Inspection on 19/11/08 for Whitelodge

This inspection was carried out on 19th November 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitelodge 31/12/05

Whitelodge 12/12/05

Whitelodge 25/07/05

Whitelodge 25/01/05

Whitelodge 25/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Whitelodge 101 Downend Road Fishponds Bristol BS16 5BD     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: Kath Houson     Date: 2 0 1 1 2 0 0 8 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 28 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Whitelodge 101 Downend Road Fishponds Bristol BS16 5BD 01179567109 01179025636 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) : Quality Care Homes Ltd care home 21 Number of places (if applicable): Under 65 Over 65 21 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 21. The registered person may provide the following category of service only: Care home Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Whitelodge is a care home which provides accommodation for 21 older people. The home can be found in the residential areas of Fishponds and Downend in Bristol. The home can be described as an older type property which has bedrooms for single occupacy. Some of the bedrooms have en-suite toilet facilities. The house has been extended over the years to provide further accommodation on to the second floor. The main objectives of the home are to ensure an excellent quality of life for the residents; and to provide first class care in a friendly, relaxed yet stimulating environment. The area of Fishponds has many facilities, such as local shops and pubs, colleges, churches and parks. There are bus services which provide routes into central Bristol, and the South Gloucestershire area of Staple Hill, and the other neighbouring Care Homes for Older People Page 4 of 28 Brief description of the care home areas such as Hanham. The fees are based on individual assessments and range from £400-£570 per week. Fees are also subject to the level of care or mental health needs of the potential resident. Items not included are; hairdressers, personal toileteries, chiropody, newpapers some social activities. The property has a large car park for several vehicles which can be found to the rear of the home. Twenty-four hour staff cover is provided; the home does not provide nursing care. Care Homes for Older People Page 5 of 28 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: This is an overview of the findings found during the inspection. We looked at information we have received since the last inspection visit How the service dealt with any complaints & concerns since the last visit. Any changes to how the home is managed how well they care for people living at the home. The visit: An unannounced visit was made on the 17th and 18th November 2008. During the visit we: Talked to people who use the service, staff, the manager and relatives. A telephone interview also took place with other relatives. Their comments are included throughout Care Homes for Older People Page 6 of 28 this report. Looked at information about the people who use the service and how well their needs are being met. Looked at other records such as their policies and procedures, staff rotas, and the medication procedure. Discussed, with the staff team that they had the skills and knowledge and training to meet the needs of the people who use the service. Looked around the building and did a tour of the premises to make sure that the home is clean, safe and comfortable. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 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 28 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 receive enough information prior to admission into the home which ensures that only individuals whose needs can be met are admitted into the home. Evidence: Since the last inspection the home has had two new admissions. Pre assessment documents were looked at and found to be supported by the homes admissions practices. For instance, the manager made arrangements to visit the potential residents to assess their needs. This was later confirmed by the documentation and during a discussion with the people living in the home. One resident said I was given more than enough information about the home before I moved in. Admissions into the home only take place if management is confident that they are able to meet the assessed needs of potential people who choose this home as their place of residence. Another resident said my family looked around a few homes and this was the best one. The service has a detailed Statement of Purpose which contains the relevant Care Homes for Older People Page 10 of 28 Evidence: information and the aims and objectives of the service provision. The Statement of Purpose would be available for those with complex sensory needs. For example in large print. Residents and their relatives both made comments about the information they received about the home prior to admission. Comments included yes and they visited mum in her respite home and we visited a couple of times to spend time here, yes my sister did and is very happy with finding this home. Care Homes for Older People Page 11 of 28 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. People are confident that care plans proplerly record how their needs are to be met. Risk assessments are comprehensive which encourages individuals to live the life they choose. People are protected from errors by effective medication practices. Dignity and respect is maintained and people understand they have rights within the home. Evidence: A number of care plans were selected and found to be person centered and individualised. Each care plan has been agreed with relatives and signatures of the people who use the service were seen, to confirm individuals involvement in the development of their care. People with complex health care needs are monitored closely and support is obtained from other health care professionals. The care plans were well documented; one relative spoken with said my relative was well cared for during their time of illness, all the staff looked after my relative brilliantly, other relatives said, we are encouraged to attend meetings concerning our relatives plan of care. Care Homes for Older People Page 12 of 28 Evidence: The service encourages a positive atmosphere where issues can be discussed such as disability. The manager recognises when a persons health needs change then alternative arrangements are made. For example, one individual had to be relocated to a room in a different part of the house to meet their individual needs. The risk assessments were completed in each care plan and there was evidence to show that they are reviewed regularly for instance, changes to peoples health care needs are reassessed accordingly. The service has reviewed its medication practices; all medication charts were looked at and no omissions were seen. An effective medication system exists with regular audits signed off by staff. The pharmacist takes part in the training of staff in the administration of medicine in the home to ensure that any drug errors are kept to a minimum. People are spoken to respectfully, dignity was maintained at the time of the inspection. Staff knocked on peoples door before entering. Visitors are welcomed and an open door practice exist. For instance a relative said we have the option to have meals with our relatives. Additionally people have the choice to have church mass at the home or attend mass at the local church, relatives are very active and remain constant in the lives of people who live at the home. Care Homes for Older People Page 13 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People maintain contact with their family and friends and have a flexible lifestyle at the home; peoples voice and opinions are taken onboard and concerns are addressed;meals are well balanced and meet peoples dietary needs. The increase of stimulating activities would be of benefit to people which would enhance their mental health and well being. Evidence: People using the service are given the opportunity to take part in a variety of activities both within the home and in the community. This information is based; on the homes Statement of Purpose, the homes completed Annual Quality Assurance Assessment form (AQAA) and from discussions with the manager. The AQAA states, regular afternoon activities and regular entertainers visit the home. The homes newsletters informs people of up and coming events. Hiring a vehicle means that people can go out on big trips. For example a day trip to Weston Super Mare was arranged in the summer. During a telephone conversation with a relative who mentioned concerns about activities in the home said there was not enough activities going on in the home and I visit the home regularly and often Care Homes for Older People Page 14 of 28 Evidence: unannounced. A relatives written response to the question in a recent survey, Are there activities arranged by the home that you can part in? responded usually. Another response from a health professional states in their survey it would be good, ideally to see more mental stimulation for the residents. Due to the number of people with dementia, management need to take on board the above comments. This would help to promote peoples well-being and mental health. A relative spoken with said I am my mothers main carer and I would see that she is well cared for at Whitelodge. The manager also said many of the relatives who visit maintain their responsibility to their relatives whilst they are in the home. This would show the home encourage and maintain contact with family and friends. This was also observed during the inspection where several relatives were visiting throughout the day. The family of many of the people who use the service manage their finances. This is evident in care plans and during a recent conversation with a relative during the inspection. People are encouraged to exercise choice and control over how they wish to live their lives whilst in the home. For instance the home has regular residents meetings. At the residents meeting of September 2008 they discussed meals, where all the residents were happy with the food and meals that are being served. Residents also asked if they could have their breakfast at a different time and that everything at the home was OK. This shows that the home encourage people to voice their opinions and promotes an independent lifestyle. During the inspection people were having lunch and the food looked appealing. The cook is dedicated to providing good quality food and enjoys cooking the meals. There were comments from a number of people who said the meat was a little tough. The cook came out into the lounge where people where having their meal and apologised. The cook went on to say I will talk to the butcher about the meat being a little tough. The people who use the service were satisfied with that response. Recent conversations with a relative said the food is good and often I turn up to have a meal with my mum. The meals are balanced and nutritional and cater for speicalised dietary needs of the people who use the service. Care Homes for Older People Page 15 of 28 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. The home has a complaints procedure which encourages people to voice their views and opinions. Procedures for the protection of vulnerable adults provide clear guidelines for members of staff to follow which protect people who use the service from abuse and neglect. Evidence: The home has an open culture which encourages people and their relatives to express their views and concerns in a safe and understanding manner. For instance, one relative said I had a concern about my mums health and asked to see her care plan. The manager showed the care plan and discussed the concern with the relative. The relative was satisfied with the response and continued to say I no longer have any concerns with the home just that one incident where I was not happy with mums care. The home has a complaints procedure in place which is discussed at the residents meetings when new people are admitted into the service. This ensures residents new to the home are kept informed about the complaints procedure which is made accessible to them. Some relatives were complimentary about the service provided at Whitelodge and said Care Homes for Older People Page 16 of 28 Evidence: thank you very much for all the help, support and kindness shown to my mother during her short stay with you. I know she was very happy at Whitelodge and for that myself and family are very grateful. Other relatives also said, thank you so much for all the kindness you showed to my relative during her few months with you, she was very happy, very contented in Whitelodge and appreciate all you did for her. Staff guidance is in place for dealing with allegations of abuse. A random inspection took place in September 2007 with regards to the manager obtaining Protection of Vulnerable Adults (POVA) first checks from any individuals prior to the start of employment at the home. This has been partially met and the manager was able to show a list of POVA training which had been planned for the staff team. The staff files also show Criminal Records Bureau (CRB) certificates. Staff spoken with were able to discuss their understanding of how the home deals with abuse and neglect. Care Homes for Older People Page 17 of 28 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. People live in an environment which meets their needs. The home is comfortable and cosy with personalised rooms. People would benefit from attention being given to the appearance of bathrooms. Evidence: Whitelodge is a detached house which can be found in Fishponds/Downend borders of Bristol. The home is close to shops in Fishponds Road which has a number of facilities. The local pubs and parks; post office, shops and large supermarket, can be found in the busy area. There are local bus routes into the center of Bristol. The house has been expanded over the years and is in a good state of repair and well decorated. The bedrooms seen during the inspection, vary in size and have en-suite toilet facilities. Each bedroom has a hand held call bell for people to use for gaining assistance during the day or at night. The communal areas consist of 2 large lounges. Lift access to the bedrooms on the first and second floors was available and in working order. The en-suite toilet seats in several of the bedrooms were stained. This was discussed with the manager. Also the water taps in all the bathrooms were heavily clogged with lime scale. It was suggested to the manager that this could be removed with lime scale remover. In a recent Care Homes for Older People Page 18 of 28 Evidence: residents survey sent by us which asked the question is the home always clean and fresh? The residents response was always. The home was found to be clean and tidy with no offensive smells. Care Homes for Older People Page 19 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are generally satisfied with the care they receive. However, references must be obtained with a satisfactory criminal records check to ensure that people who use the service are kept safe at all times. Evidence: There are a long standing staff team and were complimentary about working in the home. The residents too spoke positively about the staff and said the girls are very friendly and treat us with respect, the staff are always good and treat me well, the staff always look after me. The staffing rota shows there are enough members of staff on shift throughout the day and night. Staff spoken with were National Vocational qualified (NVQ) Level 3, and have completed many of the mandatory training such as, health and safety, POVA, food hygiene, medication training and fire safety, first aid. Updates in specialist subjects have also been completed. These include; problems with eating and drinking, stroke management, dealing with bereavement, understanding diabetes and dementia training, basic life support (BLS). These subjects equip the staff team with the relevant skills to assist the residents with their health care needs. The homes recruitment practices have been improved since the last random Care Homes for Older People Page 20 of 28 Evidence: inspection. The findings state that the manager must check for CRBs and POVA first before the start of employment at the home. Several staff files were looked at and contained, the job description, the terms and condition of the post, the recent enhanced Criminal Records Bureau (CRBs) checks. However, a staff file which was looked at showed to have a reference missing and a CRB which failed to reflect a satisfactory history. The manager must ensure that robust checks are made before accepting potential employees into the home. This is to maintain the welfare and safety of the people who use the service. The manager was able to show the planned POVA training which was due to take place in January 2009. Other training in which staff were able to participate include, manual handling, advanced resuscitation, infection control and tissue viability. These help to improve the level of knowledge on the management of pressures sores. All new members of staff undertake an induction training within the home. This equips the staff team with the relevant skills needed when providing care to the residents. Care Homes for Older People Page 21 of 28 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. The service works toward a clear health and safety procedure. The manager has an open door policy which makes the home a welcome place for both the residents their families and the staff team. Evidence: The manager has the relevant qualification and experience in providing care to the elderly. There are opportunities for the residents and staff to express their views about the service. This was evident from the residents and staff meeting which regularly take place and the notes were made available. Regular residents and staff meetings encourage and promote an open culture of the home. Staff said the manager is brilliant and very very helpful. The staff said the manager is supportive. Regular notifications are sent into the Commission which informs us of any changes to the residents needs.The homes recent completed Annual Quality Assurance Assessment form contained the information we need to assess how the home is being Care Homes for Older People Page 22 of 28 Evidence: managed and to look at any improvements that may have been made. The homes policies and procedures were made available during the inspection and show that the home is managed in the interest of the people who use the service. There are systems in place to check on the quality of the service. The manager was able to show the questionnaires that were sent out. The responses from the questionnaires are; the home is warm and welcoming, first class staff always approachable. The quality assurance feedback show positive outcomes for the people who use the service. The home has a clear health and safety policy where regular checks are carried out. The home has had a pharmacy audit twice a year and the findings were reported as good. Health and safety checks, which were carried out in September 2008, the equipment and the water temperatures are regularly checked to ensure that the home is a safe place for both residents and the staff. The staff team are supervised on a regular basis and use this as an opportunity to discuss concerns with the manager. We saw the daily life of the home to be warm and comfortable experience for the residents; the home is busy and relatives can come and go as they please; people can exercise choice in terms of drinks and food, in what they want and when they want it. There is a need for management to pay greater attention to the levels of stimulation provided by the service as indicated in the adequate judgement in daily life and social activities. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 29 19 Schedule 2 The manager to ensure that 05/09/2007 (3) two written references to include one relating to the persons last period of employment, which involved work with children or vulnerable adults, of not less then three months duration. Written verification of the reason why the perspective employee ceased to work in that position unless it is not reasonably practicable to obtain such verification. (This would apply if employment was less then 3 months) Requirements partially met: 2 29 19 Schedule 2 The manager to ensure a 05/09/2007 POVA First check is obtained before any individual commences employment in the home. CRB to be obtained and if not received or obtained before employment the individual can only work under supervision. (The working of waking night can only take place where there is another employee also working waking night shift.) This must only take place ie employment and individual commences work in the home where it is necessary Page 24 of 28 Care Homes for Older People to maintain the level and meet needs of individuals who live in the home. Requirement partially met. Care Homes for Older People Page 25 of 28 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 1 12 16 The registered person shall maintain regular and ongoing programme of activities and provide facilities for recreation. This would enhance peoples health and well being. This ensures stimulating activities for people in the home 23/04/2009 2 29 19 The registered manager must obtain two references for all potential employees prior to the start of any employment at the home. This is to ensure that people who use the service are kept safe at all times. 23/04/2009 3 29 19 The registered manager must obtain a satisfactory CRB check before the start of employment. People are to be kept safe and free from potential harm at all times. 23/04/2009 Care Homes for Older People Page 26 of 28 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 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 28 of 28 - 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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