Inspection on 02/08/06 for Tidings

This inspection was carried out on 2nd August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tidings 14/06/07

Tidings 20/02/06

Tidings 24/08/05

Tidings 31/01/05

Tidings 24/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 Tidings 1 Irnham Road Minehead Somerset TA24 5UD Lead Inspector Jane Poole Key Unannounced Inspection 2nd August 2006 09:30 Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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 Tidings DS0000016190.V305415.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 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. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tidings Address 1 Irnham Road Minehead Somerset TA24 5UD 01643 702831 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) MRS EILEEN ISABEL WAIN MRS EMMA LOUISE BRYANS MRS EMMA LOUISE BRYANS Care Home 6 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. REGISTERED FOR 6 PERSONS IN CATEGORIES MD AND LD. One named service user, over the age of 65 to reside, as detailed in application dated 15 March 2006 20th February 2006 Date of last inspection Brief Description of the Service: Tidings is located in the seaside town of Minehead. The property is located very near to the town centre and is in walking distance to the sea front. Tidings is registered with The Commission for Social Care Inspection to provide personal care for up to 6 people with a learning disability or mental health problems. The home is not registered to provide nursing care. Accommodation is arranged over two floors and mezzanine landing. Communal areas include a lounge and dining room; all bedrooms are for single occupancy and have been fitted with a wash hand basin. Tidings is a family owned and run business. The Registered Providers are Mrs Eileen Wain and Mrs Emma Bryans. The Registered Manager is Mrs Emma Bryans. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector over a 7 hour period. The inspector was able to meet all service users, tour the building, observe care practices, meet with the provider and view records. At the time of the inspection 5 people were living at the home. What the service does well: Tidings has a family type atmosphere and service users appeared very comfortable and content in their surroundings. People are free to move around the home and spend time alone or in the company of others. Throughout the day the inspector observed constant interaction between staff and service users. Service users are able to make choices about all aspects of their day to day life. Prospective service users are able to spend time in the home before making a decision to move in. It was evident that the home considers, not just the needs of the prospective service user, but also the needs of the existing service user group when assessing a new service user. All service users have comprehensive care plans that have been discussed and agreed with the individual. Service users were very happy with the opportunities for social and educational activities. Records seen showed that service users took part in a wide range of activities and had ample opportunity to access the local community. The home itself is located in a central position in the town of Minehead within walking distance of the main shopping area and the sea front. All areas of the home are well maintained and furnished and decorated to a high standard. Service users are able to personalise their rooms which gives them a very homely feel. All service users spoke highly of the staff team and stated that they would be comfortable to approach a member of staff with any worries or concerns. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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 Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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, 3, 4 & 5. Overall quality in this outcome group is good. Prospective service users receive adequate information about the home and have ample opportunities to visit before making a decision to make it their home. The service user guide clearly states what is included in the basic fee. EVIDENCE: Since the last inspection the home have applied to CSCI to register two additional rooms on the ground floor, the statement of purpose has been up dated to reflect this change. All current service users living at the home are assisted with their fees by the appropriate Local Authority and have a financial agreements which reflects this. The service user guide gives clear details about what is included in the basic fee. Service users are responsible for payment of personal items and services such as magazines, toiletries, hairdressing and chiropody. The service user guide also states that transport charges are not included in the basic fee and charges are made at the discretion of the management. No new service users have moved to the home since the last inspection, however one person is currently considering moving in. The prospective service user has been given opportunities to visit the home and spend time with staff and other service users. This will be an ongoing Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 9 process until the person has decided whether or not to make Tidings their home. The proprietor stated that the first few months of any stay is considered a trial period to ensure that the home is able to meet the service users needs and that the service user is comfortable in their new environment. The provider gave evidence that in assessing the needs of any prospective service users she also considers the needs and wishes of the existing service user group. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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, 8, 9 & 10. Overall quality in this outcome group is good. Each service user has a care plan which is comprehensive and personal to them. Service users are given opportunities to make choices about their day to day lives and the running of the home. EVIDENCE: Each service user living at the home has a care plan which has been discussed with them. The inspector viewed two plans of care in detail and found them to be comprehensive and personal to the individual. The care plans gave clear guidelines to staff to enable them to meet the needs of service users in their preferred way. There were clear daily records for each service user and a monthly summary. Care plans are adjusted in line with changing needs and abilities. It was apparent that all changes are fully discussed. Service users were aware of the information contained in care plans and stated that they have a full review with professionals outside the home and their keyworker at least annually. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 11 Throughout the day the inspector noted that service users were given opportunities to make choices and decisions about their day to day lives and the running of the home. The registered manager acts as a financial appointee for one service user. The home are currently encouraging service users to be more independent and responsible for their personal monies. The inspector was able to have lunch with service users and staff and noted that this was a chance for people to informally discuss issues relating to the home and plans for the future. In addition to informal discussions there are formal monthly service user meeting with minutes taken. Risk assessments have been completed in respect of the environment and individual activities. Any identified risks have been minimised and any resulting restrictions for service users form part of their care plan. The provider gave evidence that she is aware of issues of confidentiality and it was noted that details about this were contained in the staff handbook. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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, 15, 16 & 17. Overall quality in this outcome group is good. Service users have opportunities to participate in a wide range of social and educational activities. Service users are assisted to maintain contact with friends and family. Service users are free to spend time alone or socialise with staff and other service users. EVIDENCE: Service users are encouraged to take an active part in the running of the home. Some service users assist with meal preparation and shopping, which enables them to maintain and develop independent living skills. On the day of the inspection some service users were seen cleaning and tidying their own rooms and all stated that this was something they were encouraged to do. There are ample opportunities to use community facilities, on the morning of the inspection the majority of service users went into town to shop and have a Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 13 coffee in a local cafe. Service users stated that they also attended local colleges and adult learning centres. The home is ideally located to take advantage of the local facilities such as shops, pubs and cinema. For trips further afield the home has a vehicle. All service users were very happy with the opportunities for social and education activities. A record is kept of all activities undertaken and these show a wide range of leisure activities and attendance at local clubs. Many of the service users are able to stay with friends and family members and all are going on holiday to Cornwall next month. Everyone spoken to stated that they are able to have visitors at any time. There are no set times to get up or go to bed and routines in the home are dependant on the wishes of service users and planned activities. Privacy is respected and service users are able to spend time in communal areas or in their own private rooms. Staff were seen knocking on doors before entering and interacting in a respectful, warm and friendly manner. Throughout the day there was constant social interaction between staff and service users. The main meal of the day is in the evening when all service users are at home. There are no set menus but records are kept of all food served. It was apparent that service users are given opportunities to make choices about the meals on a daily basis. At lunchtime the service users have a lighter meal. The inspector was able to join staff and service users for lunch and found it to be a pleasant sociable occasion with people chatting and laughing together. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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. Overall quality in this outcome group is good. Service users have access to a range of healthcare professionals appropriate to their needs. The systems for the recording and administration of medication promote safe practice. EVIDENCE: Service users are registered with local healthcare professionals according to their needs and wishes. All appointments are recorded and these show that people are accessing doctors, dentists, psychologists, chiropodists, opticians and speech and language therapists. Referrals to specialists are made on an individual basis and assistance is provided to attend appointments outside the home. Clear records are kept of peoples’ healthcare needs and interventions provided, including the effects of medication prescribed. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 15 The home is small and has a family type atmosphere, which enables staff to quickly notice any changes in behaviour or mood. Service users stated that staff spent time with them discussing any worries or concerns they may have. Service users are able to dress in their chosen style. There is a keyworker system in place in the home to ensure consistency of care. No service users living at the home administer their own medication although there is a policy in place to guide staff if any service user wished to do so. The home uses the Nomad Monitored Dosage System for medication. Service users medication is kept in individual secure lockers. The inspector viewed the Medication Administration Records and found them to be correctly signed when received into the home and administered to service users. Each service user has a list of homely remedies signed by their General Practioner. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 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. Overall quality in this outcome group is good. Reasonable steps have been taken to minimise the risk of abuse to service users. The atmosphere in the home promotes an open culture, which allows service users to raise worries or concerns with staff. EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. No complaints have been made to the home or the CSCI since the last inspection. Service users stated that they would be comfortable to talk with a member of staff or the provider about any aspect of their care that they were not happy with. The home has contact details of independent advocacy services in the area and one person living at the home has used an advocate. The inspector viewed the whistle blowing policy and advised the proprietor to ensure that the contact details given for outside agencies are appropriate. All staff undergo an enhanced Criminal Records Bureau check before commencing work at the home. Service users were seen to move freely around the communal areas of the home and had unrestricted access to their personal rooms. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 17 The proprietor gave verbal evidence that she is aware of the vulnerability of service users and provides instruction to staff to minimise the risks of abuse. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 18 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, 25, 26, 28 & 30. Overall quality in this outcome group is good. Tidings provides a very homely and comfortable environment for service users. All areas are maintained to a high standard. EVIDENCE: The home is located in a central position in the seaside town of Minehead. The main shopping area and seafront are within walking distance. The house itself is a large older style property, which has been refurbished by the current owners. Recently the outside of the house has been re-rendered and new double glazed windows have been fitted throughout. All areas of the home are fitted with a fire detection system, which is regularly serviced and tested. Since the last inspection the home has applied to register an addition two bedrooms. These rooms are located on the ground floor and will have exclusive use of a bathroom, which has been fitted with mobility aids. The registration of Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 19 these rooms will enable 2 service users who may have poor mobility to live comfortably at the home. The home is well decorated and furnished in domestic style. All communal areas are located on the ground floor making them accessible to all. There are two lounges and a dining room. Service users were happy to show their personal rooms to the inspector. All were a good size and comfortably furnished to suit the needs and wishes of service users. Each bedroom seen was extremely personal and very homely. One of the currently registered rooms is on the ground floor, the other 5 and the bathroom, are upstairs. There is no lift in the home so service users need to be independently mobile. There is no laundry room in the home, the only washing machine is located in a store cupboard in the yard. There are hand-washing facilities and it meets the current needs of the home but should be kept under review as the number of service users increases. Care staff and service users are responsible for all domestic duties in the home. On the day of the inspection all areas seen by the inspector were clean and fresh. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 20 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, 32, 33, 34 & 35. Overall quality in this outcome group is adequate. Staff are confident in their roles and well motivated. There is no evidence of a training needs assessment for the team or for individual members of staff. EVIDENCE: The home employs 6 staff members, 2 have a National Vocational Qualification in care at level 2 or above. Between the hours of 8am and 3pm there are two members of staff on duty. After 3pm there is one member of staff on duty and overnight one person provides sleep in cover. The provider and manager provide on call support and there are also 2 members of staff who live on site. All staff employed are over the age of 21. The provider stated that staffing levels are kept under review. When a new person moves to the home staffing levels are agreed with the funding authority. Staff observed on the day of the inspection demonstrated a good understanding of the needs and personalities of service users. They appeared confident and well motivated. Service users all stated that staff were kind and Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 21 friendly. As previously stated throughout the day there was constant interaction between staff and service users. One new member of staff has been appointed since the last inspection. The personal file of this person showed evidence of a robust recruitment procedure and a comprehensive induction programme. All staff have received training in fire safety, first aid, manual handling and food hygiene. The inspector did not see evidence that individual staff members have personal training plans. There is a handbook for employees that is comprehensive and gives details of relevant policies and procedures. The home holds regular staff meetings, which are an opportunity for staff to share views and suggestions for the running of the home. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 22 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): 37, 38, 39, 40, 41 & 42. Overall quality in this outcome group is good. The home is well managed taking into account the views of service users and other interested parties. Appropriate steps have been taken to provide a safe environment for service users. EVIDENCE: The registered manager of the home was not available at the time of this inspection. The registered provider was available throughout the day. The registered provider has an NVQ level 3 in care and the manager and deputy are both working towards the Registered Manager Award (NVQ level 4) All members of the management team work hands on in the home. The provider was able to demonstrate a good knowledge of the service users and staff. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 23 Tidings is a family run business with a warm relaxed atmosphere. Service users all stated that the management of the home were very approachable and always listened to their viewpoints. The inspector observed that staff and service users were very comfortable with the registered provider. There are regular formal staff and service user meetings which form part of the quality monitoring systems in the home. The home has good links with service users families and feedback is sought on an informal basis. Each service user has a regular review of their care with professionals outside the home which is an opportunity for these professionals to air their views and set goals and objectives for the next year. Regular checks of the environment enable the home to assess the quality of the facilities and plan improvements accordingly. The home has comprehensive policies and procedures but some of those seen would benefit from being personalised to the home, for example the lone working policy and handling service users finances policy. All records requested by the inspector were made available, all seen were well maintained and up to date. A fire log is maintained that shows that the detection system is serviced annually, alarms are tested weekly and emergency lighting monthly. There are regular fire drills and service users spoken to were aware of how to respond in the event of a fire. There is a comprehensive fire risk assessment. All accidents are recorded. Outside contractors check the gas and electrical installations on a regular basis and all portable electrical appliances are checked annually. All requirements and recommendations made at the last inspection have been actioned. Up to date certificates of insurance and registration are displayed in the office. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 3 2 3 3 X Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA30 YA32 YA35 YA40 Good Practice Recommendations The registered person should keep the laundry facilities under review to ensure that they continue to meet the needs of the service users. 50 of care staff should hold a National Vocational Qualification in care at level 2 or above. A staff training assessment should be carried out and personal training plan for each member of staff developed. Policies and procedures should be personalised to ensure that they are appropriate to the home. Particular regard should be paid to the lone working policy and the policy on handling service users money. Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 26 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 Tidings DS0000016190.V305415.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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