded as good practice for services to minimise their involvement with residents’ finances. There is a designated Health & Safety Officer who is responsible for ensuring that all aspects of health and safety are attended to and that appropriate records, policies and procedures are in place. The Inspector examined several of these documents and was impressed with the logical and organised way in which this area of work was being managed. The records indicated that training and regular updates are provided to staff in key areas such as moving and handling, fire safety, first aid, infection control etc. Periodic inspections are carried out by qualified people on all equipment used in the home and on gas and electrical appliances. Hot water is monitored to ensure that it is kept at a safe temperature. Risk assessments are carried out for all safe working practices and appropriate procedures are developed and promoted to staff. At the time of the inspection it was noted that the Emergency Lighting Inspection Certificate expired in December 2005 and the Periodic Inspection Report for the Electrical Installations was unavailable. Lime House has been asked to forward the current certificates to CSCI. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 X X X X 2 X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X X 2 Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 24 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 OP31 Regulation 8&9 Requirement An application for a suitably qualified, competent and experienced manager to be registered with CSCI should be submitted. A current inspection certificate should be in place demonstrating: (i) the safety of the electrical installations (ii) the effective working of the Emergency Lighting Timescale for action 28/04/06 2. OP25 & 38 23 31/03/06 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. Refer to Standard OP9 Good Practice Recommendations Risk assessments in respect of self-administering medication, along with outcomes and actions are clearly recorded and regularly reviewed. Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Lime House DS0000005746.V268707.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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