Inspection on 23/01/09 for Mirabeau

This inspection was carried out on 23rd January 2009.

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

Mirabeau 26/03/07

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Mirabeau Sheepcotes Lane Witham Essex CM8 3PJ     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: Sarah Hannington     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 28 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 28 Information about the care home Name of care home: Address: Mirabeau Sheepcotes Lane Witham Essex CM8 3PJ 01376585599 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): mirabeau@zerothreecarehomes.co.uk Zero Three Care Homes LLP Name of registered manager (if applicable) Mrs Melanie Wilkinson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 7. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Mirabeau is a Registered Care Home providing twenty-four hour support to six adults with a learning disability (potentially mixed gender, age range 16 to 25). The Registered Provider is Zero Three Care Homes Limited Liability Partnership. The home has the advantage of being located in a rural setting close to excellent community facilities including a shop; post office; library and pubs. There are bus links to towns in the area and a rail link close by. Other facilities within easy reach are churches; sports and leisure; colleges and parks. The property is situated down a quiet lane over looking fields to the front and rear. The grounds extend over one acre with a patio area Care Homes for Adults (18-65 years) Page 4 of 28 care home 7 Over 65 0 7 Brief description of the care home at the rear that overlooks gardens and an orchard. The home provides six single rooms furnished to a high standard, four upstairs and two on the ground floor. Communal facilities include a kitchen diner, a separate dining area and a large lounge area. Parking is provided to the front of the property. Fees are primarily based on the care needs and requirements of the individual. Care Homes for Adults (18-65 years) Page 5 of 28 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: The last unannounced Key Inspection for this service was held on the 26th March 2007. This site visit took six hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the manager. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. The site visit also focused on any requirements and recommendations from the last key inspection. A number of people (who use this service) and four staff were spoken with during the site inspection and a tour of the building was undertaken. Care Homes for Adults (18-65 years) Page 6 of 28 We looked at all the information that we have received, or asked for, since the last key inspection or what the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. This included; The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. In addition to the day spent at the service, the inspector reviewed written material submitted to the Commission since the last inspection in order to reach the conclusions identified in this report. What the care home does well: What has improved since the last inspection? All people who live at Mirabeau now have access to the local community and access a number of colleges, facilities and local gym. All people have the offer of a summer holiday. The manager has altered and improved flooring throughout and improved the lighting so that the environment is more suitable to the needs for the people that live there. There is now a one-bed apartment built within the house so that one individual can fully learn how to live independently as much as possible, whilst still having full staff support if need be. The organisation have created more privacy in the garden by planting trees. The team have created an allotment for growing vegetables and have also had a greenhouse Care Homes for Adults (18-65 years) Page 8 of 28 built. 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 9 of 28 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 28 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. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: We were informed by the manager and by looking through records that once a person is referred and has shown an interest in the home, a service user guide will be provided to them. (Additionally a statement of purpose can also be provided) The service user guide is a document that gives a quick snap shot of what the home and staff provides. The service user guide can also be provided in picture form, braille, large print and upon request different languages. Both these documents are annually reviewed and updated. By providing these documents it allows people to make a decision to see if the home can provide for their individual needs before any visits or admission are arranged. The statement of purpose is a more in-depth document produced by the manager that describes what people can expect the staff and home to provide. It includes information such as, aims and objectives, policies and procedures, Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: services that are provided, care that can be provided, the number of staff they have and their qualifications, specialist services that may be provided, costs, contracts, complaints assessment process, hours of operation and general information about the organisation and Mirabeau care home. Once this information is given, then a date will be set for the manager or another qualified member of staff to carry out an assessment of need, with the individual and their representatives. As part of this process a number of visits will be arranged to the home so that the person can meet the other residents and the staff. They will also have the chance to see what the home is like, how many communal rooms are available, bathing, kitchen and laundry facilities, look at the garden and general things they would like to know before making a decision. It also gives the person a chance to sample the food provided and ask about any issues that are important to them. Just as important is that the person can see if the room they would be offered if accommodation were to be provided. By having the different types of visits as suggested by the manager, a person can get to explore the local area and sample what is provided within the local and wider community. The assessment process is recorded onto the managers assessment document, which is then kept and forms part of a persons care plan. Additionally if a person is to be funded through the local authority or health or primary care trust, then these agencies will also supply their own assessment to the manager upon referral. If they can do so, then a letter is written to the individual confirming this. These letters were evidenced within peoples care information looked at. We looked at the information of a new resident who has recently moved into the home. This information showed us that, good assessments and information about this individual were secured. The family and resident have been well informed and involved at each stage. Overall all documentation looked at, showed us that detailed and sufficient information is provided in both the statement of purpose and service users guide and described well all information that would be of benefit to all interested parties. We were told by a relative that, I had lots of visits to the home and was given plenty of information to enable us to make a decision. Care Homes for Adults (18-65 years) Page 12 of 28 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 using the service can be confident that their identified needs will be met appropriately and that they will be able to live the lifestyle they choose. Evidence: All documentation held within peoples care files was regularly reviewed and the service has a clear planning process. Annually (or when needed) meetings are held with the person who receives the support, their representative, social workers and other agencies if appropriate. Looking at four of the residents care files, it showed us that, all pieces of important documentation were signed by the person in question as a way of showing their involvement and agreement of what had been recorded. Also well documented were peoples regular access to a wide range of support networks and access to a lifestyle of their choosing. This could include educational, leisure and social interests. Support included daily routines such as; skills used on a daily basis and within their home to maintain their rooms, laundry and various other home based tasks. Additionally people told us that they go out shopping with staff for food and help Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: the best they can when meals and snacks are prepared. The four care plans looked at, were all very individualised and very specific to the person. All four care plans showed us that they had high support and complex needs, as a result all had detailed risk assessments and protocols for staff to use. The guidance and assessments, highlighted possible triggers, and how to respond to behaviour, shown at times of stress for these people. Through the risk assessment process, guidance went on to assess, what were the likelihood and consequences if behaviour escalated and how staff could possibly de-escalate it. It then suggested, what to do, if the behaviour continued, what outside agencies to be called and used. It included what medication prescribed for these episodes was to be used and what to record, who to inform and what pieces of documentation to be used, with each stage of this persons specific behaviour may take. Risk assessments for all, were concise, clear and reduced the risk for all individuals and for others who maybe involved and could also be at risk, as a consequence. Additionally, we were shown that staff had the training and experience necessary to maintain a safe working relationship with the people they support. Care Homes for Adults (18-65 years) Page 14 of 28 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 using the service can be assured that they will have the opportunities for personal development and build upon their daily living skills so that they are able to lead a lifestyle that they choose. Evidence: Documentation looked through and discussion with relatives, residents and staff showed us that people could 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. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: The meals offered to residents are appealing, home cooked, of high quality, nutritional, reflect individuals tastes, dietary needs and were praised by all residents spoken with. The majority of residents and relatives commented that they were very happy with the food supplied, one resident commented that, the food is very good. Care Homes for Adults (18-65 years) Page 16 of 28 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 using the service can be confident that their personal care and health needs will be met. Evidence: The management of medication was found to be of a good standard with appropriate ordering, administration and the recording of medicines by staff. The registered manager oversees the disposal of medication. The home operates the Monitored Dosage System and is supported by the local Pharmacist who undertakes periodic checks on the homes administration and recording systems. All staff had received medication training and are responsible for the administration and recording of medications. Health wise all people had support to access other professionals such as, dentists, speech therapy, chiropody, health care staff, district nurses, occupational health and consultants. The information looked at such as visits, daily notes, and summaries were to a good standard and were in a style that if read to a person, could be easily Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: understood. Care Homes for Adults (18-65 years) Page 18 of 28 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 at Mirabeau are protected by staffs knowledge, training and understanding of safe guarding procedures and by the organisations policy and procedures in dealing with complaints. Evidence: The manager through discussion and paperwork showed us, that she works transparently and welcomes any chance to learn about her practices and the overall quality of care given to people in her care by the staff of the home. The manager has a good complaints procedure in place. There have been a number of complaints received by the home from neighbours however speaking with the manager at the time of this inspection they seemed to have been resolved as much as they can be at present. All complaints are recorded, maintained and outcomes recorded. Recently another professional (Consultant NHS) raised a safeguarding issue with the manager and safe guarding team in Essex. The manager had worked well with the safe guarding unit and had taken on board any requirements made by them. For example, although all staff have had training around protection of vulnerable adults, the safe guarding team has offered the team further training. However, communal areas could include clearer information of the contact names of the safeguarding unit and how to make a complaint, this would ensure that all people Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: in contact with the service could access information more easily than at present. Staff spoken with showed us that, they are skilled, well trained and that attention is given to ensuring that people who live at Mirabeau receive a good quality of protection and that awareness has been raised. Advocacy services are used if the residents wish or if the management think that a situation requires their input. This allows people who live at Mirabeau to have an independent person to secure their rights and voice their opinions. Care Homes for Adults (18-65 years) Page 20 of 28 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. People live in an environment that is homely, safe and comfortable. Evidence: Since the last inspection the premises has had improved lighting throughout and a change of flooring in communal and peoples bedrooms. The home is well looked after and maintained. There are no odours throughout the home and it is cosy, homely and comfortable. Numbers of toilets and bathrooms are sufficient. The outside environment is pleasant, attractive and provides appropriate and practical usage for the residents of home. Staff spoken with and documentation looked at, showed us that, they have received universal infection control training and that they showed good knowledge around this area. Overall the home environment presents no health and safety issues. Care Homes for Adults (18-65 years) Page 21 of 28 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. People who live at Mirabeau are cared for by a competent and qualified staff team and are protected by robust recruitment policy and practices. Evidence: The home has an experienced well-dedicated staff team in place. At the time of inspection, the home was fully staffed and no agency staff are used. The staff rota showed that staff ratio is good and provides additional support depending on activities or appointments people may have. The majority of residents, staff and a relative commented that they felt there were sufficient numbers of regular staff on duty and one relative stated that, The home seems to have a very low turn over of staff and I think this is good. The skill mix of the staff group was being used positively in meeting the various needs of residents. Recently two waking night staff have been provided for the home, prior to this there was one waking night staff and one member of staff slept at the premises. Staff spoken with and documentation looked at, showed us that they receive good support through induction, handovers, staff meetings, supervision and appraisals. The manager maintains robust recruitment checks and six of the staff files sampled, all Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: evidenced that they had the required information available. The homes induction programme was looked at and showed us that it follows the guidance in line with the Skills for Care requirements and includes further foundation and NVQ training. Staff spoken with said the training opportunities are good and relevant to the work they carryout. A training matrix clearly showed that the staff had completed courses and that training opportunities are good and include manual handling, health and safety, first aid, fire awareness, safeguarding and infection control. The manager advised us that 6 members of staff have attained NVQ Level 2 and that 4 members of staff, are currently undertaking NVQ Level 3 and 2. Senior staff all have the NVQ 3 and are on each shift throughout the week and weekend. Staff spoken with reflected that courses undertaken had developed a better understanding of the residents that they worked with. Staff said that they are all well supported by the manager and her senior team, through regular supervision, observations, monitoring of people and reviews held with other professionals. All peoples as a result are protected and an acceptable level of their health, safety and welfare is secured. Care Homes for Adults (18-65 years) Page 23 of 28 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. People live in a well run home that ensures that their best interests are met. Evidence: The Registered Manager is qualified to NVQ Level 4 in Care and has completed the Registered Managers Award and is also an NVQ Assessor for levels 2, 3 and 4. Discussion with the manager and documentation looked at, showed us that good management skills, and strategies are in place and this creates a good ethos throughout the home. The manager has made good progress to ensure that good practices among the team are implemented and that awareness around person centred approaches are raised. The day-to-day running of the home is efficiently organised. The manager is knowledgeable and is highly organised and efficient in her role. There are clear accountability of roles among the team and a strong shift leader support system. The management team lead by example and encourage the staff team to practice in Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: terms of a residents rights and empowerment. Practice is continually changing and adapting according to individual and group need which in turn moulds the service provided. The health, safety and welfare of residents and staff have been made a priority. All health and safety checks that were inspected are up to date. Policy, procedures and documentation evidence that resident finances are protected. Within the fire records looked at were found to be to a good standard, risk assessments are in place for all residents and staff carried out annual fire training and regular fire drills. Fire safety officers visit every year and checks made by the team are regular and promotes the safety of all residents. The organisation has been proactive in having a good quality assurance process, which is in place and gains the views from residents, relatives and others who come into contact with the service and making this available to CSCI and all other interested parties. Care Homes for Adults (18-65 years) Page 25 of 28 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 28 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 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - 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!