Inspection on 17/09/08 for Millstream View

This inspection was carried out on 17th September 2008.

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

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

Millstream View 29/04/10

Millstream View 24/09/07

Millstream View 16/08/06

Millstream View 06/03/06

Millstream View 26/10/05

Millstream View 21/02/05

Millstream View 26/08/04

Millstream View 29/05/03

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Millstream View Mill Lane Adwick Le Street Doncaster South Yorkshire DN6 7AG     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: Ramchand Samachetty     Date: 1 7 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect 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 27 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 27 Information about the care home Name of care home: Address: Millstream View Mill Lane Adwick Le Street Doncaster South Yorkshire DN6 7AG 01302721408 01302729413 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Pamela Hankinson Type of registration: Number of places registered: Doncaster Metropolitan Borough Council care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service users with challenging behaviour can only be accommodated in the 8 bedded unit. Date of last inspection Brief description of the care home Millstream View is a Care Home registered to provide accommodation, care and support to up to 13 young adults with a learning disability (18-65 years of age). The accommodation is offered within two separate units. One unit, which is located on the ground floor, provides care for up to 8 young adults with learning disabilities and challenging needs. The second unit is located in a part of the building where the accommodation has been arranged into 5 individual and separate flats. Both units have separate access. They each have a dedicated staff group. The Home is situated on Mill Lane, in Adwick-Le-Street village, Doncaster. It is close to local amenities, including shops, a post office, and a church. The `Adwick Social Education Centre is situated Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 13 Brief description of the care home next to the Home, and is attended by the majority of the service users of Millstream View. Millstream View is owned and managed by the Social Services Department of the Doncaster Council. The post of registered manager is currently vacant. The home has produced a statement of purpose, which gives more information about the service it provides. Further information can be obtained from the home. Care Homes for Adults (18-65 years) Page 5 of 27 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: This key unannounced inspection was carried out on 17 September 2008, starting at 09.45 and finished at 18.30 hours. The manager, Mr Tommy Wright was present throughout the inspection. The service is registered to provide accommodation, care and support for up to 13 adults, aged between 18 and 65 years of age. The service currently charges four hundred and ninety one pounds a week. There were 9 people living at the home at the time of this inspection. Three people were on holiday in the company of three members of staff. The inspection included a tour of the premises, examination of care documents and other records, including those pertaining to complaints, staff employment, medicines and maintenance of equipment and quality assurance methods. Care Homes for Adults (18-65 years) Page 6 of 27 We looked at the information contained in the Annual Quality Assurance Assessment which was submitted to us before this inspection. We considered the views of people who were using the service and comments expressed to us by other professionals involved in their care. We gave feedback about our initial findings to the manager and to his line manager. We have reviewed our practice when making requirements, to improve national consistency. some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, it a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 27 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 9 of 27 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. Peoples needs were assessed before their admission to the home in order to make sure that such needs could be met. Evidence: The statement of purpose and a new service user guide was available. These documents have been revised and made more easily accessible to people who use the service. However, there was still no information in these documents about the fees charged by the home. The care records that we checked showed that the needs and aspirations of people being admitted to the home were appropriately assessed before their admission. This ensured that their needs could be met and also that they were compatible with the existing client group. These assessments were carried out by both the placing social workers and staff at the home. Care Homes for Adults (18-65 years) Page 10 of 27 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 living at the home were provided with care and support plans, which ensured that their identified needs were met. However, the methods used for recording and reviewing their care plans were not always robust and could affect the way care is delivered to them. Evidence: We checked the care plans of two people who lived at the home. They were developed from a comprehensive assessment of their individual needs and aspirations. The care plans were written in plain English (easy word). this helped people using the service take part in developing and reviewing their care plans. Staff explained that in some instances, advocates had been involved in ensuring that the needs and choices of individuals were appropriately addressed in their care plans. The care planning documentation had been improved to allow the use of person centred planning. However, one of the care plans we checked did not have sufficient information about the identified care needs of the person concerned. Sections on, for Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: example, social activities, safety and personal goals were left blank. In discussion staff indicated that they were aware of his care and support needs and were well able to cater for them. The care plans that we checked showed that risks faced by the people concerned were appropriately identified, assessed and managed. We also noted that people who used the service were appropriately supported with making decisions about the way their care was provided and about their daily activities. Records showed that care plans were reviewed every six months. We noted that in one instance, one persons goals had been appropriately revised and reset as a result of a care review. However, the method used for conducting care reviews were not always recorded. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who lived at the home were supported in taking part in a range of social activities, which helped them maintain their preferred lifestyle and improve their quality of life. Evidence: During weekdays, people who used the service attended the local day services centre, which is situated near the home. They undertook various daytime activities with the support of day service staff. Alternative activities were provided to people when they stayed in, at the home, both on weekdays and during weekends. These included both indoor and outdoor activities of their choice. People who lived at the home commented that staff would help them decide how to spend their time once they had returned from the day centre and that there were always something to do to keep them occupied. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: The manager described a range of recreational and developmental activities, that were available to people living at the home. These activities were planned on a monthly basis and were well publicised in the home. Staff explained that most people were undertaking training regarding skills retention and skills acquisition through the ASDAN programme. We noted that all the activities undertaken were appropriately included in individual care plans, together with the staff support that was required to ensure that they were carried out. One person said that he was happy that staff helped him to attend his social club. Others said that staff would accompany them to shop, attend bingo club and the gym in the local area. At the time of this inspection, we noted that three people who lived at the home were taking a weeks holiday at a seaside resort. Three members of the care team were accompanying them. Records showed that people who lived at the home were supported by their keyworkers to keep in touch with their relatives and friends. They also told us that staff treated them well. We observed some interactions between staff and people who lived at the home. They were based on respect for the individual and issues of privacy and dignity were well addressed. People who lived at the home had their main meal at the day centre. They were provided with other meals, which included breakfast, an afternoon meal and supper at the home. In discussion, we noted that the cook was liaising with the day centre about its menus. this helped the home to prepare and serve different meals, which completed the ones served at the day centre. People we spoke to told us that they were happy with the meals, which were served to them at the home. Care plans checked showed that nutritional needs of people, had been adequately assessed. In one instance, this had resulted in a referral being made for the involvement of a dietitian, in order to improve the health of people living at the home. Care Homes for Adults (18-65 years) Page 14 of 27 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. People living at the home were receiving appropriate personal and health care support and this ensured their continued wellbeing. Evidence: The individual care and support plans that we checked contained the necessary information about what personal and health care support was required for the people concerned. The plans included a section on health to ensure that people living at the home had good access to health services as required. These included the services of GPs, dietitians, psychologists and occupational therapists. During our visit, we met a community behaviour therapy nurse. She explained that staff had requested her advice and support in drawing an action plan to assist in the management of a person s challenging needs. She was pleased with the collaboration she was receiving from the staff. Care records showed that peoples health care needs were being met. Visits by health care professionals and health issues were recorded, together with actions taken. this helped in making sure that the health of individuals were appropriately monitored. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Most people living at the home had complex needs and were not always able to express their views or make decisions. However, they were well supported by the care staff and also, in some instances by independent advocates. This helped to promote the rights and best interests of people using the service. In discussion with care staff, it was noted that a number of them were very knowledgeable about the specific needs of each individual and the way these needs should be met. The home had use of a corporate Doncaster Councils policy and procedures for the management of medicines. The manager confirmed that staff who administer medicines had received the appropriate training to do so. We checked records regarding the receipt, storage and administration of medicines. These were satisfactory. We noted that a few items of prescribed medicines, for some people who lived at the home, were stored at the day centre. The manager explained that this procedure ensured that the people concerned could have their daytime medication without the daily transfer of these medicines and in a safe manner. The manager told us that staff who administer medicines at the day centre had also received training to do so. The manager also confirmed that this secondary dispensing of medication was done in consultation with the relevant GPs and the pharmacist. Records were kept regarding the medicines stored at the day centre. The manager commented that there was good liaison between the day service and the home staff. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living a the home were protected from harm. Procedures were in place to safeguard and protect them at all times. This helped to keep them safe and to promote their wellbeing. Evidence: The home had use of the corporate complaints procedure of the Doncaster Local Authority. A brochure relating to the procedure called the view point was available at the home and people could use it to make a complaint. The statement of purpose and service user guide also contained information on how to make a complaint. We noted that the information on complaints had been revised and made simpler for people use it. There had been no complaints at the home in the previous twelve months. Staff said that they would deal with any concern that people might have in a prompt manner and this helped to address them successfully. Staff also commented that they would also involved independent advocates where there were concerns. Adult protection procedures were in place in order to protect and safeguard people who live at the home. These procedures were those of the Social Services Department of Doncaster Council. The home has developed its own procedures for reporting actual or suspected abuse of people using its services and staff said that they had found them helpful. We spoke to a few members of staff and they confirmed that they had received Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: training and guidance on adult safeguarding policy and procedures and that they were confident in implementing them. Staff training records also confirmed that such training had been provided. Care Homes for Adults (18-65 years) Page 18 of 27 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 home was well maintained and clean. It provided a pleasant, comfortable and safe environment for people who lived in it. Evidence: The home was purpose built as a hostel and therefore provided large communal areas and industrial type facilities, in particular the kitchen. It offered accommodation on two floors and access between them was provided by stairs only. The main door of the building was provided with a security lock to ensure the safety of people who live at the home. We noted that parts of the building were not in use and were kept locked. The home was divided into two sections. One section had been organised as flats and appeared more domestic, with a smaller lounge, kitchen, washing machines and hygiene facilities. The other section had fewer bedrooms and was used for people who had more challenging needs. The communal areas in this section included two lounges, bathrooms, toilets and a large kitchen. One room in this section had been developed to provide sensory stimulation for people who use the service. One of the bathrooms had a mechanically adjustable bath in order to provide assisted bathing to people who required it. The other bathrooms and shower rooms had been upgraded and made more pleasant. All parts of the home were clean, tidy and free from malodours. Bedrooms were Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: personalised to reflect individuals tastes and preferences and people who lived at the home said that they liked their rooms. Care Homes for Adults (18-65 years) Page 20 of 27 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. There was a good and competent care team in place and it was able to meet the identified needs of people who used the service. Evidence: There were twelve people living at the home at the time of this inspection. Three were away on a planned holiday with staff support. The manager confirmed that five of the nine people had complex and challenging needs. The remaining four were less dependent and were accommodated in the flats. At peak times, (07.00- 11.00 and 14.00- 22.00 hours), there were five members of the care team on duty. There were two care workers between 11.00 am and 12.00 noon. Two waking care staff were scheduled to work at night. We noted that the level of care staffing took into consideration, the times when people, needed help most. Staff told us that the care staffing level had improved and they were more able to provide support to people, on a one-to-one basis. The manager also confirmed that he was not included in the daily number of care staff deployed to prvide direct care and support to people who live at the home. Staff told us that they had received training on a number of topics. These included moving and handling, fire safety, food hygiene, health and safety, first aid, mental capacity act and managing challenging behaviours. We noted that a number of staff Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: had also received training on Equality and Diversity. Staff commented that the training had equipped them to give better care and support to people using the service. Training records showed that the manager had prioritised a number of training sessions. Staff told us that they were satisfied with the training opportunities being offered to them. Training records showed that four care workers had undertaken the Learning Disability Award Framework. Twelve care workers (60 ) had achieved their National Vocational Qualification (NVQ) level 2 in care. The home had use of the Doncaster Councils recruitment and selection policy. This included guidelines on the practice of equal opportunities and of anti-discrimination. Except for the manager, there had been no other staff recruitment since the last inspection. Staff working at the home had all undergone the appropriate preemployment checks, to ensure their suitability to work with vulnerable adults. Care Homes for Adults (18-65 years) Page 22 of 27 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 home was well managed and it was meeting the needs of its client group. There was a good and committed staff team which was working well to provide a good standard of care and support. Evidence: The new manager has experience of working in care settings for people with learning disabilities. He has obtained qualifications in care and in general management. He has applied for his registration as the manager of the home. Staff told us that they were satisfied with the way the home was managed. They described the manager as being very supportive and approachable. The manager informed us that he had carried out a satisfaction survey regarding the quality of the service being provided. Questionnaires had been sent to relatives and advocates of people living at the home. The manager was awaiting the return of the questionnaires in order to complete this quality audit. The manager confirmed that the registered provider was continuing the required monthly visits to the home and was also completing the written monthly reports and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: these were also used as a quality monitoring tool. In discussion, staff told us that they had received the necessary health and safety training and guidance to enable them to work in a safe manner. Information in the annual quality assurance assessment indicated that appropriate health and safety policies were in place. Risk assessments about the environment and various work practices had been developed and reviewed. Records showed that equipment and utilities in use at the home had been checked and serviced as required. These ensured the safety and welfare of people who lived and worked at the home. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The fees charged by the home and other items that people who use the service have to pay for, should be included in the service user guide. All the relevant information relating to identified care needs should be included in individual care plans to ensure care and support is appropriately delivered and recorded. Methods used in conducting reviews of care plans should be appropriately recorded together with outcomes achieved, in order to show proper evaluation of care and support given. 2 6 3 6 Care Homes for Adults (18-65 years) Page 26 of 27 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 27 of 27 - 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!