Inspection on 13/12/05 for Linden Lodge Residential Home

This inspection was carried out on 13th December 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 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

Linden Lodge Residential Home 27/02/09

Linden Lodge Residential Home 12/10/06

Linden Lodge Residential Home 01/06/05

Linden Lodge Residential Home 29/09/04

Linden Lodge Residential Home 22/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Linden Lodge Residential Home Browns Lane Dordon Tamworth Staffordshire B78 1TR Lead Inspector Mrs Suzette Farrelly Unannounced Inspection 13th December 2005 12:30 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 Linden Lodge Residential Home DS0000028077.V273187.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 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. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Linden Lodge Residential Home Address Browns Lane Dordon Tamworth Staffordshire B78 1TR 01827 899911 01827 899922 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) Mr David Charles Ms Deborah Frances Leyland, Mr Donovan Charles, Mr Mark Peter Davies, Dr Alan Roy Gummery, Ms Patricia McDonagh Ms Deborah Frances Leyland Care Home 34 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (34) of places Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2005 Brief Description of the Service: The home is purpose built and is registered to provide care to the older person and the older person with dementia (34 beds). The accommodation is provided over three floors, with the ground and first floor accommodating service users who require specialist dementia care. The majority of the service user accommodation is provided in single rooms. All rooms have good size en suite facilities. Lounge/dining and assisted bathing facilities are provided on each floor. The home is located opposite a small number of shops and close to the village amenities. A sensory room and accessible enclosed garden areas are provided to meet specialist care needs of the elderly service users. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection of 2005/06 and took place from 12:30 to 18:00 and the registered manager and clinical manager were present for the duration of the inspection. Discussion took place with the administrator; four care staff, a relative and nine residents. A tour of the home took place and records related to the residents, staff and management of the home were undertaken. What the service does well: What has improved since the last inspection? The registered provider has meet all the requirements from the last inspection related to: • The management of medication. The registered provider has instigated a new system of ordering, storing and administering medication reducing the risk of mistakes and harm to residents. New process for developing care plans has been implemented and this now meets the standard. The registered provider has also ensured that the care is evaluated monthly. The registered manager has made good all fire doors ensuring that they close correctly protecting staff and residents in the event of a fire. • • Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 6 • New mattresses have been purchased and the registered provider has a system in place to audit equipment in the home so that it is replaced as needed. What they could do better: The home is managed to a good standard and the registered provider is recommended to carry out the following to increase the quality of the service. • • Documentation related to the residents should be dated and signed to ensure that there is an audit trail. Documentation of interaction with relatives and ensuring that information related to changes in the residents needs are clearly explained to relatives and documented. Policies and procedures concerning the management of abuse need to be more robust and reflect national and local guidelines. All new staff must have a Protection of Vulnerable Adults check before commencement of employment. • • It is a requirement that all staff have a Protection of Vulnerable Adults check before commencing employment. 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. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3, 4 and 5 were assessed. Residents have a full assessment before entering the home ensuring that their needs can be met. Residents and their relatives are informed of the home’s ability to meet their needs. All residents and their relatives are invited to visit to assess the quality, facilities and suitability before making a decision to live at the home. EVIDENCE: Three residents’ care profiles were examined and it was noted that all had received a full assessment prior to admission covering mental and physical abilities. From this assessment care plans for long and short-term needs were developed. The registered provider does not write to the resident and/or relative to inform them of their pending admission, instead discussion regarding admission takes place when the resident and/or relative visits the home. This may result in misunderstanding and it is recommended that the home write to all prospective residents and/or their relatives prior to admission. Three residents and a relative stated that they visited prior to admission and made the final decision to move into the home after this visit. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 9 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): 7, 8, and 9 The residents’ health, personal and social care needs are set out in comprehensive care plans and health care needs are fully met. The residents are protected mostly by the policies and procedures for dealing with medicines. Residents feel they are treated with dignity and respect. EVIDENCE: Three care profiles were fully examined and it was confirmed that there were suitable care plans describing the assistance and care required to meet all the activities of daily life. The daily records reflected the care given and the day-to-day life of the resident. The staff carry out risk assessments related to pressure damage, falls, mobility and nutrition. These are evaluated six monthly, it was discussed that monthly is more acceptable to demonstrate minor changes in ability and increased risk. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 10 Relatives are invited to review the care with the resident on a regular basis and a form is completed to demonstrate this. The registered provider is advised to keep a record of the discussion that took place to demonstrate changes that may be required. The registered provider has addressed all the requirements related to the management of medication from the last inspection. It was confirmed that there is a new system of ordering, storage and administration of medication. The home has three trolleys to administer the medication to the three floors of the home. The medication is dispensed directly to the residents and then the Medication Administration Record (MAR) is completed. It was noted that there were occasional gaps on the MAR, it is important that all administration is signed and where there is an omission this is clearly coded. The home have installed a suitable controlled drug cupboard and purchased a controlled drug register to maintain records of controlled drugs in the home and their administration. Medication is stored in a domestic fridge that is only used for medication. It is advised that this is locked or moved to the medication room. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 14 The residents find that the lifestyle experience in the home meets with their expectations and preferences and satisfies their social, cultural and religious interests and needs. Residents maintain contact with their relatives, friends and the community as they wish. Residents are able to exercise choice and control over their lives. EVIDENCE: Information concerning the activities for the next month is available in the reception area and on each unit. A copy was seen and it confirmed that there are a variety of activities taking place. Two staff spoken to stated that activities usually take place on one of the unit and residents from the other units join in if they wish. Relatives are formally invited to some activities particularly entertainment and special events. A record of residents’ likes and dislikes is available in their profiles and the activities organised try to meet these needs. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 12 The home has a good relationship with the learning disability group who have a club next door to the home. Residents from the home join this group for activities and special events. It was also confirmed that the residents visit the local theatre on a regular basis and go out into the village to shop. Community groups who visit the home include Girls Brigade Band, Tamworth Athletic Group and the Church. Some residents visit their own church at weekends either with relatives or a member of staff. The staff assist the residents to make choices concerning their daily lives. The care profiles indicated where staff need to encourage residents to make choices and how this can be done effectively. One profile indicate that the resident should be offered the choice of two sets of clothes appropriate for the weather. The registered provider does not manage any of the residents finances, small amounts of personal monies is kept to pay for daily needs such as hairdressing and chiropody. From touring the home it was noted that the residents are facilitated to personalise their own rooms bringing in pictures, ornaments and other item of importance. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents and relatives are mostly confident that their concerns and complaints are taken seriously and acted upon. Residents are partly protected from abuse. EVIDENCE: The home has received no complaints since the last inspection. Commission for Social Care Inspection has received one complaint. This is being investigated and any requirements will be included in the next inspection report. The policies and procedures concerning complaints were seen and these meet with recommendations, guidelines and requirements. Through discussion it was realised that the staff do not record minor concerns raised by the residents and their families. It is recommended as good practice to record these ensuring there is an audit trail of concerns raised. The staff have received training in the Protection of Vulnerable adults and two staff spoken to were able to explain their role in discovering an act of abuse. The policies and procedures available did not reflect the knowledge of the staff and could be misleading. This was discussed with the registered manager who confirmed that they would be examined and up dated. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24, 25, & 26 The residents live in a safe, well-maintained communal and personal environment containing sufficient facilities to meet their needs. Residents are encouraged and helped to personalise their own rooms. The home is clean, pleasant and hygienic. EVIDENCE: A tour of the home was undertaken visiting the communal areas, the laundry and a selection of bedrooms. The home was found to be clean, pleasantly decorated and hygienic. The home has three floors and there is an integral lounge and dining area on each floor. These areas are suitably lit and have a selection of furnishings to meet the needs of the residents. Four residents said that they enjoyed living at the home and found it friendly and comfortable. All the lounge areas had a Christmas tree and other decorations associated with Christmas. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 15 The bedrooms seen were clean and free from unpleasant smells. It was noted that each room is individual and contained a variety of possessions belonging to the resident occupying the room. The doors to the bedrooms had a variety of pictures, embroidery and photographs chosen by the resident to assist them to identify their own room. All bedrooms had a locked facility for the resident to store personal items or medication if self-medicating. All bedroom doors had locks, which enable the door to be locked from the outside and the resident to exit the room without having to unlock the door. Each bedroom has a large en-suite bathroom containing a toilet and hand washbasin. Three Showers and five baths are available throughout the home with communal toilets close to the lounge area. The home has three sluice rooms, one situated on each floor. These were well organised and clean and found to be locked when not in use. The laundry is situated on the third floor. The home only launders nightclothes and underwear, all other laundry is sent to the industrial laundry at the nursing home. This area was disorganised when seen, staff tidied this area during the inspection. The registered manager said it was planned to change this area so that residents could if able wash their own clothes with assistance from staff. This is planned for the New Year. The home has under floor heating throughout, it was noted during the tour that there are hot spots in the home. The clinical manager said that this was a problem with the under floor heating and regulating it was a problem when the weather continually changed from mild to cold. This needs to be investigated and a plan of action put into place to alleviate the above problem. One resident’s room was very warm, the resident said that they did not mind and enjoyed the warmth. The lighting in some bedrooms was insufficient and accidents could occur at night. The registered manager said that this would be checked to ensure that the correct wattage had been used. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 28, 29 & 30 Trained staff who are competent to carry out their role care for the residents reducing the risk of harm. The residents are mostly supported by the home’s policies and procedures for employing staff. EVIDENCE: Six staff employment files were examined including induction programmes and training. It was found that about a third of staff have a National Vocational Qualification Level II or III in care, it was discussed that the registered provider must ensure that a minimum of half the staff should be qualified. A further four staff are undertaking this training. On employment all staff have to carry out a comprehensive induction-training programme that covers all areas of care and some specialist areas such as dementia. They must also complete 17 sections of care that is similar to the National Vocational Qualification. Three staff spoken to discussed their induction and their understanding of the needs of the residents. All staff employed are checked through the Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) list to ensure that they are suitable to work at the home. It was seen that some staff have commenced work prior to this information being received. This was discussed with the administrator and information related to acquiring a POVA check within 76 hours was discussed. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 17 All other information related to the staff employment was available and the records are up to date and organised. The home has a training matrix with all recent training recorded for all care staff and ancillary staff. This demonstrates along with certificates seen that the home have a programme of training dealing with statutory training, such as fire, manual handling and food hygiene to specialist training such as dementia, team building and care planning. It was also noted that staff who administer medication have achieved accredited medication administration training. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 33, 35, 37 & 38 The home’s record keeping, policies and procedures and accounting of financial procedures safeguard the residents’ rights and interests. Health, safety and welfare of the residents and staff is promoted and protected. EVIDENCE: Through records and discussion with the registered provider, staff and residents it was confirmed that the home have a robust and clear quality assurance and monitoring system. A full report was seen containing audits of the home and comments received by residents, their representatives and other stakeholders. Clear information on the improvements to be made and when these would be achieved was available, based on the information through the quality agenda. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 19 Financial records belonging to the residents were examined. The residents’ money is kept in a non-interest account and the administrator keeps clear and up to date records on in coming money and money spent. Receipts are kept, of money spent and the incoming and outgoing monies can be easily traced. A summary of all expenditure is produced monthly and a copy is sent to the residents and/or their representative. The registered provider discourages the keeping of residents’ personal belongings in the safe at the home. Where an important item cannot be looked after by the resident the registered provider encourages the families to take the item home. There is a policy and procedure for found items and clear records are maintained. All records in the home are kept in a locked office. The registered provider ensures that residents and relatives are involved in the process of planning care. This has not always happened and recently a family complained about the lack of information. The registered provider stated that this has been investigated and documentation will be easier to follow to demonstrate when residents and relatives are informed and included in the process. Training related to fire safety; manual handling, first aid and food hygiene have been carried out. The training records show when up dates to this training is required. Record related to the maintenance and service of equipment used in the home is up to date. The administrator and the maintenance person maintain these records. Risk assessments are carried out for all safe-working practices and findings of the risk assessment are recorded, detailing actions to be taken to minimise the risk. The registered provider ensures that all accidents, incidents, injuries and illness are recorded and where appropriate reported to the Commission for Social Care Inspection and other organisation such as the Environmental Health. Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 3 X 3 3 2 2 STAFFING Standard No Score 27 X 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X 3 3 Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 17 S.3 Requirement The registered provider must ensure that all medication administration or omission is clearly marked on the Medication Administration charts. The registered provider must ensure that all concerns and complaints are clearly recorded and that the complainant is informed in writing of the outcomes. The registered provider must ensure that there are robust policies and procedure regarding: • The recognition of abuse and what actions are to be taken if abuse is discovered or suspected. The management of challenging behaviours including verbal and/or physical aggression. Whistle Blowing Timescale for action 06/01/06 2 OP16 22 S. 4 31/01/06 3 OP18 13 S.3 06/01/06 • • Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 22 4 OP25 22(2)(p) The registered provider must ensure that the lighting in residents’ bedroom is suitable. The registered provider must ensure that the laundry area is kept clean and tidy and dirty washing is in washing baskets. Good infection control practices must be adhered to thus preventing the risk of cross infection. The registered provider must ensure that all staff have a POVAfirst carried out before commencement of employment. 06/01/06 5 OP26 13(3)(4) 06/01/06 6 OP29 19 S.2 12/01/06 Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 23 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 OP3 Good Practice Recommendations It is recommended that all documentation is dated and signed by the person completing the form to ensure that there is an audit trail. It is recommended that the registered provider writes to all prospective residents and/or their relatives stating that the home can meet their needs and the conditions under which admission is accepted. It is recommended that all risk assessments be conducted on a monthly basis to ensure that small changes are recognised and preventative care can be prescribed. It is recommended that the fridge used for medication is locked or moved to the medication cupboard. It is recommended that minor concerns be recorded including the actions taken to rectify the concern to ensure an audit trail. It is recommended that all documents are dated and signed to assist the registered provider with auditing and to demonstrate when actions were taken. 2 OP4 3 OP8 4 5 OP9 OP16 6 OP37 Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Linden Lodge Residential Home DS0000028077.V273187.R01.S.doc Version 5.0 Page 25 - 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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