Inspection on 13/02/06 for The Minster

This inspection was carried out on 13th February 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Minster 22/08/07

The Minster 27/09/06

The Minster 03/08/05

The Minster 09/03/05

The Minster 26/07/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Minster Mill Street North Petherton Bridgwater Somerset TA6 6LX Lead Inspector David Kidner Unannounced Inspection 13th February 2006 13:00 The Minster DS0000059630.V265967.R01.S.doc Version 5.0 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 The Minster DS0000059630.V265967.R01.S.doc Version 5.0 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 Adults 18-65. 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. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Minster Address Mill Street North Petherton Bridgwater Somerset TA6 6LX 01278 661528 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) Voyage Ltd Nicola Rossenrode Care Home 10 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 10 persons in categories LD and PD. Date of last inspection 3rd August 2005 Brief Description of the Service: The Minster is registered with the Commission for Social Care Inspection to accommodate ten service users with a learning disability and associated physical needs. Voyage owns the home. The home is situated in the village of North Petherton near Bridgwater. The home can accommodate service users who require a bedroom on the ground floor. However, the home does not have a passenger lift to the first floor. All bedrooms are of single occupancy and have full en-suite facilities. It is decorated and furnished to a very high standard with an extensive rear garden and patio areas. The Minster is situated in the heart of the village and is very close to all community resources such as shops, post office, church, pubs, chemist, doctors surgery, library and hairdressers. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted over one afternoon (4.00hrs). The Registered Manager and the Deputy Manager were not available at the time of the inspection. The Inspector would like to thank the service users and the staff team for making the inspector welcome at the home and for their contribution to the inspection process. At the time of the Inspection nine service users were living at the home. There have been a number of admissions to the home since the last inspection. This appears to have had a very positive effect on the home by creating a more homely atmosphere. There was one vacancy. The Inspector viewed most parts of the home and was shown around by one service user; viewed records in relation to care and support plans, health and safety and medicines records. The Inspector met all of the service users. Two care staff were spoken to in private and others spoken to in the communal areas. The Inspector observed the staff team interacting with service users in a very professional, caring and supportive manner. As a result of this inspection the home received one requirement and four recommendations. What the service does well: The Minster provides a very high standard of accommodation and facilities. All parts of the home are accessible to the service users who have no mobility difficulties and there are ramped areas for service users who have the use of wheelchairs to enable full access of all ground floors and outside facilities. The home has many aids and adaptations to promote the independence of the service users. There are detailed care and support plans with risk assessments where needed. All records were well maintained. Service users access a variety of health care professionals as and when needed. The team wish to provide service users with a variety of opportunities, experiences, choice, independence and involvement as much as possible. The home conducts regular service user’s meetings. The home maintains good records in relation to health and safety. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 The home does not ensure that a robust pre-admission assessment is conducted. Service users and their families, friends and care managers are encouraged to visit the home before moving to The Minster. EVIDENCE: The Home has a Statement of Purpose and Service user Guide. These are available for prospective service users, their relatives and placing authorities. At the previous unannounced inspection it was a requirement that the home conducted a detailed pre-admission assessment to ensure that the home can meet the needs of prospective service users. This has been implemented. The Inspector viewed the pre-admission assessment for two of the most recently admitted service users. It was noted that one assessment has been completed in detail but had not been signed or dated. Another pre-admission assessment could not be located. Pre-admission assessments must be completed and should be located in the service user’s individual file. The Inspector spoke to one recently admitted service user who stated that they had visited The Minster and stayed overnight before making their mind up to move to the home and had also chosen their bedroom. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 9 The home has An Absconding Policy. It is noted that the policy states that all the external doors are to be alarmed when it is dark. At the time of the inspection, which was conducted during daylight hours, the alarms had been activated thus creating a large amount of noise within the home as some service users were accessing the garden and patio areas and other activities were taking place. The home should review its practice in relation to this as this can impose freedom of movement for all service users as well as unnecessary noise levels. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 The home has yet to develop two care plans. However, other care plans viewed are user friendly and detailed. Risk assessments are implemented where needed, signed and dated. The home maintains good records in relation to service user’s finances. EVIDENCE: The Inspector viewed three care and support plans. Two of the care plans are in the process of being developed as the service users have recently been admitted to the home. There was evidence of care plans; risk assessments and other documentation being obtained from the previous home so they can inform the new care plan to be developed. Key workers conduct monthly reviews with summaries kept. Care Plans are formally reviewed on an annual basis in a multi-disciplinary type review. Behaviour Management Guidelines were in evidence where needed and signed by the Registered Manager. Risk Assessments have been reviewed and updated as needed. The Inspector noted that visits to all health care professionals had been well documented. These included visits to the GP and Consultant Psychiatrist. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 11 At the previous Inspection it was recommended that the Registered Manager should consider that two staff signatures are obtained for all service users individual financial transactions. The Inspector briefly viewed some transactions and noted that where ever possible two signatures are obtained. Staff also confirmed this. Also at the previous inspection it was recommended that the Registered Manager should consider keeping individual records of service users individual bank accounts so as to demonstrate the breakdown of individual charges and personal allowances. This will then infrom the service user and other interest stakeholders, if appropriate of individual income and expenditure from this account. The Registered Manager was not available at the time of the inspection so this could not be discussed in more detail. This will remain a recommendation and be followed up at the next inpsection. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 17 The home encourages and supports service users to access the local community and to partake in a variety of leisure, recreational and social activities. The home has a planned menu that appears healthy and choices are offered. EVIDENCE: At the time of the inspection service users were partaking in and being offered choices in leisure, social and recreational activities. Activities are based on individual choice/need and records are kept of all activities that are undertaken. The Inspector spoke to a number of staff and they confirmed that the service users access a wide range of activities such as swimming, bowling, pubs, walks, cafes and day trips. They also commented that service users are accessing local facilities in the village more often now that staffing levels have improved. However, this can be compromise if there is staff sickness and annual leave. The home continually keeps its staffing levels under review to ensure minimum staffing levels are maintained. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 13 The home operates a five-week menu. Wherever possible service users are involved in menu planning and can request an alternative meal if so wished. The Inspector witnessed this at teatime, as service users were being offered another choice of meal and a choice in deserts. The inspector sat with service users and staff at teatime. The mealtime appeared quite relaxed and unhurried. It was noted that service users were being encouraged to take dishes, cups and cutlery to the kitchen after use. The Inspector noted that placemats, side plates and condiments were not used or offered. It is suggested that this be reviewed and such items could further promote a homely environment and enhance mealtimes. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 The home provides technical aids and equipment to promote independence. Service users have good access to a variety of to healthcare professionals with records kept. The home maintains good records in relation to the administration of medicines. EVIDENCE: The Minster has aids and equipment to promote independence. Moving and Handling needs are identified in individual care plans where needed. The Inspector viewed risk assessments in relation to the Moving and Handling of all service users. These had been reviewed and dated. At the previous inspection the Inspector that items on the agenda for the forthcoming staff meeting included the times that service users get up and go to bed. Following discussions with a total of six care staff the Inspector was advised that service users are not woken early on a morning to get up and that they can choose when to go to bed. It appears that some clarification and discussion was to be held with the staff team as to this matter. Standard 18 of The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 15 The National Minimum Standards clearly state that; Times for getting up/going to bed, baths, meals and other activities are flexible (including evenings and weekends), subject to restrictions agreed in the individual plan (Standards 2 and 6 refer). The Inspector is aware that one or two service users choose to go to bed early and get up early. As good practice it was recommended that where this is the case, and as part of the agreed care package, that this is documented in individual care plans and kept under review. This has been addressed. The care and support plans that were viewed contained documentation of the visits made to health care professionals. These included visits to the GP, dentist, chiropodist, optician, speech and language therapist, physiotherapist and consultant psychiatrist. Records are kept of all visits and consultations. The home uses the Boots Monitored Dosage System. The Inspector viewed the arrangements in relation to the storage and administration of medicines. This was satisfactory. MAR sheets were very well maintained. However, it was noted that on two occasions hand transcribed medicines did not have two staff signatures to support this. It is recommended that this be addressed. The home has experienced the sudden death of two services users over recent months. The Inspector was informed of this and is very aware that the families of the service users were extremely grateful of the services that the home provided and the support that they received from the Registered Manager and care team and a very difficult time. The staff team were also distressed at this time and the service offered staff support and counselling where needed. A bereavement workshop held on 01.11.05. The home has appropriate policies in relation to the death of a service user. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home has a detailed complaints procedure and there are policies and procedures in place to safeguard vulnerable service users. EVIDENCE: The home has a complaints policy. A record is kept of complaints that are received at the home. There has been one complaint since the last inspection. The Inspector viewed the records in relation to this. The complaint had been recorded and addressed appropriately. The complaint was upheld. The home has a number of systems to safeguard vulnerable people. There is a copy of the Safeguarding Vulnerable Adults procedure. The home has previously taken appropriate steps in relation to the safeguarding of vulnerable adults when needed and has kept the Commission for Social Care Inspection informed. The Inspector spoke to a number of staff including two recently appointed staff members. All staff were aware of the home’s Whistle blowing Policy and Complaints Policy. All prospective staff has a POVA check and an Enhanced CRB clearance before being employed to work at the home. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29, 30 The Minster is fully accessible and designed to meet the needs of the service users as stated in the home’s statement of purpose. The shared bathroom and toilet facilities are very well presented and have specialist equipment installed where needed. The home has a variety of specialised equipment to maximise independence. On the day of the inspection the home was very clean and tidy. EVIDENCE: Since the last inspection the lounge, dining room and some hallways have been redecorated, new leather suites have been purchased for the lounge, new curtains have been fitted in the lounge area and there are a variety of pictures and soft furnishings. This further enhances the appearance and homeliness of the home. The Inspector was shown around some parts of the home by one of the service users. Not all bedrooms and en-suite facilities were viewed. All ground floor areas of the home are wheelchair accessible, including accessible pathways around the exterior of the home. There is a large patio The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 18 area to the rear of the property that has access to the large rear garden. There are a variety of aids and adaptations around the home. The shared bathroom and toilet facilities were very well presented and have specialist equipment installed where needed. The home has adequate laundry facilities. All cleaning agents are kept in a locked cupboard in the laundry room. The home has a cleaning schedule. On the day of the inspection all areas of the home were clean, hygienic and tidy. There were no mal-odours. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 The Registered Manager and Deputy Manager were not available at the time of the inspection therefore it was not possible to assess the majority of these standards. However all these standards were assessed at the previous inspection conducted on 03.08.05. It was not possible to view staff recruitment files. EVIDENCE: All staff are issued with a job description that clearly defines their role. The Inspector spoke to some staff that had recently been employed and they confirmed that they had received job descriptions. They also confirmed that they had received training in first aid, healthy and safety, fire training, moving and handling, LDAF, food hygiene and protection of vulnerable adults. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42 The Minster is very pro-active in seeking the views of the service users and monitoring the quality of the services provided. The home strives to promote all matters relating to health and safety. EVIDENCE: The home and Voyage as an Organisation, continuously self-monitor the service. Copies of the Regulation 26 visits are sent to the CSCI (Commission for Social Care Inspection) for information. The service users and parents/relatives have been kept informed and involved in the planning of the refurbishment and redecoration of the home as much as possible. The Operational Manager for the home has recently completed an Annual Service review for the home. It is a very detailed document and a copy has been sent to the CSCI. The Minster also conducts regular service user meetings. It was noted that the home is conducting these meetings three monthly. The Inspector viewed the minutes to the meetings. It is very evident that the home The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 21 consults with service users as much as possible and strives to gain ideas, suggestions and opinions from the service users. Recent topics of discussion include: menus, activities, fire procedure, Pancake Day and staffing. The Inspector viewed documents and records relating to health and safety. The home has very good recording and filing systems. All appropriate checks are undertaken including weekly checks of the fire alarm system, emergency lighting, fire equipment and torches. The fire system and emergency lighting system was last serviced on 14.09.05 and the fire equipment was serviced on 11.11.05. Good records are maintained of the staff training. The gas safety certificate is dated 09.06.05. The electrical hardwiring certificate is dated 16.12.05 and portable appliance testing was conducted on 10.03.05. The home also maintains records in relation to first aid box checklists, records of hot water temperatures, fridge and freezer temperatures. Environmental Risk Assessments are conducted and reviewed when needed. The Inspector noted that the flooring in the shower room appears to have become very “bubbled” This was noted at the previous inspection. At that time the Registered Manager stated that this has been reported to the maintenance team. It is recommended that this be addressed as part of the home’s maintenance issues as soon as possible. The home keeps records of all incidents and accidents and monthly reports are complied by the Registered Manager and sent to Voyage Head Office in Taunton for further audit. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Minster Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score X X 3 X X 3 X DS0000059630.V265967.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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. Standard YA2 Regulation 14 Requirement The home must ensure that a detailed pre-admission assessment process is conducted to ensure that the home can meet the needs of prospective new admissions to the home and it should be located in the service user’s individual file. This was a requirement at the last Inspection and target date was set for 30/09/06. Timescale for action 10/03/06 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 Refer to Standard YA2 Good Practice Recommendations The home should review its practice in relation to the use of door alarms as this as this can impose freedom of movement for all service users as well as unnecessary noise levels. It was noted that one of the care plans had not been signed or dated by the Registered Manager, service user or other interested stakeholders, this should be addressed so as to clarify the agreement of the plan of care and support DS0000059630.V265967.R01.S.doc Version 5.0 Page 24 2 YA6 The Minster 3 YA7 4 YA42 to each service user. This was a recommendation at the last inspection. The Registered Manager should consider keeping individual records of service users individual bank accounts so as to demonstrate the breakdown of individual charges and personal allowances. This will then inform the service user and other interest stakeholders, if appropriate of individual income and expenditure from this account. This was a recommendation at the last inspection. The home should ensure that the flooring in the shower room is safe, as it has become very “bubbled” since the last inspection. The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 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 The Minster DS0000059630.V265967.R01.S.doc Version 5.0 Page 26 - 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. 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