Inspection on 04/04/06 for Winthorpe Hall Care Home

This inspection was carried out on 4th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Winthorpe Hall Care Home 27/08/08

Winthorpe Hall Care Home 12/11/07

Winthorpe Hall Care Home 12/01/07

Winthorpe Hall Care Home 19/09/05

Winthorpe Hall Care Home 20/07/05

Winthorpe Hall Care Home 21/03/05

Winthorpe Hall Care Home 27/07/04

Winthorpe Hall Care Home 29/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Winthorpe Hall Care Home Gainsborough Road Winthorpe Newark Nottinghamshire NG24 2NR Lead Inspector Steve Keeling Unannounced Inspection 4th April 2006 11:00 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 Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 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. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Winthorpe Hall Care Home Address Gainsborough Road Winthorpe Newark Nottinghamshire NG24 2NR 01636 701826 01636 701234 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) Mr R C Pountney ** Post Vacant *** Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the total number of beds, a maximum of 28 may be used for the category OP 19th September 2005 Date of last inspection Brief Description of the Service: Winthorpe Hall is a residential care home registered to provide personal care and accommodation for up to 28 older people. The home is privately owned and is situated within a small village, just north of the market town of Newark. Major road networks are located a mile away and there is a local bus service into Newark. There are a small number of amenities available within the village itself. Winthorpe Hall is a very spacious, converted and extended building providing accommodation on three floors, to which a passenger lift aids access. The main lounge areas and dining room are on the middle floor and smaller sitting areas are on the ground floor. Entrances are accessible to wheelchair users. Bedrooms are spacious and some offer en-suite facilities. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 4.5 hour period and involved one inspector. The main method of inspection was case tracking, this is a method of selecting residents within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the computerised records of the residents to ascertain if the residents identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two residents notes were case tracked. At the time of the inspection a total of 21 residents were accommodated at the home. It was evident that the acting manager and care staff within the home are committed to providing an appropriate standard of care for the residents. The acting manager and staff within the unit were very helpful and cooperative thus ensuring that the inspection process progressed in a professional and efficient manner. What the service does well: All residents spoken with on the day of the inspection stated that their needs are met at the home, paying particular praise to the staff employed at the home, stating that they are always attentive, friendly and respectful. Residents at the home can benefit from the large mature gardens in which the home is situated. There is a choice of large bedrooms available within the home and all bedrooms viewed as part of the inspection process were safe, odour free and homely. The acting manager at the home assesses service users needs prior to residency and documentation is sought from Social Services departments to ascertain resident’s needs and aspirations. A computerised care planning system is in place, which is updated appropriately. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 7 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 Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6, Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The acting manager of the home performs pre-admittance assessments and utilises a recognised assessments tool to aid the process. The home does not provide intermediate care services. EVIDENCE: It was evident that the acting manager performs preadmission assessments in the community or within the secondary care setting prior to residents being admitted to the home. The acting manager utilises an effective assessment tool (activities of daily living) to identify the holistic needs if the residents. In conjunction with the acting managers assessment it was evident that documentation from a Social Services assessing officer is also utilised effectively within the pre-admittance assessment procedure. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 9 Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The case tracking procedure revealed that the residents “holistic” needs are addressed through an individual computerised, care-planning process. All service users stated that they are treated with respect and dignity and that their privacy and dignity is always maintained. No service users within residential home are responsible for the administration of their own medication at the time of the inspection, although facilities for self-administration of medicines are available should it be required. EVIDENCE: The computerised care plans viewed on the day of the inspection were found to be appropriate in addressing the identified needs of the residents within the Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 11 home. The care plans give clear instructions to staff of how to meet the identified needs. The computerised care planning system does not readily afford the opportunity for service users or their representatives to agree to, and sign the care plans. From a previous inspection it was recommended that all care plans should be available in “hard copies” so that they can be viewed more easily and signed by residents. At the time of the inspection no service users were responsible for the selfadministration of medicines. It was established that should a service user wish to be independent in the administration of medicines the acting manager would perform a risk assessment, if the service users was deemed as being safe, selfmedication would be facilitated. Medication was stored securely in the home and a medication trolley was used to transport medication around the home, increased security was available for controlled drugs. A previous inspection identified shortfalls appertaining to the receipt of controlled drugs. The identified shortfall has been addressed effectively and a controlled drugs register now states the precise number of controlled drugs that are held in the home for each service user and the receipt of controlled drugs had two signatures evident. Through discussions with three service users it was indicated that staff always respected residents privacy and dignity within the home. All residents were particularly complimentary towards the staff within the home, and were described as lovely, caring, attentive and hard working. Residents also stated that the staff at the home made every attempt to promote the principles of privacy and dignity. Residents were very presentable at the time of the inspection; one service user stated that the laundry facilities within the home are very good and that her clothes were always returned promptly and in a clean well ironed condition. The inspector witnessed several staff addressing the residents in a very pleasant and respectful manner and it was evident that the service users were comfortable and contented within the home environment. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents at the home enjoy a lifestyle that satisfies their physical and social expectations. Residents are actively encouraged to maintain contact with family members, friends and representatives from the local community. The home affords residents the flexibility of choice in relation to daily routines within the home. Although minor shortfalls were evident as daily menus were not displayed in a prominent position within the home. EVIDENCE: Residents stated that the routine within the home is flexible; residents confirmed that they are able to get up and retire when they wish and could choose how to spend there days within the home setting. The acting manager together with care staff at the home stated that no restrictions are placed on the family or friends of the service users in relation to visiting times. Residents confirmed that the home is very flexible in relation Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 13 to visitations. Residents stated that the staff within the home always made visitors very welcome and appreciated the importance of service users maintaining effectual contact with people beyond the immediate environment of the home. Residents are encouraged to participate in social activities within the home such as movement to music, sing songs, games, video afternoons, luncheon clubs, annual fates, and the pantomime at Newark on Trent. Residents spoken with substantiated that activities within the home are satisfactory but were looking forward to the summer months when they can utilise the well manicured grounds in which the home stands. Residents spiritual needs are accommodated at the home as local representatives from various religious denominations visit the home on a regular basis. The dining room is very spacious, well decorated and appropriately lit. Service users spoken with stated that they enjoyed their meals and it was evident that an appropriate menu is made available to them, although the daily menus are not displayed within the dining room. To aid the process of choice for the residents, the daily menu should be displayed at a prominent position within the home to allow for residents perusal, this function was not being performed on the day of the inspection. The acting manager stated that a menu board would be purchased and displayed in the dining room to aid the communication process. The home has had a visitation by the Department of Environmental Health on 13th February 2006 the report from the Department of Environmental Health stated that the kitchen preparation areas are satisfactory. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18, Quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are confident that any complaints or concerns will be listened to, taken seriously and acted upon. The acting manager of the home could not provide evidence that the care staff at the home have received appropriate training in relation to the protection of the vulnerable adult. EVIDENCE: Following requirements from a previous inspection the complaints procedure has been revised and now specifies timescales in which a concern or complaint should be addressed. The complaints procedure is given to all new residents or their family members at the time of admission. The complaints procedure is also on display within the foyer of the home to allow residents and their relatives easy perusal. All residents spoken with said that they would not hesitate to raise any concerns or complaints and that they were confident in the acting manager’s ability to address any elements of a complaint in a sensitive and professional manner. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 15 At the time of the inspection the acting manager of the home was not investigating any complaints and the Commission for Social Care Inspection had not received any complaints within the last six months. A Resident spoken with stated that they had been in the home for several years and had never observed anything that gave her concern or would initiate the complaints procedure. At the time of the inspection the acting manager could not evidence training opportunities afforded to care staff at the home in relation to the protection of the vulnerable adult, as the training documentation/matrix was not at the home. The Commission for Social Care Inspection will require the acting manager to provide the documentation relating to the training opportunities afforded to care staff at the home thus evidencing that staff are fully aware of the principles relating to the protection of vulnerable adults. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26, Quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. On the whole the home provides a homely, clean and comfortable environment for residents, although some areas would benefit from minor redecoration. EVIDENCE: All of the bedrooms viewed during the inspection were clean, pleasantly decorated, smelt fresh and comfortably furnished. Residents are encouraged to bring photographs and ornaments to personalise their bedrooms. Unoccupied bedrooms, which had been recently redecorated in anticipation of further residency, were tastefully decorated to a high standard, and safe. The home would benefit from minor paintwork especially in some of the corridors, as some paintwork was chipped and somewhat shoddy. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30, Quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Care staff employed on the day of the inspection was sufficient to meet the identified needs of the service users. The recruitment practices utilised at the home could place residents in a potentially unsafe environment. Documentation appertaining to the training opportunities provided to care staff at the home does not clearly evidence that staff at the home are appropriately trained. EVIDENCE: On the day of the inspection 21 service users were accommodated at the home. Staffing levels were appropriate to meet the needs of the service users. Four carers were on duty throughout the morning period, three care staff throughout the afternoon period, and two carers covered the night period. The manager hours are not included within the care staff rotas so as to provide the opportunity to effectively manage the home The acting manger and the proprietor of the home confirmed that five staff employed at the home were not in possession of all the required statutory Criminal Records Bureau checks and Protection of Vulnerable Adult “first” Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 18 checks together with two satisfactory written references. The checks which must be obtained prior to employment. It was agreed that the staff concerned be would be temporarily suspended from duty until the appropriate checks have been obtained and evidenced. The Commission for Social Care Inspection will require the proprietor of the home to evidence that all staff employed at the home have undergone the aforementioned checks by 18/04/06. If the aforementioned checks shortfalls continue the Commission for Social Care Inspection will consider legal action and prosecution. The acting manager did not adequately demonstrate that the staff have been given the mandatory training required from an accredited trainer to enable them to maintain their own and the service users safety. The Commission for Social Care Inspection will require evidence, which clearly identifies the training provision in relation to Basic Food Hygiene, Basic First Aid, Moving and Handling, Prevention of Cross Infection and Health and Safety, together with evidence of the National Vocational Qualifications (NVQ) of care staff at the home by 18th April 2006 together with any planned training events within the year 2006. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome group is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The manager’s position is currently vacant although an acting manager is in post. Service users are protected from financial abuse and their financial interests are safeguarded. The acting manager could not evidence that resident’s safety is promoted at the home through an ongoing comprehensive maintenance programme. EVIDENCE: Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 20 The acting manager at the home has four years experience at Winthorpe Hall in an administration capacity. It was established that an application has been made by the acting manager to the Commission for Social Care Inspection for her to be assessed as fit for registration as the manager of the home. At the time of the inspection it was evidenced that the service users monies are effectively managed. A clear record of monitory transactions could be evidenced. The resident’s monies are securely stored, individually within a secure environment. Receipts are evident for all transactions performed, and a clear financial audit trail was evident thus protecting the service users from financial abuse. The proprietor is not appointee for any service user. It was established that if residents wish hold monies independently, lockable facilities are available on request. The acting manager was unable to evidence that the home is maintained to a satisfactory standard in relation to the control of Leginella contamination, the testing of emergency lighting, the testing of fire equipment and fire alarms, the maintenance on all equipment designed of aid mobility such as wheelchairs, hoists and specialist baths and that hot water outlet checks are performed to minimise the risk of scolding. The records appertaining to the all the aforementioned issues will be required as evidenced to the Commission for Social Care Inspection by 18th April 2006 to ensure residents are safe within the home environment. The acting manager in attempting to provide a service, which is run in the best interests of the residents, ensures that monthly resident meetings are performed together with annual quality assurance questionnaires to identify any issues of concern. The information is collated and an action plan is devised if required, thus improving the service provision at the home. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 X X 2 Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 18/04/06 1. OP29 19 (b) (i) 2. OP29 19 and Schedule 2 3. OP29 19 and Schedule 2 4 OP30 13 (6) 5 OP38 12 (1) The registered provider shall ensure two written satisfactory references are obtained before appointing a member of staff and any gaps in employment records are explored. The registered provider shall ensure a Protection of Vulnerable Adult (PoVA) First check is received before any new staff commences in employment. Outstanding from 14/08/05 The registered provider shall Provide evidence of enhanced checks through the Criminal Records Bureau in respect of all existing staff. Outstanding from 14/08/05 The registered provider shall make arrangements by training staff or by other measures to prevent service users being harmed of suffering abuse or being placed at risk of harm or abuse. The registered person shall ensure that the home is conducted so as promote and DS0000024670.V287940.R01.S.doc 18/04/06 18/04/06 18/04/06 18/04/06 Winthorpe Hall Care Home Version 5.1 Page 23 6 OP38 12 (1) make proper provision for the health and welfare of service users. The registered person shall ensure that the home is conducted so as promote and make proper provision for the health and welfare of service users. 18/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 Refer to Standard OP7 OP15 OP37 Good Practice Recommendations Always provide printed care plans so that they can be viewed more easily and signed by service users or their representatives. Display a menu in a prominent position so that residents are aware of the choices available. The registered provider should ensure that at all times records are available for inspection in the care home by a person authorised by the commission to enter and inspect the home. Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Winthorpe Hall Care Home DS0000024670.V287940.R01.S.doc Version 5.1 Page 25 - 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!