CARE HOMES FOR OLDER PEOPLE
Three Corners Nursing Home 3 Greenway Road Churston Ferrers Brixham Devon TQ5 0LW Lead Inspector
Fiona Cartlidge Unannounced Inspection 12th April 2007 11:05 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Three Corners Nursing Home Address 3 Greenway Road Churston Ferrers Brixham Devon TQ5 0LW 01803 842349 01803 846079 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) www.threecornersch.co.uk Mrs Elizabeth Agnes Hunter Mrs Victoria Jennifer Bundy Care Home 40 Category(ies) of Dementia (7), Mental disorder, excluding registration, with number learning disability or dementia (7), Old age, not of places falling within any other category (7), Physical disability (40) Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. Residents aged 65 years and over PD Maximum registered 40 Residents (both) OP Maximum registered 7 Residents (both) DE Maximum registered 7 Residents (both) MD Maximum registered 7 Residents (both) Date of last inspection 27th April 2006 Brief Description of the Service: Three Corners is situated in a level position on the edge of the village of Galmpton, which lies between Brixham and Paignton, a car park is available in the front of the home. Access to the building is via a modern porch. The accommodation is provided in twenty-two single rooms and nine shared rooms. Each room has a nurse call system and is equipped with the furniture and adaptations required for individual Residents. A variety of equipment and adaptations are provided to meet the needs of disabled Residents. There is at least 1registered nurse on duty at all times supported by a team of Health Care Assistants. The home is registered to provide care for up to forty older people of either gender who have personal care and general nursing care needs. Information about the home was found in the entrance hall and in all bedrooms, people may request a copy of the latest inspection report from the administration office. Information given to the Commission by the provider indicates the current range of fees is from £320 to £520/week. Additional charges are made for chiropody, hairdressing, newspapers/magazines and some activities e.g. pantomime £9. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The site visit took place over 5 hours 10 minutes and was unannounced. A partial tour of the home took place when some bedrooms and all communal areas were viewed. Four residents had their care case tracked this means their records were examined in detail and all four residents were spoken to in depth about the care and services they receive. 5 other residents were spoken with during the visit, as were 3 visitors/relatives, 3 members of staff, the manager and registered provider. Personnel records of 3 members of staff and policies and procedures were also inspected. Seven visiting health care Professionals retuned surveys. What the service does well:
Prospective Residents have the information they need to make an informed choice about their admission to this home. An assessment of care needs of prospective Residents takes place prior to admission to the home; this allows the homes personnel to make a clear decision about whether or not the individuals needs can be met, if so the prospective resident and or their representative is provided with confirmation of their suitability for admission. Existing Residents confirmed that the home was meeting the expectations they had when they were admitted. The registered person promotes and maintains residents’ health and ensures access to health care services to meet assessed needs. Residents spoken with confirmed they receive a good level of care. Written information was received via survey forms that were returned to the Commission by 7 visiting health care professionals. All of these indicated that the home communicates clearly and works in partnership with them and that they are satisfied with the overall care provided to Residents within the home. Residents are treated with respect and their right to privacy is upheld. Staff were seen and heard knocking on doors before entering rooms and were carrying out personal tasks in private. Staff observed in conversation with Residents were heard to be courteous and respectful. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 6 Effort is made by the home to provide social interaction/stimulation for residents. Staff were seen encouraging and enabling residents to engage in meaningful conversation and activities such as playing a game of dominoes, going out for a walk, assisting with household duties such as dusting and keeping their own bedroom tidy. Residents are able to maintain contact with family and friends and exercise choice and control over their lives. The people living in the home said they were happy with the visiting arrangements, visitors said they feel welcomed into the home and are able to visit their relative/friend in private or socially. Residents receive a wholesome appealing diet, The feedback about food was positive all of the residents but one spoken with said how good it was. This home offers a safe, clean, well-maintained environment. All of the Residents spoken to were satisfied with their private accommodation and there was evidence that they are able to bring personal items with them into the home. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of residents in this home. The residents were complimentary about the staff team confirming their needs were met 24 hours a day. Comments received from clients included: ‘I am really impressed with the care and support that I am given here at Three Corners’, ‘the staff are kind and attentive’, ‘as soon as you ask the staff for something you get it’. Management arrangements are meeting the needs of the service, and the quality of the service is continually assessed. Patients, visitors and staff made positive comments about the manager in the home saying they felt comfortable approaching her with Issues. The senior management team work well together and issues at this level are regularly discussed and documented. A quality management system is being introduced. Each resident has a key worker and residents and relatives are invited to become ‘friends of the home’ a group forum for them to communicate ideas for future improvements to the service. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can
Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 8 be made available in other formats on request. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective Residents have the information they need to make an informed choice about their admission to this home. The admissions process is safe. This home does not provide intermediate care. EVIDENCE: The home has a statement of purpose this document sets out the aims and objectives of the home and provides information about the service. This and a simpler guide to services in the home were seen in the bedrooms of all Residents. The personal records of 4 Residents were seen in detail and these Residents were then spoken with about their experience of living at Three corners these
Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 11 Residents confirmed that the home was meeting the expectations they had when they were admitted. One Service User said that their daughter had visited and chosen the home because they themselves had been too poorly. This residents daughter confirmed they had chosen the home for two main reasons; firstly its proximity and secondly because she knew some of the staff that worked at the home. Both the service user and their daughter who was visiting confirmed that the home had done an excellent job in improving the individuals health and general wellbeing. An assessment of care needs of prospective Residents takes place prior to admission to the home. Documents seen provided evidence that the home uses a standard assessment form; this assesses prospective Residents needs in depth and allows the homes personnel to make a clear decision about whether or not these needs can be met, if so the prospective resident and or their representative is provided with confirmation of their suitability for admission. Other records seen included copies of assessments carried out through care management arrangements and hospital/community health care teams where applicable. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are set out in an individual plan of care. The registered person promotes and maintains residents’ health and ensures access to health care services to meet assessed needs. The majority of medicines in the home are handled safely, however some aspects of the use of non-oral medication such as prescribed creams and lotions have the potential to place Residents at risk. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Residents spoken with confirmed they receive a good level of care. Personal records held on behalf of 4 Residents were examined; in all of those seen there were documented assessments which provided information about skin integrity, moving and handling, safety - including risk of falls, nutritional
Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 13 screening and social needs. The information generates the plans of care, which provide the basis for the care to be delivered. The plans of care are held in the resident’s private accommodation and all those spoken to in detail were aware of it. All of the plans had been regularly reviewed. Records are maintained for all visits to the home by social or health care professionals, all Residents are registered with a GP. Records provided evidence that as well as visits from General Practitioners, district and specialist nurses and chiropodists visit. A physiotherapist was seen assessing and advising a resident during our visit. Records of outpatient appointments show that visits to community and hospital health resources are enabled. Written information was received via survey forms that were returned to the Commission by 7 visiting health care professionals. All of these indicated that the home communicates clearly and works in partnership with them and that they are satisfied with the overall care provided to Residents within the home. The medication system is generally well managed, we looked at storage and recording and checked balances against records of controlled medication stored in the home these were accurate. The medication administration records did not provide accurate information about who or when topical medications such as prescribed lotions or creams are administered this poses a risk to Residents, as there is no clear record that they have or have not received their treatment, which may lead to under or over administration. Staff were seen and heard knocking on doors before entering rooms and were carrying out personal tasks in private. Staff observed in conversation with residents were heard to be courteous and respectful. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effort is made by the home to provide social interaction/stimulation for residents. Residents are able to maintain contact with family and friends and exercise choice and control over their lives. Residents receive a wholesome appealing diet but sometimes they are unaware of choices. EVIDENCE: During the site visit, some residents were seen sitting in the conservatory/lounge and garden. Other residents were seen spending time in their rooms, reading, listening to music, or watching television. Staff were seen encouraging and enabling residents to engage in meaningful conversation and activities such as playing a game of dominoes, going out for a walk, assisting with household duties such as dusting and keeping their own bedroom tidy. Records are maintained of activities attended and future organised activities are advertised via posters and word of mouth. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 15 The feedback about food was positive all of the residents but one spoken with said how good it was; on the day of inspection lunch was served, residents were served minced meat, mashed potatoes vegetables and gravy followed by apple and blackberry crumble and custard. Residents said they were unaware of any choice for lunch other than a salad instead of a hot meal. Some residents ate lunch in the lounge/conservatory; some residents ate their lunch in their own accommodation. Where residents required assistance this was usually provided appropriately by staff on a 1:1 basis in a relaxed and timely fashion. The manager said a new process is being introduced into the catering department, it is hoped this will include residents views in menu planning and further develop options. Residents spoken with during the afternoon said they had been offered a choice for the evening meal of sandwiches or macaroni cheese and a choice of desserts. The people living in the home said they were happy with the visiting arrangements, visitors said they feel welcomed into the home and are able to visit their relative/friend in private or socially. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives/friends know how to make a complaint. People are safe living in this home. EVIDENCE: This service has a complaints procedure it is clearly written and easy to understand and was seen advertised on notice boards around the home as well as in the guides found in all of the bedrooms. Residents and visitors confirmed that they felt comfortable discussing issues with the staff and manager. One confirmed that when they had raised an issue it had been dealt with by senior staff in the home in a manner that met their expectation. There have been no complaints referred to the Commission about this service. The manager confirmed they had not received any within the service either. Records seen show that the Staff are made aware of and attend training on the recognition and reporting of incidents or allegations of abuse or neglect. The homes policy and procedures for safeguarding adults gives clear specific guidance about referring to external agencies. Residents said they feel safe living in the home. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This home offers a safe, clean, well-maintained environment. It does however lack space for communal dinning and the temperature in the conservatory/lounge is not always comfortable for those who use it. EVIDENCE: A tour of the building showed that some areas of the building have been decorated since the last inspection. Evidence that improvements are on-going included 10 bedrooms that had been painted and 2 that have had new floor covering. one bathroom on the 1st floor has been redecorated and a new wet room/shower has been fitted on the ground floor to enable Residents to be helped safely with bathing. Some areas of the home are still in need of improvement some bedrooms need re-carpeting and decorating one was found with a damaged vanity unit. All of the Residents spoken to were satisfied with their private accommodation and
Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 18 there was evidence that they are able to bring personal items with them into the home. The lounge on the ground floor is of ‘conservatory’ type construction ceiling and window blinds are in place. Temperatures in this room are regularly recorded and showed fluctuation. Some residents complained of feeling hot and others looked uncomfortable in the heat, a fan was available in the room, and the doors leading to the garden were open. A smaller lounge is available on the first floor but this was not used during our visit. There is currently no separate dinning room; residents eat communally in the lounge/conservatory either whilst sat in armchairs with individual tables or at a table large enough to seat 4 or in their own accommodation. There is a range of equipment around the home, available to assist staff in moving and handling residents, as well as a disinfecting sluice, hand washing facilities and disposable gloves and alcohol rubs for use when/if in contact with body fluids. The environment was clean and odour free at the time of the visit. Records show that all equipment and systems are regularly serviced. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of residents in this home. The homes recruitment practise protects residents from being placed at risk of harm or abuse. EVIDENCE: Three Personnel files were examined, these records showed a commitment to safe recruitment practises, files contained detailed application forms, 2 written references, Criminal Record Bureaux checks, health checks and proof of identity. The records also contained policies signed by the staff members relating to protection and whistle blowing. Training and development records provided evidence that training is provided and ongoing. Staff spoken to on the day of the site visit confirmed they received sufficient training to enable them to meet the needs of those living in the home. All new members of staff as well as some existing members are on the Skills for Care Scheme. Information provided in the pre-inspection questionnaire suggests that 12 care staff (48 ) have obtained a National Vocational Qualification (NVQ) in care at
Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 20 level 2 or above a further 7 are currently working towards the qualification. One member of staff is to commence their nurse training this year and another is undertaking an associate practitioners course. The residents were complimentary about the staff team confirming their needs were met 24 hours a day. Comments received from clients included: ‘I am really impressed with the care and support that I am given here at Three Corners’, ‘the staff are kind and attentive’, ‘as soon as you ask the staff for something you get it’. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Management arrangements are meeting the needs of the service, and the quality of the service is continually assessed. The registered provider shows a responsible attitude toward promoting and protecting the health, safety and welfare of residents and staff. EVIDENCE: The registered manager is an experienced 1st level registered nurse and is currently working towards the Registered Managers Award. Patients, visitors and staff made positive comments about the manager in the home saying they felt comfortable approaching her with Issues.
Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 22 Communication systems are regular through staff handovers and regular staff meetings. The senior management team work well together and issues at this level are regularly discussed and documented. All are aware of the services business development plan, which shows continuing growth supported by strong financial arrangements. The home has access to professional business and financial advice and has all the necessary insurance cover in place to enable it to fulfil any loss or legal liabilities. A quality management system is being introduced. Each resident has a key worker and residents and relatives are invited to become ‘friends of the home’ a group forum for them to communicate ideas for future improvements to the service. Best practise guidance for caring for people is being introduced and staff are continually supported through training and supervision. Maintenance and associated records provided evidence that the registered provider has a sensible approach towards maintaining the health and safety of residents and staff; the fire precautions logbook indicates that the fire alarm is tested weekly and emergency lights monthly. Records and discussion confirmed that the staff have regular training in fire safety. Information provided to the commission by the provider indicates that gas and central heating systems are checked and serviced by suitably qualified contractors. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13(2) Requirement When medication including prescribed lotions and creams is administered to people who use this service it must be clearly recorded. This will ensure that people receive the correct levels of medication. Timescale for action 01/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. OP15 2. OP19 Refer to Standard Good Practice Recommendations The way in which meal choices are offered should be reviewed to be more successful in allowing people to know about and make choices about what they eat. Improvements to the environment should continue as indicated in the homes business plan. Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Three Corners Nursing Home DS0000028760.V330178.R01.S.doc Version 5.2 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. 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!
