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Inspection on 09/02/09 for Venville House

Also see our care home review for Venville House for more information

This inspection was carried out on 9th February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People told us they were happy living in the home. Venville House is small, only having eight beds, and very "homely", giving the impression of a shared house rather than a residential care home. This meant that people, particularly those with dementia, settled in well. Staff were seem to have a friendly and respectful relationship with people and people were free to spend the day as they wished. Routines are relaxed with no set times for getting up in the morning or go to bed at night. The house is clean and homely, and there is nothing institutional about the house. The staff are reported as being very kind and considerate. Many of the people living at Venville House have lived in Princetown and the local area all their lives and were pleased to be able to stay in an area they know well. The home is commended for supporting people with the opportunity to continue to participate in the local community, and to maintain contact with friends and relatives. People said that the meals were very nice and plentiful; the meat and vegetables are locally sourced and are often organic. One person said, "I`ve never had a bad meal, always lovely". Staff are competent and there are sufficient to meet the needs of people living at the home. Staff feel well supported, and said they were very happy in their work. The majority of staff have achieved a National Vocational Qualification in Care, well above the standard set by the Commission.

What has improved since the last inspection?

A new conservatory has been built at the rear of the property that provides a very spacious and attractive seating area with access to the small patio. The pre-admission assessments have been reviewed to ensure that they clearly identify people` s needs before they move to the home. The necessary pre-employment checks, including obtaining two written references and a criminal record bureau check are undertaken prior to the commencement of a new member of staff starting work.

What the care home could do better:

No requirements for improvement or good practice recommendations have been made as result of this inspection. Mrs Huntley and her staff team strive to provide a real "home" to the people living at Venville House.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Venville House Tavistock Road Princetown Yelverton Devon PL20 6QE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Gurnell     Date: 0 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Venville House Tavistock Road Princetown Yelverton Devon PL20 6QE 01822890557 NONE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Lindsey Huntley care home 8 Number of places (if applicable): Under 65 Over 65 8 8 8 8 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 0 0 0 0 The maximum number of service users who can be accommodated is 8. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia aged 65 years and over - Code DE(E) Mental disorder aged 65 years and over, excluding learning disability or dementia - Code MD(E) Physical disability aged 65 years and over- Code PD(E) Date of last inspection Brief description of the care home Venville House is a care home for eight older people, in Princetown near Yelverton. The mome provides care for older people who may have dementia, a menal health problem Care Homes for Older People Page 4 of 26 Brief description of the care home or physical disabilities. This is a small care home, which serves the local community of Princetown and is close to the local amenities. Accommodation is provided over two floors and all bedrooms are single rooms, many with ensuite toilet facilities. A stair lift provides access to the first floor. There is a lounge room, a dining room and a conservatory on the ground floor. Outside there is a rear patio garden area. Many of the rooms have views of the surrounding village and Dartmoor. Mrs Huntley, the owner and Registered Manager, provides a family orientated service where there is attention to individual needs and choices. People are encouraged to maintain their independence and links with the community wherever possible. The fees range from 288 to 381 pounds per week, and items not covered by the fees include hairdressing, chiropody, continence pads, toiletries, and newspapers. Copies of the Service Users Guide and Statement of Purpose, that provide information about the home, are kept in the dining room. These are available at all times. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The previous inspection of Venville House was undertaken on 5th February 2007 and judged the home as providing good services to people. This inspection was unannounced and undertaken on 9th February 2009. As part of this inspection Mrs Huntley completed an Annual Assurance Quality Assessment (AQAA), a document that allows the home to tell the Commission how people s needs are met, what has improved over the past 12 months and what further improvements the home wishes to make. As part of this visit a tour of the building was made and all eight people living in the home spoken with as were the three staff on duty as well as Mrs Huntley, the owner Care Homes for Older People Page 6 of 26 and Registered Manager. Records relating to the care provided for three people were looked at including their medication records. Documents relating to staff recruitment and training and health and safety were also looked at. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving to Venville House are provided with information about the home, and are invited to visit, in order to make an informed decision about whether it is right for them. The care needs assessment means that peoples needs are identified and planned for before they move to the home. Evidence: One person newly admitted to the home was spoken with, and he said that he was made very welcome and had settled it. Another person who had moved in some time ago said that he was really pleased he was able to bring his dog with him as this made all the difference about deciding to move into residential care. The care plans for three people were looked at in detail and all contained a preadmission assessment identifying their care needs prior to their admission: these assessments also included information obtained from social services who were Care Homes for Older People Page 10 of 26 Evidence: responsible for identifying peoples needs to make a judgment with regards to the suitability of residential care. People had also been asked about their preferences and their perceived needs with regards to staff support, this demonstrated good practice and allowed people to express how they wanted to be supported. Mrs Huntley said she visits people in their own homes or in hospital before their admission to undertake the assessments and invites people to visit the home to spend time with the staff and the residents before making a decision to move in. Mrs Huntley had written to people confirming that the home was able to meet their needs and including a copy of the assessment for them to sign and return. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social care needs are well met. The home has a good system for the management of medication. Evidence: Venville House provides care and support to eight people who are both physically and mentally frail due to a dementia or a mental health problem. All of the people living at Venville House were spoken with, and although not all were able to directly comment about the care and support they receive, they all said that they were very happy living at home. They said the staff were kind and very helpful. Staff were seen to support people with respect and obviously had a close relationship with them. Those people who were not able to comment about the quality of the care they receive were seen to be well groomed and appeared happy as they were in conversation and laughter with others: staff were able to describe their care needs well. Three care plans were looked at in detail and these contained a number of documents that described each persons care needs and any associated risk assessments. The Care Homes for Older People Page 12 of 26 Evidence: care plan format is one of a tick-chart with space for a comment regarding specific care needs. These forms give consideration to all activities of daily living such as personal hygiene, mobility, communication, eating and drinking and nutritional needs, and family relationships. Assessments had been undertaken with regard to the risk of falling and wandering at night due to confusion, difficulties with swallowing and the risk of choking, skincare and the risk of developing pressure sores and anything identified particular to each person. Although each of these documents was brief, taken together they provided a picture of the care and support required by each person and the actions required by staff. There was a a clear record of GP and district nurse visits and the outcome of these visits. The daily care notes were clearly written and enabled an easy review of significant events. Each of the three care plans and the risk assessments had been reviewed monthly and a summary of the months events made, as well as a record of the persons weight to monitor for weight loss. Mrs Huntley was advised to ensure that any changes recognised at these monthly reviews were transferred on to the care plan document to ensure this reflected an up-to-date picture of somebodys needs. Medication practices were seen to be safe as each persons medicines are stored separately, thereby reducing the risk of errors. Medicine is directly administered from the containers it is dispensed in and there was an up to date record of when medication was administered. Each of the persons care plans looked at contained a list of their medication as well as patient information leaflets are detained from the local pharmacist regarding the use of the medicines and any possible side-effects. Mrs Huntley explained that people were encouraged to remain responsible for their medication if they were able and wished to do, and currently one person was doing so. Mrs Huntley explained that they worked with GPs to avoid medication wherever possible, particularly for sedation, and a healthy diet was provided to avoid the use of laxatives. People who develop terminal illnesses are able to stay at Venville House if the District Nursing Service and the staff are able to meet their changing needs. Where known, wishes relating to the persons end of life and funeral arrangements are recorded in their care plan. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Venville House are given a good level of support to be able to maintain contacts with family and friends. Meals are well cooked and suited to peoples needs. Evidence: Venville House is registered to accommodate only eight people and this is one of the things people valued. Mrs Huntley and her staff provide a home from home and look to avoid any institutional routines. People are spoken to each day about what they would like to do, either individually or with others. Several leaflets for places of interest in the local area were on the table in the hallway to help people choose to do something different from time to time. On the day of the inspection, three people had gone into the town with a member of staff. People are offered the opportunity to go out to visit the local cafes, to go for a drive, and to visit the local town. Mrs Huntley said an extra member of staff was on duty on Mondays, and on other days if events are organised and needed extra staff, to enable people to spend the day out if they wished. In the care notes for one person, it was noted she had requested to visit the local Prison Museum and this was arranged for Care Homes for Older People Page 14 of 26 Evidence: her. In the AQAA, Mrs Huntley confirmed that should someone wish to go away for a few days holiday they are supported to do so by the staff. One of the reasons that people have chosen Venville House is that it has allowed them to maintain contact with family and friends who live in the area, some of who visit on an almost daily basis. Mrs Huntley and staff are commended for their efforts to provide interest and stimulation for people who are at risk of isolation due to their dementia related confusion. People said there were no rules that they have to comply with, for example getting up and going to bed, and people are free to leave the home for a walk if they wish. Although the front door is fitted with an alarm, this is to alert staff to anyone leaving and to allow them to accompany the person should that be necessary. Staff said they always try to accommodate any wishes to go out. There are three dogs at Venville House, two belonging to Mrs Huntley and one belonging to a person living in the home. People were seen to be enjoying their company and the person who owns one of the dogs said he is free to come and go with his dog as he pleases. He said he was grateful for the staffs help in looking after his dog. The menu at the home is traditional and very much enjoyed people. Mrs Huntley confirmed that locally sourced meets and fresh vegetables are used daily and often these are organic. On the day of the inspection people were offered chicken pie with mashed potatoes, cabbage, carrots, parsnips and gravy, and dessert was a choice of peach Pavlova or creme caramel. Alternatives to the main menu were available such as a baked potato or sandwiches. Snacks, fruit and hot and cold drinks are available throughout the day. Mrs Huntley confirmed she is planning to put a fridge and freezer in the dining room to allow people to help themselves to drinks and ice creams etc. If someone is able to make themselves a drink or snack they are supported to do so by staff to maintain their independence. People are able to eat as a group in the dining room, or to sit at separate table, depending on what best suites their needs. The planned menu showed a roast meal twice a week and a cooked teatime meal: the menu is planned in consultation with the people living in the home and they are asked what meals they would like. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place to ensure any concerns people may have are listened to and taken seriously, and that they are protected from abuse. Evidence: The Commission for Social Care Inspection has received no complaints or concerns regarding Venville House. In the AQAA, Mrs Huntley confirmed that she had received 4 complaints since the previous inspection. These were looked at and related to issues such as clothing not being put away to the persons satisfaction and a blanket with a hole in. The concerns had been well documented and the actions taken by the staff recorded. People said they found the staff and Mrs Huntley approachable and could talk to them easily about any issues. A complaints and suggestion box is in the hallway to allow people or visitors to make their views known, anonymously is wished. Mrs Huntley formally asks people and their relatives to complete a questionnaire about their views of the home and the most recent results from the questionnaires in January 2009 showed a high level of satisfaction. Mrs Huntley confirmed people are given a copy of the complaints procedure when they first move to the home. Staff training records provided evidence that staff have received training the Mental Capacity Act and deprivation of liberty with regard to peoples mental health needs and their involvement in choices about their lives, as well as promoting equality and diversity and the protection of vulnerable adults. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Venville House provides a comfortable and domestic scale environment where people can feel at home. Evidence: Venville House accommodates eight people and is domestic in scale, it is particularly suited to the needs of people with dementia, who might find a larger or a more institutional service harder to cope with. Mrs Huntleys children spend some time at Venville House and people are made aware that there will be both children and animals in the house. The house was clean and bedrooms, the lounge area and kitchen were tidy and in good order. Bedrooms were seen to be personalised with items people had brought from home. Locks are fitted to all bedroom doors, so that people have the option of having a door key for privacy and to secure their belongings when out of their room. Mrs Huntley was in the process of decorating some of the bedrooms as mildew had formed around the windows due to condensation. The majority of radiators were covered to reduce the risk of burns should people come into contact with the hot surface. There was a bathroom on each floor, and each bath was fitted with an electronic bath Care Homes for Older People Page 18 of 26 Evidence: seat enabling easier movement in and out of the bath. The hot water temperature to the baths was controlled to reduce the risk of scalds. Mrs Huntley confirmed that the bathroom on the ground floor was due for refurbishment. Confidential information is kept in locked cupboards and Mrs Huntley was in the process of rearranging where the office documents and computer were going to be permanently located. At the time of the inspection some information and the computer were in the conservatory and other documents were kept in the dining room and an office at the rear of the building. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Venville House has a good level of staffing. Staff are well trained. Recruitment procedures ensure as far as possible only suitable people are employed. Evidence: People said that the staff were kind and caring and assisted them promptly when they needed help indicating that there were sufficient staff on duty. At the time of the inspection there were three members of staff on duty as well as Mrs Huntley. Two care staff were on duty in the evenings and one waking and one sleeping-in member of staff on call during the night. The staff on duty were spoken with and all confirmed they felt very well supported by Mrs Huntley and the other staff. They confirmed they had been given the necessary training to understand the needs of people living in the home and receive regular individual supervision with Mrs Huntley. The recruitment records for two care staff were looked at, including one person who had recently started work at Venville House. Each contained a completed application form, two written references and checks on whether the staff member had been referred to the Protection of Vulnerable Adults list or had any criminal convictions: all Care Homes for Older People Page 20 of 26 Evidence: these documents had been obtained prior to the person starting work. This ensured as far as possible only suitable people were employed at the home. There was a record to show that each person who had started work at the home had been provided with induction training with support from Mrs Huntley and an external training provider. Training indicated that staff had recently received training in first aid, fire safety training and the protection of vulnerable adults. The majority of the staff (89 ) have obtained a NVQ qualification, a nationally recognised qualification in care. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Venville House is well managed and the service is focused on the needs of the people who live in the home. Evidence: Mrs Huntley has owned Venville House for many years. She is registered with the commission as the manager as she manages the home on a day-to-day basis. She has completed NVQ in Care at level 4 and the Registered Managers Award, both nationally recognised qualifications for which Mrs Huntley had to demonstrate her skills and competence in understanding the care needs and managing a home for older people. The home has a formal quality assurance system in which Mrs Huntley formally consult with the people living in the home and their relatives regarding their views on the quality of service provided. The most recent consultation took place over December 2008 and January 2009 and the results demonstrated a high level of satisfaction. One relatives said they were very happy with the care provided and another that the Care Homes for Older People Page 22 of 26 Evidence: standard of care was excellent. From discussions with people and reviewing the comments made by their relatives, it was very clear that this is a service that is focused on the individuals who live in the house. The home does not look after any money for anyone living in the home and either they or their relatives retain responsibility to this. Fire records were looked at during this inspection; these were up to date. Weekly checks and bi-annual servicing of the fire system show that it was well maintained in good working order. Staff had received regular training in what to do in the event of a fire and a fire risk assessment had been completed. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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!