Inspection on 23/01/09 for Margaret Riley House

This inspection was carried out on 23rd January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Margaret Riley House 26/01/07

Margaret Riley House 13/01/06

Margaret Riley House 20/06/05

Margaret Riley House 14/02/05

Margaret Riley House 29/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Margaret Riley House 4 Rosebery Avenue Blackpool Lancashire FY4 1LB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christopher Bond     Date: 2 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Margaret Riley House 4 Rosebery Avenue Blackpool Lancashire FY4 1LB 01253346814 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Blackpool Society For Mentally Handicapped Children & Adults care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home This home is specifically used for respite care, which is the short term care of people who have a learning disability. Most of the people who use the service live with their parents or carers within the community. The home is registered for five people but there are rarely more than three people using the service at any one time. People generally stay overnight, for a weekend, or when their parents or carers are away on holiday. There is one single room and two shared rooms. The shared rooms are used by service users who wish to share, and if the total number of people using the facility exceeds four. All the bedrooms are large and are well decorated, and the house has two lounges where service users can congregate and socialise. There is a dining room to the rear of the house and a bathroom area on the ground floor. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The house is situated in a quiet residential area of Blackpool. There are shops within walking distance of the house, and Blackpool Pleasure Beach is close by. There is a bus route into Blackpool town centre, which leaves from nearby. Margaret Riley House is part of a group of three houses run by Blackpool Society for Mentally Handicapped Children and Adults in the Blackpool area specifically for adults who have a learning disability. Information relating to the homes Service User Guide and Statement of Purpose is included in the welcome pack, which is given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: As part of the inspection process an unannounced visit took place over a total of 2.5 hours. The service users personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication procedures were examined in detail. We spoke at length to the senior support worker during our visit. Three people who used the service were also spoken to as part of the inspection process. The Commission for Social Care Inspection also sent out surveys to the care staff of this home to tell us about their experiences of working at Margaret Riley House. Unfortunately none were returned to us. Care Homes for Adults (18-65 years) Page 6 of 29 Every year the registered person is asked to provide us with written information about the quality of the service they provide. They are also asked to make an assessment of the quality of the service. This information, in part, has been used to focus our inspection activity and is included in this report. Information about the services offered by this home can be found in the welcome pack given to all prospective guests. The fees for this service are from GBP 12.00 per night, with a weekly charge of GBP 84.00. What the care home does well: What has improved since the last inspection? What they could do better: Mencap services in Blackpool have recently been reorganised, with the majority of the care provided by the organisation being passed to another service that provides domiciliary care. This means that Margaret Riley House does not currently have a registered manager as the previous manager moved to the new provider. The responsibility for managing this respite service is unclear as the Mencap organisation have not provided us with information about how the service will be run and who will be managing the home. Whoever becomes manager must have the proper training, qualifications and experience and show that they are able to manage the home competently and professionally. The facilities within the home need to be assessed by a person who is trained to do so, Care Homes for Adults (18-65 years) Page 8 of 29 in order that aids and adaptations can be provided for those who have difficulty walking. One person who was staying at the home whilst we were there needed a lot of help getting up the stairs and the organisation should address this situation. The Mencap organisation need to continue to offer a full training programme whilst a registered manager is being recruited. Planned training events had become less frequent after the previous manager left the service. The staff also need to be supported in their role through one-to -one meetings to discuss training and performance issues. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to help them to make a decision about this service. Their needs are written down to help the staff at the home care for them properly. Evidence: It was good to see that there was plenty of important information about this respite service written down. This meant that people could look at this information and it would help them make a decision about whether this respite service was right for them and met their needs. Its important to make sure that the information is clear and easy to read, the information should be clear and accessible to all. It is also important that the information is up to date, and mentions who the manager and staff are that will be working at the home. Everyone who used this service had information written down about them to help make sure that the people who worked at Margaret Riley House knew about their Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: needs and could care for them properly. This included information such as their likes and dislikes, whether they needed help with personal care, and whether they took prescribed medication. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are empowered to make decisions and have a say about the service they receive. The residents care is planned properly, meaning that their needs are being addressed properly. Evidence: There was some good information kept regarding the needs of each person who used this service and what they did during their stay. This was updated after each visit. Such information is important because it helps the home to provide a constant standard of care and enables different carers to have the same information, which helps to ensure continuity. Three people were staying at the home during this inspection. All three people had met with the senior support worker on their arrival and had decided what activities they would like to take part in over the forthcoming weekend. This was a consensus and the service users made the decision. The service users decided which room they Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: would like to use and were in control of most of the things that happened during their stay. The service users were also involved in many household tasks, such as preparing meals, setting the table, washing up and ensuring the house was tidy. This is important because their skills and abilities were being maintained and developed. As part of their visit to Margaret Riley House service users are able to enjoy activities in the local community with the support of the senior community support worker. Each activity had been risk assessed to ensure that no unnecessary hazards were faced. A certain, controlled amount of risk is necessary to ensure that people enjoy activities fully and can benefit from resources that may help them to develop their skills and abilities. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used this service received a well -planned experience and positive outcomes. Activities were frequent and appropriate. Evidence: The evening meal was being prepared whilst we were there. This looked appetising and nutritious and the people who were staying at the home had a choice regarding what they would like to eat. There were menus available to show the range of choice that was available. Good food is important, and one of the relatives told us that the food was always lovely. Some of the people who stayed at the service had family who had gone on holiday. Their stay at the home was their holiday. The senior support worker spoke of the need to make their stay as enjoyable as possible and one person had invited friends to Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: visit during their stay. There was a strong emphasis on using the resources available in the community such as bowling, swimming, restaurants, social clubs, shopping and trips to the cinema. There were activities available within the home, such as games, DVDs, and television for if the weather was bad or people wanted to stay in. Overall, people were being given a choice regarding the activities that were on offer. The activities were appropriate and the people who were staying at the service said that they always enjoyed their stay because they did different things. The senior support worker who was on duty whilst we were there said that public transport was generally used to help maximise peoples experiences and Independence. Risk assessments had been completed form all outside activities to help ensure that the people who used the service remained safe. Friendships were encouraged and the people who were using this service knew each other from day services or the Mencap social club which took place every week. Visitors to the service were welcome. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service receive good quality care from conscientious and supportive staff. The service did not meet the needs of some people who used this service because their mobility issues had not been addressed properly by the organisation. Evidence: Some of the people who used this service needed help with personal care. The care plans of the people who used the service were looked at and there was detailed information available as to the their needs and abilities. There had been some deterioration in some peoples mobility and it was clear that aids and adaptations were required around the home to ensure that everyones stay was comfortable and that they could get around the home properly without much help. A stairlift was required because there was no passenger lift and one person who was staying at the time of our visit had poor mobility and needed a lot of help getting to her room. Risk assessments needed to be updated for this person as there were elements of safety that needed addressing. The senior support worker usually helped this person to access her room but agreed that the needs and mobility of this person were becoming Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: greater. All three of the service users who were staying at the service at the time of the inspection looked happy and relaxed. They communicated their thoughts about the home confidently and spoke highly of their support. There was an excellent relationship between the support worker and the service users. It was observed that she spoke to them with respect and they placed great trust in her. This is important because it shows that people were being treated properly and courteously. Some of the people who used Margaret Riley House had been prescribed medication and this had to be brought with them from home. This was stored safely and good records were kept of administration. There were some good policies and procedures in the home regarding the safe administration of medication to help ensure that the care staff had guidance at all times. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected from harm by good policies and procedures and regular training. People feel confident that their views and concerns will be heard and addressed: the residents have a voice. Evidence: There was a thorough policy in place with good guidelines of what to do to ensure that people were safeguarded from harm. The organisation had provided training for its staff regarding safeguarding individuals who use the service. This is important because it helps to ensure that the care staff work safely and properly when supporting vulnerable people. Training in this area must continue to ensure that the care staff have good knowledge in this area. The illustrated complaints procedure was on display in the hallway of Margaret Riley house and the three service users who were spoken to were confident that their concerns would be dealt with properly, should there be any. Because of the excellent relationship between the senior community support worker and the service users worries were dealt with promptly and appropriately before they developed into concerns or complaints. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation was warm, clean and of a high standard. The people who used the service were pleased with the facilities on offer. Mobility aids and adaptations were not in place to assist those people who have a disability. Evidence: The house was very homely. All of the rooms were large and were decorated to a high standard. The whole house was well maintained and small maintenance tasks were dealt with quickly so as not to inconvenience the service users too much. People who used this service were encouraged to bring in personal possessions to make their stay more comfortable. There were lots of these around the house. One person had brought a selection of DVDs, photographs and ornaments with them. One of the people who used this service described the house and her room as really nice. It was clear that the people who we met were looking forward to their stay and were very familiar with the layout of the home. All the bedrooms were large and well decorated, and the house had two lounges where service users could congregate and socialise. There was a dining room to the rear of the house and a bathroom area on the first floor and a smaller bathroom on the Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: ground floor. The whole house was exceptionally clean. The senior community support worker said that she encouraged guests to be involved in helping to keep the house clean and smelling fresh. As previously mentioned, the organisation needs to re-assess the facilities that are available because the needs of the residents are changing rapidly. Further mobility aids will have to be installed and an assessment of the home by a qualified occupational therapist would be beneficial. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care staff who work for this organisation are recruited properly meaning that the people who use the service remain safer. Evidence: Care staff numbers for this service were sufficient enough to ensure that the assessed needs of the service users were being attended to properly. There was one carer on duty at the time of the inspection and three people were staying at the home. The senior community support worker confirmed that there had been several training events since our last visit to the service. The organisation should continue to provide adequate training for the care staff and ensure that a plan of forthcoming training is available. One to one support for the care staff must continue on a regular basis and their training needs discussed and recorded to ensure that they have the correct knowledge to work with those who have a learning disability. The support workers within the organisation had achieved a nationally recognised care qualification (National Vocational Qualification level 2 or 3). The senior support worker had recently completed her level 3 qualification. This is important because this qualification helps to ensure that the care staff have the necessary skills to provide Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: care for adults who have a learning disability. Staff records showed that new carers had been properly checked before starting their jobs, including obtaining Criminal Records Bureau disclosures. This helped to make sure that the residents were safer by ensuring that only suitable staff are employed. The recruitment procedure was good and records were available in the care staff files to show that references had been obtained prior to employement. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service continues to provide a safe home for the people who use respite facilities. A registered manager is not employed by the organisation which is affecting the running of the service. Evidence: Mencap services in Blackpool have recently been reorganised, with the majority of the care provided by the organisation being passed to another service that provides domiciliary care. This means that Margaret Riley House does not currently have a registered manager as the previous manager moved to the new provider. The responsibility for managing this respite service is unclear as the Mencap organisation have not provided us with information about how the service will be run and who will be managing the home. Whoever becomes manager must have the proper training, qualifications and experience and show that they are able to manage the home competently and professionally. Most of the managerial tasks were being undertaken by the senior support worker, Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: with the support of the Mencap Committee. It is important that the organisation recognises that this cannot continue. Good records were being kept of safety checks within the home. These showed that professionals were checking the electric and gas equipment and the fire alarm system regularly. This helped to ensure that the service users stayed in a safe home. Survey questionnaires received from parents and carers were complementary of the service on offer. Some safety training had taken place since the home was last inspected. The care staff had received training on how to ensure that people are assisted to move about the home safely. All of the mandatory or expected areas of safety training must continue to be provided by the organisation on a regular basis. This training includes first aid, food hygiene, fire safety, health and safety awareness and infection control awareness. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 23 The mobility of the people who use the service needs to be assessed and appropriate aids and adaptations fitted to help ensure that their stay is more comfortable. Access to the upper floor must be improved for all of the people who use the service. 30/04/2009 2 38 8 the owners of the home must appoint a suitably qulaified, skilled and exeperiences person to be registered as manager. To ensure that the home is run properly and in the best interests of the people who use the respite service. 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Adults (18-65 years) Page 27 of 29 No. Refer to Standard Good Practice Recommendations 1 1 The Service User Guide and Statement of Purpose should contain current information about the management and staff at the home. This information should be accessible and easily understood wherever possible. The facilities at this service should be assessed to ensure that those with a physical disability can move about the home freely and safely. Care staff should receive appropriate individual support on a regular basis to discuss their performance and training needs. The care providers must continue to provide regular mandatory safety training for its care staff to help ensure the people who use this service remain safe. 2 29 3 36 4 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!