Inspection on 27/04/09 for Quintaville

This inspection was carried out on 27th April 2009.

CQC 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

Quintaville 18/06/08

Quintaville 02/07/07

Quintaville 09/01/07

Quintaville 20/12/05

Quintaville 29/09/05

Quintaville 11/02/05

Quintaville 06/07/04

Quintaville 24/03/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

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St George`s

5 Seafield Road

Credence House

Poldhu

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Quintaville 1 Quinta Road Babbacombe Torquay Devon TQ1 3RJ     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: Michelle Finniear     Date: 2 7 0 4 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 Older People 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 Older People 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Quintaville 1 Quinta Road Babbacombe Torquay Devon TQ1 3RJ 01803328289 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : johnmurphy250@hotmail.com L Murphy & Co Ltd care home 25 Number of places (if applicable): Under 65 Over 65 25 25 25 25 25 dementia learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 0 0 0 Quintaville is a residential home that is registered for persons in the categories of: Dementia, Old Age, Learning disability, Mental Disorder and Physical Disability. The home has 25 bedrooms, 23 of which are single rooms and 1 is suitable for shared occupancy. Many of these are en-suite. At the front of the building there is a small well tended garden and a courtyard area is found at the rear, which can be accessed through a large patio door. On road parking is available at the front of the home. The home has three floors and a vertical lift is provided for people who have mobility issues. Care Homes for Older People Page 4 of 27 Brief description of the care home Two large lounges are available which provides different environments in each. Meals are taken in a separate dining room at small tables seating up to four persons. Off the dining area there is a dedicated room provided for hairdressing. The home is within walking distance of local shops. The weekly cost of care at Quintaville varies between 330 to 450 pounds per week dependant on need. Copies of Inspection reports are available at the home. Care Homes for Older People 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: To complete this inspection we asked the owner/manager to give us information in an Annual Quality Assurance Document about how the home is run; we sent questionnaires to people who live and work at the home; we looked at previous inspection reports and information we have received during the year about the home; we sent questionnaires to visiting professionals such as GPs and district nurses asking them their views on the care given; we visited the home without telling them the day we were coming; we looked at records the home keeps about the people who live there and the staff they employ; we spoke to people at the home about the care they receive; we looked round the home and spoke to the staff on duty and the owner/manager Mr Murphy. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? Since the last inspection the home has: Updated information about the home to give to people who may be thinking about moving in. This helps people make a choice about whether the home is the right place for them. Made sure records are being updated by staff. This helps to ensure peoples changing needs are identified and met. Made sure staff have training in how to safeguard people from abuse; Improved the system for letting people have a say in how the home is run and improve the quality of care provided; Made sure that staff are now are receiving supervision. This helps to make sure staff are working in the same way and to their best potential to support people; Care Homes for Older People Page 8 of 27 Chemicals are being stored away to minimise the risk of accidents; All staff and people staying at the home who are not being cared for have recieved a Criminal records bureau check. This helps to ensure people are being cared for by people who are suitable to work with vulnerable people; Care plans have been improved and are being regularly updated; Window openings have been restricted to stop people falling from the windows; and staff are recieving a full recruitment procedure. This helps to ensure people are being cared for by staff who are suitable to be working with potentially vulnerable people. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 are fully assessed before they move to the home. People have opportunities to learn about what the home is like before they make a decision to move in. Evidence: Quintaville has a statement of purpose and service user guide available to give people information about the services and facilities the home provides. This was updated following the last inspection. It contains information such as peoples rights of tenancy and what they can expect to receive for the fees they pay. On the site visit we spent time looking at how the home makes sure they can meet the needs of people who move to live at the home. We looked at the records and paperwork for a recent admission to the home, and then spent time talking to this person about the process that had been followed. This had included the owner visiting Care Homes for Older People Page 11 of 27 Evidence: the person and completing an assessment of their needs, and the person visiting the home on several occasions to meet people already living there, look at the accommodation available and decide if they felt it was the right place for them. An assessment was also undertaken of additional equipment that would be needed by a physiotherapist and occupational therapist to make sure this was in place before the person moved in. Other people who completed questionnaires said that they had received information about the home before they moved in, including a contract. One person said I had visited the home several times and another said they had chosen the home because they had received information from another nephew of my aunt who had personal contact with the owner and from reports posted on CSCI website. People who completed questionnaires indicated that they had received contracts, and one person said the contract is easy to understand. The contract contains information about the fees to be paid and information about when notice might be given. A signed copy of this was seen in one persons file during the site visit. The home does not provide intermediate care, which means they do not provide a specialist intensive rehabilitation service with the aim of returning the person to their own home. Care Homes for Older People Page 12 of 27 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Peoples health and personal care needs are being met well. Care plans are robust being regularly updated to ensure they reflect changes in peoples need. Evidence: On the site visit to the home we looked at a number of care plans, and spoke to people living at the home about the care they receive. Each person living at Quintaville has a care plan which identifies the support they need and how this is to be given. Since last inspection the care planning system has been improved considerably, and care plans are now detailed, concise and regularly updated. Information contained within them was easy to access and understand, and contained information about peoples life before they moved into the home and choices they make about their health and personal care. Evidence could also be seen of support from external medical services such as district nurses, general practitioners, occupational therapists and physiotherapists. People Care Homes for Older People Page 13 of 27 Evidence: living at the home have access to dental and podiatry services, and in the past the home has had access to mental health support services. The people spoken to said they were very happy with the level of care they received. People who completed questionnaires were also happy. One person wrote Everyone at Quintaville is very kind to me and I am very well cared for. I am so happy to be living here. It couldnt be better. Other people wrote My doctor is called straight away if I am not well, and Im very pleased, the care and support is very good. A district nurse who completed a questionnaire said the home manager referred people appropriately to their service when they required nursing care, and said that personalised care was evident. In particular they felt that the long-term care for patients who were very frail was good, and that the management were responsive to requests. On the visit we looked at the homes medication systems. These had also been recently audited by the supplying pharmacist. Medication is sent to the home in a series of colour coded blister packs for each person. These help reduce the risk of errors when giving out medication and make it easy to check that medication has been given out. Staff are signing for each administration and the management of controlled drugs seemed satisfactory. The home has a small fridge full medication which needs to be kept cold, and the temperature of this is monitored. The home has a list of approved homely remedies, which can be bought over the counter and given to people without a prescription. People spoken to and who completed questionnaires indicated that their privacy and dignity were respected at all times. This was also seen when care was being observed. Care Homes for Older People Page 14 of 27 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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 have opportunities to participate in leisure activities. Meals are of excellent quality. Visitors are encouraged to remain involved in their relatives care. Evidence: The people living at Quintaville at the time of the inspection site visit had very different needs and experiences of care. Some people had lived there as a group for over 30 years, and one person who had only been at the home for less than a fortnight. However there was a good sense of community, with people able to join in activities at the home or spend time on her own as they wished. There was good interaction between people living at the home and people who completed questionnaires confirmed that there were activities arranged by the home that they could take part in. As an example one person wrote that they had opportunities to take part in activities, classes, quizzes, bingo, knitting class, hairdresser comes every week. As a part of a recent residents meeting people had expressed an interest in doing more knitting, so the home responded by setting up a knitting group which people were really enjoying. One person who chose to spend time in their room was involved in knitting a blanket. People are encouraged to visit to the home at any time. One person who recently Care Homes for Older People Page 15 of 27 Evidence: moved in said they had done so in part because the home was close to where their relatives lived and they could visit the more frequently. A relative wrote the owner (Mr Murphy) always contacts me in regards to any issues arising with the care and well-being of my relative. The home has a chef and provides a good choice of menus and meals each day. On the day of the visit the meal choices for lunch were steak pie or braised chicken, mashed potato, cauliflower, sliced beans and carrots with banana custard for dessert. The evening meal was bubble and squeak with Turkey nuggets and beans followed by strawberry cheesecake. People spoken to said the meals were very good. One person wrote that they enjoyed the meals. There is always a wholesome meal and fresh produce. The chef discusses our menu with us. Care Homes for Older People Page 16 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 homes policies and procedures help protect people from abuse and ensure their rights are protected. Evidence: People at the home we spoke to were clear about what they would do if they had a problem at the home. The people who completed questionnaires also said that they would be happy to talk to Mr Murphy if they had any concerns. One person said the complaints procedure was outlined when my relative moved to Quintaville and any updates are given to me. Another person said I know that if ever I did have a problem it would be dealt with immediately by Mr Murphy. One complaint was received since the last inspection regarding medication that had been left out on the table in the dining room while a member of staff responded to an emergency. This was immediately and responsibly addressed by the owner. Staff have received training in safeguarding and adult protection. This should help to ensure, along with the homes policies and procedures, that people are protected from abuse or abusive practices. Staff have also received training in the deprivation of liberty safeguards which concerns peoples rights if they have limited capacity. It is understood that they are to complete training in the Mental capacity act in the near future. This helps to ensure they understand peoples rights to make choices and Care Homes for Older People Page 17 of 27 Evidence: ensure they are protected as far as possible when doing so. Care Homes for Older People 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have choices about where they spend time at the home and about the private accommodation they choose to live in. Evidence: When we visited the home we made a tour of all areas of accommodation, and the service areas of the home looking at cleanliness, decoration and how well it met peoples needs with equipment and furnishings. Quintaville is an extended property, currently registered for up to 25 people in single rooms. Accommodation varies from large rooms with ensuite facilities to rooms which are much smaller with the use of communal bathrooms and toilets. The home has substantial communal space, including two large lounges, one of which was being refurbished to a very high standard during our visit. People have the choice of where they wish to spend their time in the home, and there are other service areas such as a hairdressing room for peoples use. People have a choice of bedrooms they wish to occupy and there is a passanger lift to access all floors. The rooms on the higher floors and in one wing tend to be larger with a higher number with ensuite facilities. Some rooms on the first floor are quite small for current standards, however several people have chosen to stay in them despite Care Homes for Older People Page 19 of 27 Evidence: being offered larger rooms elsewhere within the home. All areas of the home seen were clean and odour free on this visit. Some would benefit from modernisation and renovation. Since the last inspection window openings have been restricted to ensure that people cannot accidentally fall from windows above the ground floor. The owner stated that water temperatures are regulated to ensure people cannot accidentally be scalded by hot water. There is a bath with hoist on the ground floor which is used by choice by most people in the home. There are seating areas and an enclosed patio to the rear of the home, and planted gardens to the front through which people can watch activity in the road outside. The home have participated in an Infection control audit in the last year. One person, not a resident is currently living at the home. The owner said this person provides a night security service for the home. Care Homes for Older People 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. The staffing arrangements meet the needs of the people who live at the home. Staff are well trained and experienced. Evidence: On the site visit we looked at the staff records for recruitment and training and we spoke to the staff on duty. We also spoke to people who live at the home about how well people support them. The home has a very low turnover of staff and some staff have worked there for many years. Some other staff are family members of the owner which helps to maintain a family feel to the home. Low staff turnover helps to ensure people receive consistent care and can get to know and trust the people looking after them. The files for the most recently recruited member of staff were seen. This showed that a full recruitment procedure had been followed through including taking up of criminal records bureau checks and references. A full recruitment process helps to ensure that people working at the home are suitable to be working with potentially vulnerable adults. Some of the older staff files do not contain all of the information that would be expected if people were being recruited under current legislation, however the owner has ensured that criminal records bureau checks have been taken up on all staff no Care Homes for Older People Page 21 of 27 Evidence: matter how long they have been employed. Each member of staff working at the home has a training chart, which indicate when they last received updates in core training on when these may be due. This helps to make sure that all staff have up-to-date knowledge. In addition during the last year the manager has told us that staff have received training in the deprivation of liberty safeguards, medication training, safeguarding adult in letters course, and fire instructions. Some people have also been undertaking National vocational qualifications, which are a national award assessing peoples competency in their work role. New staff receive an induction programme and work alongside existing staff to support people until they are confident. People living at the home or their relatives who completed questionnaires for us were full of praise for the staff. They told us All staff and the owner listen and act on any thing I have to say there is never nor has been any problem with availability of the owner or staff. Everyone is always friendly and attentive to my queries. My relatives is well cared for and I cannot speak too highly regarding how well being apart from Mr Murphy, any member of staff had sufficient knowledge of my relatives needs to give positive responses. I cannot speak too highly of the care and attention given to my relative by any and all members of the staff and the owner the care and support I get at Quintaville is excellent A staff member who completed a questionnaire said I was given all the information and support I needed in their induction and that everyone is very experienced and is given the correct support to meet, and understand all of our clients individual needs . Another staff member wrote I attend training courses on a regular basis to ensure a high standard of care. Everything is kept up-to-date with new ways of working. All training is relevant to my role and I am able to interact with each resident and support their individual needs. Care Homes for Older People Page 22 of 27 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 health and safety has been assessed, to ensure the home is a safe place to live and work in. People have a say in how the home runs. Evidence: The manager of the home, Mr John Murphy is a registered nurse and has managed Quintaville for over 30 years. He has completd his Registered managers award, which is a specialist qualification in managing a care home. People living at the home, relatives and staff who completed questionnaires spoke highly of his caring and availability to them. One person said The management is always willing to listen and act upon any new ideas. He is very understanding and nothing is too much trouble for him. His main objective is to ensure that all those in his care live in a safe and happy environment, with all their needs being met with dignity and respect. Since the last Inspection the manager has formalised some of the quality assurance systems at the home. This has included issuing questionnaires to people such as Care Homes for Older People Page 23 of 27 Evidence: relatives and visiting professionals. The results of the feedback are now being recorded along with any action taken as a result. The owner has known some of the people at the home for over 30 years so feels he is able to know when they may be unhappy about something. Action is taken on any requests as soon as possible. The home has regular residents meetings which are written up with any changes made as a result being included. The home may benefit from all areas of audit being incorporated into an annual development plan for the home. The system for dealing with small amounts of peoples money was seen on the visit. The owner holds a small float of money for some people at the home to enable them to deal with small day to day purchases such as paying for hairdressing or confectionary. Accounts are held for all purchases made. All of the people living at the home have someone outside of the home to deal with their affairs. Staff are now receiving formal supervision and appraisals. The owner could show us evidence of practice supervision being undertaken as well as a formal appraisal system where staff spend time 1:1 with the manager looking at their performance and any training they may need. One person spoken to said that their appraisals were thorough and carried out regularly. Health and safety issues seen were being addressed. The home has much of the regular servicing and safety assesments on contracts with local firms and evidence could be seen of these inspections being carried out. This has included checking of electrical appliances and wiring in the home, legionella bacteria in the water sytem and maintenance of boilers. Regular fire drills and practices are being undertaken, which helps to ensure that staff know what to do in the case of a fire. The home has internal audit systems for cleaning, and it is recommended that people initial when the task is completed, so that it is clear who has undertaken the work. There are copies of infection control manuals, and it is understood the owner has made sure the system for the safe handling of food has been implemented. Staff receive first aid training as a part of their core skills package. Care Homes for Older People 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 Older People 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 33 An annual development plan should be developed for the home. This will help plan improvements based on assessments of what is working well and what can be improved. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 Older People 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!