Inspection on 04/03/08 for Virginia Lodge

This inspection was carried out on 4th March 2008.

CSCI found this care home to be providing an Excellent 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.

Other inspections for this house

Virginia Lodge 04/07/06

Virginia Lodge 27/02/06

Virginia Lodge 24/09/05

Virginia Lodge 24/02/05

Virginia Lodge 27/09/04

Virginia Lodge 04/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Virginia Lodge Old Road Longtown Carlisle Cumbria CA6 5TL Lead Inspector Nancy Saich Unannounced Inspection 4th March 2008 10:00 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 Virginia Lodge DS0000022698.V356434.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. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Virginia Lodge Address Old Road Longtown Carlisle Cumbria CA6 5TL 01228 791986 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 Julie Walsh Mrs Julie Walsh Care Home 32 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (10), Learning disability over 65 years of age of places (1), Old age, not falling within any other category (32) Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 32 service users to include: up to 32 service users in the category of OP (Old age, not falling within any other category) up to 10 service users in the category of DE(E) (Dementia over 65 years of age) up to 1 service user in the category of LD(E) (Learning disability over 65 years of age) up to 1 service user in the category of DE (Dementia under 65 years of age) Date of last inspection 4th July 2006 Brief Description of the Service: Virginia Lodge is a residential care home for up to thirty-two older people, some of who may also have dementia. It is managed by Mrs Julie Walsh. She and her husband own the service. The home is located approximately one mile from Longtown and is in a rural setting. The building is single storey and accommodation is mainly in single rooms, although people can choose to share a double room. Some of the rooms have ensuite toilets and wash hand basins. There are a number of shared areas and the home has its own gardens, including a secure garden for people with dementia. The fees range from £380 to £460 per week. Further information can be gained from the home at the above address. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 Star. This means the people who use this service experience excellent quality outcomes. This was the main or ‘key’ inspection for the home for this year. Some weeks before the inspection the lead inspector Nancy Saich asked the manager to fill out a form called the Annual Quality Assurance Assessment (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was completed promptly and with plenty of detail. We then sent out postal surveys to people who live in the home and their relatives and friends and to the staff group. We had a good response to these surveys and we quote from them in the report. The responses were very positive and gave us a good picture of what its like to live and work in the home. We visited the home and spoke to residents, staff and the management team. We toured the building, sat in lounges and shared a meal with residents. We also looked at files and documents that backed up what was said and what was seen. What the service does well: The manager is careful to only admit new residents once she knows that she can give them the care and services they need. She is also very good at giving them the right kind of information before they decide to come in. This home is very good at planning the kind of care that people want and need to allow them to remain independent, safe and happy. People in the home get good medical care and the staff look after their medication properly. People who live in the home told us that they could spend their time very much as they want. They were happy with the activities and entertainments offered to them, and were keen to do more things. We saw evidence to show that staff tried to do something with residents every day. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 6 People were very positive about the quality of food offered in the home, and we shared a very well prepared meal with them. We saw and heard plenty of evidence from staff and residents to show that this home listens and act upon complaints. We also checked out by talking to people and by reading notes, that vulnerable people in this home we are protected from abuse. Staff were very sure about how they would act if something were wrong. The home was warm, clean and tidy on the day of the visit. Residents were happy with the levels of hygiene in the home. Bedrooms and lounges were nicely decorated and furnished with good-quality furniture. The home has pleasant gardens that residents enjoy using in the summer months. This home is suitably staffed with a very dedicated team of workers. The manager is careful about recruitment and then develops staff appropriately. The staff team are well trained and qualified and show this by the way they work sensitively and patiently with the people who live in the home. The manager is a suitably experienced and trained person. Her management systems were tailor-made to the needs of people living in the home and to the staff group. We were told that the home runs smoothly and we saw high levels of satisfaction during all our discussions on the day and in the high level of surveys that were returned to us. The managements systems allow people to live a safe, comfortable life free from anxiety. What has improved since the last inspection? What they could do better: There was nothing of concern that needed to be improved on seen during this inspection. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 7 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 be made available in other formats on request. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 8 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 Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home makes sure that they only admit new people who they know they can care for and who will fit in with the rest of the group. EVIDENCE: The manager told us in the AQAA that a member of the management team sees every new person either at home or in hospital, and that they in turn can come to see Virginia Lodge. Surveys told us that residents were happy with the way their admission had been arranged. We also spoke to one new person who confirmed what we had learnt. Files contained good records of the admission procedure. People who live in the home were happy with the information they received before they came in. New residents also receive a questionnaire after the first few weeks that asks them whether they were satisfied with the way the admission was handled. The home has an up to date brochure and statement of purpose that explains to new people what the service can provide. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 10 This home does not provide intermediate care. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. People who live in this home told us that they were well looked after and very satisfied with the way their health and personal care was managed. EVIDENCE: We checked on this outcome by talking to people who lived in the service, by reading reports and by observing how staff cared for residents. People looked happy, well groomed and settled. They were comfortable and at ease in their surroundings. Every resident at Virginia Lodge has a written plan that explains to staff what they can do for themselves and what they need help with. The manager tells us in the AQAA that these plans are checked on at least once a month and that the staff seek advice from specialists when necessary. She feels that they have improved these by including a daily care plan that explains to staff how people like to spend their day, what they need help with and when. We read a number of these plans and found that they were very detailed and included the Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 12 small things that make life worth living. For example one person said she didnt like sloppy food - and it was in her plan and her food was to liking. We read a good number of the plans and these confirmed all the things we had been told and what we had seen. They were detailed and personal and were thoroughly reviewed at least monthly. The plans for people with dementia gave staff good instruction about how to deal with people who may become disorientated or distressed. The unit for people with dementia was a very calm and happy place. The AQAA tells us that residents can have medical help whenever necessary and that specialists like opticians, dentists and chiropodists give residents treatment in the home. We were also told that other specialists, for example the Community Psychiatric Nurse, are used if a resident has a specific problem. Relatives told us in surveys that they were happy with the care provided: • “I think they provide a good stable home environment with 100 personal care to each individual resident. The food is of a high standard, the bedrooms are warm and comfy and the menus have different choices. Our mother likes living here and she loves seeing her friends everyday, and we are very pleased as its such a friendly place.” We also learnt from people who live in the home that they were happy with the medical care and attention given to them. The local doctor was due to come to the home to review everyones care and the medicines given to them. We checked on the medication held on behalf of people and we found that everything was correctly accounted for, and that the manager checked it regularly. People are encouraged to manage their own medicine when possible. The home does not rely on sedative medicines for people with dementia and we judged that this was good practice. The people we spoke to, the postal surveys and our observation on the day lead us to believe that this staff team treat people with respect and dignity. As one person with dementia told us: • “We all get on well together here, these are nice people and we are all treated properly.” We also noted that people who could not communicate responded warmly to staff presence. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 13 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. Residents in this home enjoy their lives and feel that they have things to look forward to. EVIDENCE: One or two of the surveys said that it would be good if there were more outings available. The manager tells us in the AQAA that they have listened to residents and are trying to meet their needs in terms of activities and outings. They have employed staff who are trying to develop a program that will meet everyones needs. They have asked favourite entertainers to come back to the home and have organised cultural entertainments that meet specific peoples needs. There are regular monthly residents’ meetings where people can express their opinions, make complaints or suggestions. We saw the minutes of these meetings and found that residents’ suggestions had been put into action. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 14 The manager is encouraging staff to work with Residents who want to compile a life storybook. This will help staff to understand the resident as a whole person, and helps people to retain - or to gain - self esteem. We saw that residents had been doing some art and crafts and getting involved in other leisure pursuits. On the day of the visit one group of people were playing carpet bowls and the other were celebrating a birthday. We were interested in the fact that the manager has bought a number of books about activities for people with dementia and we look forward to hearing about how they have added to the range of activities people enjoy. We enjoyed a relaxed and well-prepared lunch with the residents. People were helped with managing their meal in a discreet and sensitive way. Surveys tell us that people are happy with the meals provided. • • “The food is very good. I have no complaints at all. Everything is done for me and I like that.” “I love the meals and Im allowed to choose what I want to eat.” Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 15 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 excellent. This judgement has been made using available evidence including a visit to this service. People who live in this home know that their complaints and concerns will be listened to and acted upon. EVIDENCE: No one had any complaints or concerns on the day. People who live in the home knew how to complain and who to complain to. They said that any minor things were dealt with straight away. They said that they trusted the manager, her husband and senior members of staff to deal with anything serious in an appropriate manner. We asked both experienced and inexperienced staff members about how they would protect and support residents if there was anything wrong. They were able to explain to us in a confident and correct manner how they would go about protecting vulnerable older people. They knew how to access outside agencies and would not hesitate to do this if necessary. The home has a very good complaints procedure and suitable details of how to safeguard residents. The manager was also planning further training for staff on both understanding and recognising potential abuse. She also spoke of her plans to train the staff in understanding matters related to equality and diversity so that they would understand any discriminatory behaviour. The staff had access to the most up to date information on safeguarding adults. One survey told us: Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 16 • “I don’t worry about my relative as I know they are in good hands”. Virginia Lodge DS0000022698.V356434.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 good. This judgement has been made using available evidence including a visit to this service. This is a warm, clean, comfortable home where residents feel safe and relaxed. EVIDENCE: The home is situated approximately a mile from Longtown along a country road. It is a single storey building that has been adapted to meet the needs of older people. It is set in its own pleasant grounds and has views of the surrounding countryside. This is very much a country home but the staff make sure that people can access the amenities of Longtown and Carlisle. On the day of the visit we walked around the building both inside and out. Externally the gardens and parking spaces are well maintained. There is a small enclosed patio area that is used by people with dementia. There is plenty of seating outside for residents who want to walk around the grounds. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 18 A lot of people in this home come from rural areas and they enjoy being in the country and the solitude of the situation. Inside the home was clean, fresh and tidy. Bedrooms and shared lounges were nicely decorated and furnished with good-quality furniture. There are a number of lounge areas where people can sit, socialise and relax. Most people have a single bedroom and some of these have a toilet and wash hand basin ensuite. There are double rooms available for people who wish to share. People told us that they were happy and comfortable in Virginia Lodge. • “ My room is very nice, always clean and tidy and everything is nice and warm and cosy.” A number of people had special beds to help them to be as comfortable as possible. There are suitable bath and shower rooms with special adaptations so that everyone can use the bathroom in comfort. Everyone who spent a lot of time in a wheelchair had their own that had been measured for them. We saw staff using hoists and other mobility aids correctly so that people were at their ease. We also saw paperwork that showed us that helping people to move was done in a planned way and that staff were fully trained and competent. The home has improved the laundry facilities and has one person whose job is just to wash and iron clothes. Personal and bed linen were clean and fresh and residents were happy with the way their clothing was cared for. All around the home we saw that the correct equipment and materials are available to keep down any infection. Staff had been trained in infection control and they went about their work with the care needed to keep things in an orderly way. The laundry and the main kitchen were well-organised and suitable records kept to prove that this was always the case. Virginia Lodge DS0000022698.V356434.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. This home has an experienced and well-trained staff group who showed us that they keep the needs of the residents at heart of everything they do. EVIDENCE: We saw the last four weeks of rosters. These showed us that normally there were five people in the morning and four in the evening to care for the residents. They are assisted by a number of housekeeping staff who cook meals and keep everything clean. At night there are two waking night staff. The manager lives on the site and she is always on call. We could see that each day the mix of staff was very good, with experienced and newer staff being on together. At times there is a male member of staff on duty and a number of people said that they like this mix. The staff said that although there were some vacancies at the moment they did not mind working extra until they found the right people to make up the team. We looked at the files of the last three people who had been taken on. These records contained the original application form, two references and suitable checks on background. We also spoke to the manager who was fully aware of how she should recruit new staff. She said that in the future she was going to involve residents more in this. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 20 The manager told us that over 80 of her care staff have National Vocational Qualifications in care at level 2 or three. Newer members of staff told us that they were registered and had started to work on their portfolio. We checked on a selected number of staff files and found that staff had received induction, in-house training and had gained certificates for external courses. Staff were trained in all the basic skills necessary for looking after older people and we could also see that groups of staff had attended other training courses that met the needs of the job. These had included managing medicines, safeguarding people, understanding and supporting people with dementia, preventing pressure sores, activities for people with dementia and understanding mental health needs. Staff told us they enjoyed their work: • “I like working in Victoria Lodge. We are a good team and we work well together. Our manager is always there to give us support”. The manager had plans for the following year that included training on understanding the new Mental Capacity Act, understanding equality and diversity and on different aspects of caring for people with dementia. Virginia Lodge DS0000022698.V356434.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): 31,33,35,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This is a well managed home where people feel relaxed because everything runs smoothly. EVIDENCE: The manager and her husband own the home. They are both fully involved in the life of the home. They lived on the premises and run things very much as a family business. People who live in the home know them both very well and said they trusted and respected them. Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 22 • “ They are grand! Always around, always willing to talk and listen to what we say.” The manager is experienced and suitably trained in both care and management. She has the Registered Managers Award and keeps herself up to date by reading and using the Internet. She has developed a quality assurance system that is based on the law and on the work of the home. We could see that she uses this all the time to make sure that the systems are working correctly. She also has different ways of consulting residents and their families about how the home operates. More importantly we saw evidence to show that improvement came directly from this quality assurance exercise. We checked on money held on behalf of residents and found that this was accounted for properly. We saw very good records that showed that all regular maintenance and safety checks were completed as part of the quality monitoring. In some cases the checks were more than the law requires. For example every person in the home has fire training every eight weeks –rather than the required three or six months. The management team that think this is necessary because the home is in a very isolated situation. This is an example of how well they assess risk, check quality and make plans that fit their service. We walked around the home and could see that it was hazard free and we also saw that staff were used to working in a very organised away. There were good records of all the training and checks that are needed to maintain good health and safety. Local environmental health officers and the fire officer had also inspected the home. There was nothing of concern seen in their reports and the home has been awarded four stars for their food hygiene. Virginia Lodge DS0000022698.V356434.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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 4 Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Virginia Lodge DS0000022698.V356434.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Virginia Lodge DS0000022698.V356434.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. 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