Inspection on 09/12/08 for SEVA Care Home

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

SEVA Care Home 07/01/08

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: SEVA Care Home 33 Radnor Avenue Harrow Middlesex HA1 1SB     The quality rating for this care home is:   one star adequate 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: Ann Gavin     Date: 0 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 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 Older People Page 3 of 28 Information about the care home Name of care home: Address: SEVA Care Home 33 Radnor Avenue Harrow Middlesex HA1 1SB 02088611885 02088611885 info@sevacarehome.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Akshay Chandrakant Barot Name of registered manager (if applicable) Jacqueline Laurie Redshaw Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Seva Care Home is a care home registered to provide personal care and accommodation for up to six older people. The homes Statement of Purpose clarifies that the home specialises in providing a service to the Hindu Gujarati community, but welcomes people from any background. Additionally, food on the premises is strictly vegetarian. The home is owned and run by a small, private and independent care service provider. It is a three-storey building, which has been converted into a residential home. Accommodation for service users is provided on the ground, first and Care Homes for Older People Page 4 of 28 care home 6 Over 65 6 0 Brief description of the care home second floor. Four the bedrooms are single occupancy, with the one downstairs room being a shared room. One first-floor room has an en-suite toilet and shower. There is restricted parking at the front of the house, along with a drive that can take two cars. At the rear there is good-sized, well-maintained garden. There are ramps and grabrails at the front and rear entrances. The range of fees at the time of the visit was #350 (shared room) to #480. The Service User Guide is available on request, including a Gujarati version. At the time of the inspection, there were two vacancies at the home. Care Homes for Older People 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: one star adequate 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: This was an unannounced inspection on Tuesday 9th December 2009 from 11.15 am to 5pm. Time was spent talking to three people who live in the home and with the staff member on duty with the manager. The manager was available throughout the inspection and was open and receptive to the inspection process. A variety of records were reviewed and the care of three people reviewed through talking with them,looking at their support plans and other records and talking with the staff. A number of questionnaires were sent out but had not been returned at the time of writing this report. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 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 9 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 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. People are given information about the home and have the opportunity to visit and spend time in the home before deciding to move. People know that their support needs have been assessed and that the home will be able to meet them Evidence: Seva Care home have written information about the support they offer. This is in their statement of purpose which is also available in Gujarati. The manager says that the owner is currently working on updating their web page. The manager confirmed that admissions are not made to the home until a full assessment of peoples needs has been undertaken. The majority of referrals to the home are made by social services who provide comprehensive assessments. For people who are self funding and without a social services assessment, the manager completes the homes own assessment. Care Homes for Older People Page 10 of 28 Evidence: Three peoples care was tracked during the day spent in the home. Case tracking involves talking to the people who live in the home, looking at all records and documentation concerning them and talking with their key worker. Each of the three residents had full assessments in place. The manager invites people and their relatives to the home once she has received a referral and feels that from the information received the home will be able to meet their needs. The manager then talks through with people about the support they require observes, clarifies any areas required and makes her own judgment on whether they can offer the level of support required. It was recommended that the manager formalises her assessments of people who have been referred via social services by completing the homes assessment used for private referrals. People spoken with said that they were invited to the home prior to being admitted and that they and their family were given clear information about the home and the care provided. The owners mother speaks both Gujarati and English fluently and is available to show people the home and explain services in either language. The manager is continuing to develop their understanding of the Gujarati culture and language. Care Homes for Older People Page 11 of 28 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. Every one who lives in the home has an individual plan highlighting their needs and aspirations in all aspects of personal, social, cultural, religious and health care needs. The home has good links with health care professionals Evidence: The people spoken with were happy with the support they received at the home. One person spoke of how they want to spend time with God preparing to be with God soon. This person was able to sit beside the Hindu shrine in the lounge areas and enjoyed the television which is tuned to Gujarati channel which has prayers throughout the day. The staff were observed respecting this persons space but equally being attentive to their needs. Each of the three people tracked had good detailed plans outlining the support they would require in all aspects of their life. Each of the files had a sheet at the front where the person or their relative had signed to say that they had read the care plan and the areas they wished to discuss. Care Homes for Older People Page 12 of 28 Evidence: The care plans reflected the person and how they wished to be supported. One plan spoke of how someone enjoys a daily shower and should be encouraged to dry and dry themselves. This person is now able to dress themselves and is happy with their newly gained independence. The plans were detailed covering personal, social, cultural and religious and health care needs. Each person had a chart of their weight and also waterlow score (which shows someones risk of developing pressure areas). There were very good nutritional charts and assessments. One persons whose weight fluctuates had a very comprehensive assessment which sought to eliminate all possible causes such as problems with their mouth or teeth. This person was referred to the appropriate health care professional who was observing the situation. The three care plans seen also contained good assessments of potential areas of risk such as falls, bathing, chair lift, kitchen, stairs and fire. Assessments for each person were in place with an action plan to minimize the risk identified. The staff complete a daily contact sheet giving an overview of how someone may have spent their day. There is also a weekly record chart which highlights the various aspects such as whether someone had their bed changed , room cleaned whether they had an afternoon or mid morning snack, any activities they may have undertaken. This weekly records gives the staff an overview highlighting areas that might need attention. Staff were observed offering support discretely to people. People commented how good the staff were. All the people in the home have Gujarati as their first language. The staff also speak Gujarati. The manager has now created a page for peoples health care appointments or contacts with professionals. This makes it easier to know if peoples health care needs are being met. The manager says that they enjoy good relationships with local health care professionals. There was evidence of people having appointments with dentists, chiropodists, and opticians. Currently no one in the home is self medicating. All medication is now supplied in blister packs from Boots who have offered training and audits. The MAR sheets (medicine administration records) were completed and no errors were found. The manager has a record of all medication coming into and out of the home. Care Homes for Older People Page 13 of 28 Care Homes for Older People Page 14 of 28 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. Peoples cultural and religious preferences and lifestyles are respected and catered for within the home. People are encouraged to be part of the running of the home and exercise choice over social and other aspects of their lives Evidence: The people within the home are currently all Hindu and enjoy regular weekly bhajans within the home. They have a Hindu shrine in the sitting room which everyone appreciates. Two of the people were observed playing cards with a staff member during the morning. The television was one for the most part of the day at the request of one of the people who was following the various prayers on the Gujarati channel. The manager has ordered a Karen board, a large board game which people requested at one of the home residents meetings. The staff said that residents enjoy going out walking in the morning though less so now that the weather is cooler. There is also the garden which residents enjoy tending. It is planned that the garden will be partly re designed in the summer to increase residents ability to plant and tend to plants within Care Homes for Older People Page 15 of 28 Evidence: it. The residents enjoy going to the temple occasionally and celebrating religious events both Diwali and Christmas and the house decorations for Diwali have now been left in place for Christmas. The manager has said that improving social activities within the home is part of her plans for improvement over the next twelve months.A second member of staff in the afternoon would facilitate this ( see staffing) Notes were seen of the residents focus meetings which are held informally over a meal every two months. This was the way the residents felt worked best. Residents can raise any issue plus menus ideas and social plans are made at these meetings. All food is cooked on the premises. Everyone is vegetarian and a general menu is written then residents are asked daily what they would like and it is prepared. The residents did not want set menus. The staff however do keep a record of what people eat to ensure a balanced and varied diet. Lunch was sampled and was well presented and good. There were a variety of vegetarian dishes with salad served together with Nan bread and rice. People chose to eat in the lounge. Staff were seen to be attentive to peoples needs and giving support where needed. Families of the residents are always welcome and are frequent visitors to the home as well as taking their relatives home for the day. Care Homes for Older People Page 16 of 28 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. People in the home know who to speak with if they have any concerns. All the staff have had training in safeguarding adults. Evidence: There have been four complaints during the last year all of which have been resolved. The records of these were seen. They were well kept and detailed the complaint and the action taken to resolve them. Social Services were involved in a safeguarding issue which has now been resolved and the necessary steps taken. There were no current complaints or safeguarding issues. All the staff have now had training in safeguarding One person spoken with said they would know who to talk to if they had any complaint and the staff and manager said they encourage people to speak about any aspect of their care which they would prefer differently or anything that was worrying them or they want changed. One person had made a comment about the food having too much ghee however the manager found that the other people who live in the home like to have that amount of ghee. The situation was resolved by making sure that a separate dish was provided for the person with less ghee. The manager said that the home does not handle any monies of the people in the Care Homes for Older People Page 17 of 28 Evidence: home. Care Homes for Older People Page 18 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, 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 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 in the home enjoy a homely environment which is well maintained and clean. The home has adaptations in place to assist in maintaining peoples independence. Evidence: The home is located in a quiet cul-de-sac residential road near central Harrow. There is a stair lift, ramps into the home and out to the garden and rails throughout the home to ease accessibility. The home has a living room with a large screen TV with access to Asian channels. There is also a Hindu shrine in one corner. One of the people who live in the home enjoys sitting beside the shrine where they can pray. The dining room adjoins the living room via a sliding glass door. Although it is a conservatory the area , like the rest of the home was warm. There is a bath with raising-seat and overhead shower on the first floor, and a shower room with wall-fixed shower-seat on the ground floor. There are accessible toilets on the ground and first floor. Care Homes for Older People Page 19 of 28 Evidence: The manager said that they have upgraded the laundry area which now has a sink to enable staff to wash their hands. The manager said that they have ordered a washing machine with a sluice cycle and it is being delivered in January 2009 A tour of the communal areas of the home and two bedrooms showed that the home was well maintained. The manager had noted in her AQAA (Annual Quality Assurance Assessment) that there was a plan to replace some carpets. The carpet in a room currently unoccupied is one of the carpets which has had a number of stains and will be replaced. The manager will send the timescales of when these will be replaced to the commission. The home was clean and the aroma of Gujarati cuisine filled the entrance and downstairs lounge and kitchen. Care Homes for Older People Page 20 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home can know that staff have been appropriately recruited and trained. The staff were clear about their role and in knowing what support people required. The manager must ensure that there are two members of staff on duty at all times during the day to ensure that people needs can be safely met. Evidence: The manager stated in the AQAA(Annual Quality Assurance Assessment) that there are 6 permanent staff who work in the home. 3 full time and 3 part time. There is one member of staff and the manager on from 8am to 1pm. The manager has been working on their own from 1 to 5 pm. This is not a safe practice although the owner and owners mother live very close by. The manager said that all of the people who live in the home have a rest after lunch. However with just one member of staff on who is not practiced in Gujarat people can have neither any activity nor if there was an urgent need would there be someone who could understand immediately their need. This was discussed with the manager who said that they were planning to review this once there were more people living in the home. However the manager confirmed that they would ensure that there were two people on duty at all times during the day. Since the last inspection the manager has fully reviewed the recruitment process. The Care Homes for Older People Page 21 of 28 Evidence: application form and the reference forms have been updated with more information requested in both. The current process is that once someone completes an application form and it is thought they will be a likely candidate then they are asked to complete a CRB (Criminal Records Bureau) check and references are sent for. Once the CRB and references are returned then the person is called for a second interview. The manager says that she verifies candidates identification. There are two candidates who are awaiting CRB checks and references. They are both trained and one already has an NVQ level 2. Three staff files were seen. The information was present but without any order. The manager is currently organising staff files the new folders with dividers were seen. The manager is also creating a checklist to place on each staff file to ensure all information has been obtained and is up to date. All the current staff have completed a health declaration form and the willingness to undergo medicals if necessary. The staff are up to date with training. Speaking with one of the staff they confirmed that they have had training in safeguarding and manual handling. They are due to start their NVQ in Harrow in January. The manager says that there are plans for all staff without NVQ to gain the qualification. One person is doing an English course first to facilitate this. The people spoken with in the home were happy with the care they were receiving from the staff saying they were very good Care Homes for Older People Page 22 of 28 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. The manager is focused on the needs of the people who live in the home. There are structures in place for staff management but more structured professional support is needed for the manager. Evidence: The registered manager has many years experience working in the care sector, including management teams. This is her first position as manager of a care home. She was completing a course for the Registered Managers Award at a local college where she started in February 2008. However the company went into liquidation so she is currently seeking a new supervisor. She is due to start at Thames Valley College in January 2009 in order to complete the qualification. The manager has been working hard to meet the requirements set at both the last inspection and the random visit made in July 2008. Currently she is working six days a week and as noted in the previous section has been working on her own every Care Homes for Older People Page 23 of 28 Evidence: afternoon. As the home is privately owned by a person whose professional background is not in care, the manager does not have any access to professional supervision and development. It is essential for the manager to have professional guidance to consolidate their learning and development as well as to prevent professional isolation. The manager has sought out informal culturally appropriate professional guidance however there needs to be a formal arrangement. It is a requirement that the provider formalises such supervision for the manager. The AQAA (Annual Quality Assurance Assessment) completed by the manager was satisfactory , although there are areas where more supporting evidence and detail would have been useful to illustrate what the service has done in the last year, or how it is planning to improve. The owner carries out unannounced monthly visits and has devised a form to use to record this. There is a focus on interviews with the people who live in the home, the staff as well as an inspection of records and of the premises.It may be useful to include action points with action time lines as well as space for the manager to comment and give feedback on the process. There were minutes of the staff meetings the last one was held on the 2nd December. One of the items discussed was healthy eating. The manager says they are normally every four to six weeks. The staff do have supervision though the manager needs to formalise the procedure maintaining records and diarising supervision sessions. The manager must make sure that there is a a photograph of every person who lives in the home. All the health and safety records seen were up to date and well maintained. There were regular water and fridge temperatures. A weekly check on lighting and fire alarms is carried out by staff. The fire brigade did an assessment of the home and said it complied with all the regulations. The manager sys that Harrow College will do full in house fire training plus fire evaluation plan and horizontal evacuation plan. Care Homes for Older People Page 24 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 Older People Page 25 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 1 19 23 The manager must send the timescales for the replacing of the carpets to the commission in order that people may live in a well maintained environment 31/01/2009 2 27 18 The manager must ensure that there are always two staff on during the day for the safety of the residents 31/12/2008 3 29 17 The manager must complete 31/12/2008 the organisation of staff files to enable to access information easily and to be sure that all information that is required is present. 4 31 10 The provider must formalise professional support and development for the manager in order that they may be able to consult and seek 28/02/2009 Care Homes for Older People Page 26 of 28 guidance from someone within the care professions for the benefit of the residents and the home 5 36 18 The manager must formalise 31/01/2009 and diarise staff supervision to be sure that staff have the necessary support to be able meet the residents needs 6 37 17 The manager must ensure that there is a photograph kept of all residents in the home to ensure residents safety at all times. 31/12/2008 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 3 The manager should formalizes her assessments of people who have been referred via social services by completing the homes assessment used for private referrals It may be useful to include action points with action time lines as well as space for the manager to comment and give feedback on the process in the monthly regulation 26 visits by the provider 2 33 Care Homes for Older People 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 Older People 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!