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Inspection on 23/07/07 for Park View Care Centre

Also see our care home review for Park View Care Centre for more information

This inspection was carried out on 23rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The manager has achieved the Registered Managers Award. Since the appointment of a new head of the nursing units, the process of providing more effective leadership has commenced. In the clinical rooms, air-conditioning units have been installed thus ensuring a stable safe ambient temperature. Staff training has been given high priority to raise staff knowledge and improve clinical skills. The process of devising individual staff training profiles has now commenced. Induction training now meets the Skills for Care standard. Recruitment files have been audited. An excellent system of maintaining residents` finances has been introduced. Good quality assurance policies and practices are in place. The home`s grounds and gardens have been further enhanced providing a pleasant, creative and user-friendly environment for the residents.

What the care home could do better:

The previous inspection highlighted a lack of clarity of roles and responsibilities in the nursing units resulting in a lack of effective leadership. Since the appointment of a new head of unit, the process of introducing more effective leadership has commenced. Despite improvements noted, there are still obstacles preventing staff from working as a team. As a result, trained staff do not adequately act as effective role models for each other and the junior staff. It is hoped that the next inspection visit will confirm sustained improvement and strong leadership. The supervision process needs to be strengthened and used to identify the need for additional training, mentoring and support. An action plan could be used to ensure that any targets set are met in a timely manner. Whilst in the nursing units, the standard of care planning is good, further attention is needed to ensure that these are timely reviewed. Care documents introduced to evidence daily care provided could be used more effectively.

CARE HOMES FOR OLDER PEOPLE Park View Care Centre Field View Park Farm Ashford Kent TN23 3NZ Lead Inspector Lisbeth Scoones Key Unannounced Inspection 23 and 26 July 2007 10:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park View Care Centre Address Field View Park Farm Ashford Kent TN23 3NZ 01233 501748 01233 501757 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ranc Care Homes Limited Mrs Sarah Margaretha Erasmus Care Home 88 Category(ies) of Dementia - over 65 years of age (43), Old age, registration, with number not falling within any other category (45) of places Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The forty three (43) beds for DE (E) residents are located on the ground floor. The forty five (45) beds for nursing clients are located on the first floor of the building. From time to time the home may admit people below the age of 65 years commensurate with the service user categories of Nursing and Dementia. 7th September 2006 Date of last inspection Brief Description of the Service: Park View Care Centre is an 88-bedded, purpose built two storied home located on the outskirts of Ashford. It is set in its own grounds, surrounded by well maintained gardens and has plenty of parking spaces. The home is registered to care for 45 residents requiring nursing care on the first floor and 43 residents with dementia care needs on the ground floor. Mrs S Erasmus has been the registered manager since November 2005. She is supported by two unit managers and the director of nursing and operations. The Inspection report is available and on display. Current fee levels are: Between £442,42 and £655 for residents with dementia care needs and £446,56 to £860 for residents with nursing needs. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 23 and 26 July 2007 and comprised discussions with the registered manager Mrs S Erasmus, the director of nursing and operations Mr R Greaves, both unit managers, the GP and practice nurse who visit every Thursday, members of staff, 14 residents and a visiting relative. A tour of the building was undertaken. Care plans, training records, staff files and other documents were examined and discussed. Prior to the inspection, the manager completed an Annual Quality and Audit (AQAA) and comment cards were handed out to residents and relatives. At the time of the completion of the report 4 relatives comment cards were returned. Contact was made with care managers and health professionals to obtain their views on the services provided. All this information contributed to the inspection process and is incorporated and referred to in the report. What the service does well: What has improved since the last inspection? Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 6 The manager has achieved the Registered Managers Award. Since the appointment of a new head of the nursing units, the process of providing more effective leadership has commenced. In the clinical rooms, air-conditioning units have been installed thus ensuring a stable safe ambient temperature. Staff training has been given high priority to raise staff knowledge and improve clinical skills. The process of devising individual staff training profiles has now commenced. Induction training now meets the Skills for Care standard. Recruitment files have been audited. An excellent system of maintaining residents’ finances has been introduced. Good quality assurance policies and practices are in place. The home’s grounds and gardens have been further enhanced providing a pleasant, creative and user-friendly environment for the residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with comprehensive updated information about the services the home provides. Residents are only admitted following a comprehensive assessment of all their care needs. EVIDENCE: The home’s service user guide, welcome pack and statement of purpose are regularly reviewed and comply with the standard and regulations. A brochure and website are being developed. Prospective residents are assessed prior to admission or in-house transfer to ensure that the home or specific unit can meet their needs. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans provide detailed information to enable staff to care for the residents. In the nursing units, staff must ensure that these are timely reviewed and that daily records are used effectively. In the nursing units, recording of continence management should be improved. Residents’ health care needs are met with evidence of input from multidisciplinary professionals. Residents are protected by the home’s policies and procedures for dealing with medicines. Personal care is offered in a way, which protects residents’ privacy and dignity. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 10 EVIDENCE: A sample of care plans and daily records seen in the dementia care units provides evidence that an appropriate system of recording is used. There was evidence of regular review. A sample of care plans seen in the nursing units was also comprehensive. Good nutritional assessments are available. However, staff must ensure that all components of the care plans are reviewed and updated as needs change. In relation to continence care it was recommended that more detailed information is obtained and recorded. This could result in improved monitoring of the effectiveness of planned care. The manager said that the process of auditing care plans was soon to be carried out. It was recommended that wherever possible, residents and their representative be involved in and contribute to their care plan. Care plans contain a multi-disciplinary and doctors’ page evidencing visits from the GP and health professionals (continence advisor, CPN, chiropodist, physiotherapist and others). The home benefits from a weekly surgery run by a local GP and his practice nurse. Their feedback is included in the inspection report. The delegation of certain key roles was discussed in respect of “link” status for e.g. continence promotion, nutrition, infection control, care planning, health and safety, risk assessments etc. It was recommended that this link role be maximised in respect of audit, staff training and guidance. See also standard 36 in respect of staff supervision. Medication charts were viewed and well maintained. Air conditioning units have been installed in the clinical rooms thus ensuring safe temperature levels. From observations made and discussions with staff and residents, it is ascertained that residents are treated kindly. A resident said, “ On the whole I feel that the care home is coping with the needs of my husband and I am grateful for all the care he is given”. “From our experience the care home recruits caring and friendly staff.” Relating to the dementia care unit, a relative wrote, “ The staff always seem to very aware of what is happening. Staff have given us the confidence that my mother is in good and safe hands.” Residents looked well dressed and groomed. A regular hairdressing service is offered. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 11 In respect of dignity it was recommended that residents in the dementia care units, at meal times, be provided with serviettes. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Designated staff are employed who regularly offer residents a range of activities suitable to their needs. Residents’ spiritual needs are accommodated. Residents’ relatives and friends are encouraged to maintain contact. Residents are provided with healthy meals and are offered choice and variety. EVIDENCE: The home employs three activities coordinators. Between them they provide activities in all units. Group and on-to-one activities are provided. On the day of the inspection, a number of residents and staff would have gone on a minibus outing. This was unfortunately cancelled. Residents with nursing needs have access to a KCC bus every 2 to 3 months. Every week musical entertainment is provided as well as a special monthly event. Fund raising events are organised regularly. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 13 The participation in activities is recorded in residents’ notes. Many care plans contain a “personal profile”. Such information would provide staff with an insight in the residents’ likes, dislikes and preferences. The manager said that plans are under way to increase nursing clients’ participation in more of the activities offered. It further intends to develop a reminiscence area on the nursing floor. Additional activities are being planned on the dementia units such as baking and gardening. These are good initiatives. Residents are provided with choices in respect of what they wish to wear, what they would like to eat, when to get up and go to bed. Menus seen indicate that fresh produce is used and home made dishes prepared which are appreciated by the residents. A lunchtime session was observed in one of the dementia care units. A resident said,” The food is lovely”. A resident who had an hospital appointment was provided with a packed lunch. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure provides residents and relatives with an opportunity to complain feeling confident that their concerns are listened to and acted upon. Staff training would ensure that residents are protected from abuse. EVIDENCE: There is a detailed complaints procedure on display and incorporated in the welcome pack. Residents spoken to said that they feel able to air their views and know who to complain to. The manager keeps a complaint log, which includes evidence that the complaint has been resolved. The home has an in-house Adult Protection trainer. As evidenced on the training matrix and training records, staff have received or are rostered to undertake adult protection training. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home and gardens is good, wellmaintained, clean, pleasant and hygienic providing residents with an attractive and homely place to live. EVIDENCE: The home provides a pleasant, safe, clean and well cared for environment. Whilst no unpleasant odours were detected at this visit, several comments were received that, at times, there is an odour problem. The manager’s AQAA acknowledges that further staff action needs to be taken to address this issue. One such actions discussed at the visit is the replacement of some of the floor coverings. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 16 It is evident that the home invests in maintaining good environmental standards. Recently specialist beds have been purchased. There is an ongoing programme of maintenance and renewal of furniture and furnishings. Since the previous visit, the upgrading of the gardens has been completed. The operations manager praised the manager for raising the money as well as completing the project. The dementia care units have direct access to the gardens. The garden provides wheel chair access and walking areas. Patio areas with seating and bird feeders have been provided as well as plants and raised flowerbeds. A relative wrote,” Park View encourages the use of their gardens which has given my relative a welcome degree of freedom to roam.” Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general, staffing levels are adequate to meet the needs of the residents but some concern remains in respect of clinical skills of the nursing staff. The home is committed to provide staff with the induction and ongoing training they need to deliver the care. Residents are protected by the home’s good recruitment procedures. EVIDENCE: The home has had a considerable staff turnover and the few vacancies have now been filled. The manager said she is working hard on staff retention. Staff work according to a duty rota. Staff spoken to on the dementia care units said that staffing levels are adequate. In an effort to work more effectively, very recently, the nursing units have been split in two: one 15 bedded and a 33 bedded, staffed separately. Staff spoken with on the nursing units said that staffing levels were inadequate. The manager has listened and staffing levels have recently been increased to allow for 1:2 on the 15-bedded and 1:7 on the 33-bedded unit. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 18 Staffing levels need to be continually monitored based on residents’ needs and staff competencies. In conversation with health professionals who visit the nursing units regularly, concern was expressed of the standard of some of the staff’s clinical skills and knowledge. This area was highlighted at the previous inspection visit. With the appointment of a new head of unit it is hoped that such clinical skills will be improved. The home operates in accordance with robust recruitment procedures as confirmed in a sample of staff files examined. A system is in place ensuring that nurses’ PIN numbers are current. Staff are provided with a range of training as confirmed on the current training matrix and training records. Such training covers in-house, statutory, adult protection and specialist training relating to medical conditions relevant to the categories of registration of the home. All staff have receive dementia care training. A care worker said she had recently had training in Parkinson’s disease. The home is actively trying to access Mental Capacity Act training. The home is committed to NVQ training, which is provided alongside in-house training. Due to staff changeover, currently 7 staff are NVQ qualified with 5 staff undertaking the training. Induction training is now provided to “Skills for Care” standards. The home is in the process of adapting the programme to make it more specific to the home. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager has a good understanding of the areas in which the home still needs to improve. The manager ensures that staff are aware of their roles and responsibilities but this needs to be further improved in the nursing units. Good quality assurance systems are in place regarding residents’ satisfaction and audit of services and practices. An excellent system has been introduced to manage residents’ monies. The programme of staff supervision in the nursing units needs to be strengthened to ensure sustained improvement. Through risk assessments and staff training, the health, safety and welfare of residents and staff are promoted, reviewed and safeguarded. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager demonstrates a good awareness of her role and has an open, positive and transparent style of leadership. A relative of a resident in the dementia care unit wrote, “ The family have been particularly impressed by the approach of the Park View Home manager and the staff in helping us through a difficult and frustrating period.” A receptionist, administrator, the director of nursing and operations and two unit managers support the manager. Unit managers are responsible for the overall running of their units, staffing, staff training, staff supervision and audit. Since the appointment of a new clinical nurse manager, the process of raising the standards in the nursing units has begun. A visiting nurse said that the new unit manager has made a difference but has a huge job on her hands. The manager acknowledged that further work needs to be carried out to sustain the improvements noted. This would include effective supervision, guidance, support and training. Regular staff meetings are held both at management and unit level to ensure that staff are involved with and consulted about plans for change. A relatives and residents’ meeting take place regularly. Regular audits are undertaken. This inspection visit identified a need for tighter care planning audit. Staff confirmed that they are formally supervised and that such sessions are recorded. The manager acknowledged that some staff supervisions have been delayed. It was again recommended that staff supervision be used to identify deficits in skills and to agree an action plan to address these. The manager informs the CSCI of every event reportable under Regulation 37. The director of nursing and operations meets with the manager weekly and writes a formal monthly quality report in accordance with Regulation 26. Policies and procedures are reviewed annually as part of the home’s quality assurance programme. Risk assessments are undertaken to ensure a safe environment and working conditions for residents and staff. Statutory training is provided to all staff in respect of fire safety awareness, moving and handling, infection control, and first aid and food hygiene. Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 4 2 x 3 Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 23 STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP7 OP36 Regulation 15 (2) (a) (b) 18 (2) Requirement That care plans are current and inform practice That staff are adequately and timely supervised Timescale for action 15/09/07 15/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 Refer to Standard OP7 OP8 OP27 OP28 OP36 OP32 Good Practice Recommendations That daily care records used in the nursing units are correctly completed and support the care plans That continence management and recording thereof is monitored That staffing levels continue to be carefully monitored in respect of numbers and competencies That the home aims for a minimum ratio of 50 NVQ trained staff That the home evidences that training needs identified at supervision be acted upon That the nursing units are managed effectively Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Park View Care Centre DS0000026097.V345280.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!