Inspection on 05/01/09 for Wyndham House

This inspection was carried out on 5th January 2009.

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

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

Other inspections for this house

Wyndham House 09/01/07

Wyndham House 03/03/06

Wyndham House 28/07/05

Wyndham House 07/12/04

Wyndham House 15/06/04

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Wyndham House Martlet Road Minehead Somerset TA24 5PR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Poole     Date: 0 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Wyndham House Martlet Road Minehead Somerset TA24 5PR 01643703934 01643703253 Johnhayes21@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Madeleine Vivienne Flanagan Type of registration: Number of places registered: Somerset Care Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Wyndham House is registered with the Commission for Social Care Inspection (CSCI) to provide personal care for up to 50 people over the age of 65. The home is owned by Somerset Care and managed by Madeleine Flanagan. The home is situated up a hill in close walking distance from the centre of Minehead, providing access to a wide range of facilities. The property is a three storey older house with a modern two-storey extension. The location of the home allows residents to enjoy a seaside town environment if they are sufficiently mobile. Residents are encouraged to furnish their rooms with their own possessions and have an opportunity to choose the colour scheme. There is a programme of organised activities, which encourages interaction between residents and staff. The home has been adapted to maximise independence and contains sufficient specialised equipment. There are well-established systems of care and staff management. Care Homes for Older People Page 4 of 28 Over 65 50 0 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: The quality rating for this service is 2 star. This means the people who use this service experience GOOD quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are;- excellent, good, adequate and poor. This inspection took place over a one day period. During this time the inspector was able to talk with people living and working at the home, observe care practices, view records and tour the building. Care Homes for Older People Page 6 of 28 Before the inspection 10 people living at the home, 7 members of staff and 7 health and social care professionals completed questionnaires. Some of their comments have been included in this report. The registered manager completed an Annual Quality Assurance Assessment (AQAA) setting out the homes achievements in the last year and their plans for the future. The following is a brief summary and should be read in conjunction with the whole report. What the care home does well: What has improved since the last inspection? What they could do better: People living at the home were generally very happy with the service provided but some people raised their dissatisfaction with the serving of meals. People said that they waited a long time for their food to be served and this was observed at the mid day meal. Breakfast is served at 8:45am meaning that some people have to wait some time between getting up and receiving breakfast. The home needs to look at how meal times can be made more flexible and ensure that any routines are in accordance with the wishes of the people living at the home. Care Homes for Older People Page 8 of 28 One person said that they would like there to be activities arranged in the evenings. Some care plans seen would benefit from further development to ensure that they fully reflect individuals preferences and wishes. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. Anyone wishing to move to Wyndham House has their needs assessed and is able to spend time at the home to help them to decide if it is the right place for them. Evidence: Anyone wishing to move into Wyndham House has their needs fully assessed by a senior member of staff. Copies of pre admission assessments were seen in personal files. People spoken with during the inspection, and those who completed questionnaires, felt that they received adequate information to enable them to decide if the home was the right place for them. One person said that the manager had visited them in their home and given them lots of useful information. Everyone receives an information pack which includes details about the company and a service user guide for the home. Copies of service user guides were seen in personal rooms. Care Homes for Older People Page 11 of 28 Evidence: People who are funding their stay privately have a contract with the home and those who are being financially assisted by the local authority have a copy of their terms and conditions of residency. The first 12 weeks of a persons stay is considered a trial period to make sure that the home meets the expectations of the client and to ensure that the home is able to meet their needs. In addition to permanent residential care the home also provides day care and respite care. This enables people to spend time in the home before making a decision to move in. Many people spoken with said that they had stayed at the home for holidays before moving in on a permanent basis. Two step up, step down intermediate care beds are also available, these give people an opportunity to receive a package of rehabilitation and support before returning to their own homes. Care Homes for Older People Page 12 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. Each person has a care plan that sets out their individual needs but some would benefit from further development to ensure that they give information about individual likes and preferences. People have access to healthcare professionals in line with their individual needs. People living at the home are treated with dignity and their privacy is respected. Evidence: The home uses a computerised care plan system, with hard copies of summaries held securely in the care office. 4 care plans were sampled and these gave clear information about the needs of the individual. In two instances there was limited information about personal preferences and wishes. For example: both stated that if people were not taking a good diet then the person should be offered personal favourites but there was no guidance about what these may be. Two care plans stated that people should be weighed weekly but there was no clear rationale for this and records showed that it Care Homes for Older People Page 13 of 28 Evidence: was not being carried out. All care plans seen were being regularly reviewed and people had signed to say that they agreed with their care plan. Staff demonstrated a good knowledge of individuals needs and preferences. People spoken to stated that the home assisted them to make appointments with relevant healthcare professionals and care staff gave evidence that they monitored peoples personal healthcare. Health and social care professionals who completed questionnaires answered ALWAYS or USUALLY to the questions Does the care service seek advice and act upon it to improve individuals health care needs? and Are individual healthcare needs met by the service? One professional commented that the home communicated well with healthcare colleagues. Since the last inspection the home has made available a small room on the first floor where people can see professionals, such as district nurses, if they do not wish to use their private rooms. During the inspection there was evidence that the staff act appropriately if someone is unwell and carry out instructions issued by medical professionals. People living at the home stated that they have access to professionals appropriate to their specific needs and records are kept of all appointments. People felt that their privacy was respected and more than one person said that they were free to spend time alone if they chose to. People living at the home said that staff were polite and respectful of them. During the inspection staff were observed to interact with people in a very friendly and respectful manner. Assistance was offered to people in a dignified manner that did not compromise their privacy or dignity. The home employs both male and female care staff which gives people some choice about the gender of the person who assists them with intimate personal care. Unopened post was seen being delivered to individuals. One person wrote on their questionnaire We are always treated with care and respect. The home uses a Monitored Dosage System for medication and only senior staff who have received specific training administer medication. There are adequate storage facilities for medication including medicines that require refrigeration. Some people at the home hold and administer their own medication and risk assessments, including control measures, are in place. The manager needs to ensure that these are regularly reviewed in line with the homes guidelines. Medication Administration Records were viewed. All medication is signed for when it enters the home and when administered or refused, this gives a clear audit trail. Administration records seen were well maintained and correctly signed. Controlled drugs are appropriately stored and administered in line with good practice Care Homes for Older People Page 14 of 28 Evidence: guidelines. A sample of controlled drugs seen correlated with records held. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are able to make choices and remain in control of their day to day lives. The quality of food is excellent but the home need to ensure that timings of meals are flexible and people do not wait for an excessive amount of time before being served. Evidence: The majority of people said that they were able to choose what time they got up and when they went to bed. Everyone said that they were able to choose how they spent their day. Everyone who completed a questionnaire said that they could choose what they did during the day, in the evenings and at weekends. There is a programme of activities in the home which includes trips out in the good weather. Some people continue to access facilities outside the home without staff support, one person said that they go into town to the hairdresser, one person said that they go to a nearby church and another said that they attended a local club. Everyone asked said that they were able to join in activities that interested them but did not feel obliged to take part in all organised events. Care Homes for Older People Page 16 of 28 Evidence: The home has a small shop which is run by people living at the home, there is also a library service. At the time of the inspection the activities worker was on holiday and three people said that there was limited activities when this worker was not at the home. One person wrote on their questionnaire that they would like to see more activities in the evening. People said that they continued to make choices and remained in control of their everyday lives. One person wrote on their questionnaire I very much appreciate the freedom afforded to us. People were very complimentary about the food in the home. There is a set menu that gives choices at each meal. The days menu is displayed outside the main dining room. One person stated that if they did not like anything on the menu then other alternatives were always made available. Food served on the day of the inspection was well presented and cooked. There are two dining rooms giving people a choice of where they eat meals. People are also able to eat in their personal rooms if they wish to and trays were seen being taken to these people. Both dining rooms are extremely inviting. Tables are laid with tablecloths, napkins and mats and decorated with flowers. The main meal is served plated in line with each persons choice and vegetables and condiments are available on each table. It was observed that people were offered help in a discreet, dignified manner. There were several comments about the length of time that people had to wait for meals and this was observed at the midday meal, with some people sitting at the table for almost half an hour before their main course was served. People spoken with said that this was also the case at breakfast. People living at the home said that breakfast was at 8:45am but sometimes they did not get served for some time. People who get up early have to wait before they can have breakfast. Care Homes for Older People Page 17 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 takes reasonable steps to minimise the risk of abuse to people living at the home. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. The complaints procedure is displayed in the home and contained in the service user guide. Everyone living at the home who completed a questionnaire said that they knew how to make a complaint. All staff answered YES to the question Do you know what to do if a service user or their advocate has concerns about the home? People spoken with during the inspection said that they would be comfortable to raise any worries or concerns with a member of staff. No complaints have been received in the last 12 months. The induction programme used by the home includes recognising and reporting abuse and there is refresher training for more longstanding members of staff. Staff files gave evidence of a robust recruitment procedure that includes obtaining Care Homes for Older People Page 18 of 28 Evidence: written references and checking people against the Protection Of Vulnerable Adults (POVA) list before they begin work in the home. Care Homes for Older People Page 19 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. Wyndham House provides a comfortable safe environment for the people who live there. Standards of cleanliness are excellent. Evidence: Wyndham House is located in a quiet area of Minehead within walking distance of the town centre. All areas of the home are fitted with a fire detection and call bell system, which are regularly tested. There are 50 single bedrooms that are set over three floors giving a variety of personal rooms. Many of the rooms have en suite facilities and others have wash hand basins. There are ample toilets and bathrooms around the home. There are communal assisted bathing and showering facilities which enables people to choose to bath or shower. There are two lifts in the home giving access to all areas. Care Homes for Older People Page 20 of 28 Evidence: People moving to the home are able to bring personal possessions such as small items of furniture, pictures and ornaments to personalise their private rooms. This gives rooms an individual homely feel. There are several lounges and seating areas around the home giving people a choice of spending time in communal lounges or in quieter seating areas. Outside there are attractive gardens with seating. Many people said that they enjoyed spending time in the garden in good weather. Since the last inspection the home has created a pleasant patio area that can be accessed from the first floor. This has given additional outside space to people living at the home. It was observed that people had unrestricted access to all communal areas and their personal rooms throughout the day. Laundry facilities have been improved since the last inspection to ensure that they promote good infection control practices. There are adequate hand washing facilities throughout the home. All areas seen were well maintained, appropriately decorated and furnished. All areas were clean and fresh. Everyone who completed a questionnaire said that the home was always clean and fresh. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by a staff team who are well trained and have a commitment to providing a high quality service. Recruitment policies and procedures minimise the risks of abuse to people living at the home. Evidence: The home employs 35 care staff, 30 (86 ) have a National Vocational Qualification in care at level 2 or above. (Figures taken from Annual Quality Assurance Assessment.) Prior to the inspection 7 staff completed questionnaires, the majority (5) answered USUALLY to the question Are there enough staff to meet the individual needs of service users? People spoken with during the inspection felt that staffing levels were adequate. The deputy manager gave evidence that the staffing levels are kept under review and some increases in hours, particularly domestic hours, have been put in place since the last inspection. It was noted during the inspection that call bells were answered promptly and people living at the home confirmed that this was always the case. There is a relaxed atmosphere in the home and people did not appear to be rushed. Care Homes for Older People Page 22 of 28 Evidence: There is a clear staffing structure with clear lines of responsibility. All new staff complete a comprehensive induction training and there is ongoing training available relevant to each persons role. Staff spoken with, and those who completed questionnaires, were very happy with the training opportunities available. Records are maintained of all training undertaken, these show that people are undertaking training in health and safety issues and training specific to the needs of the people living at the home. The recruitment files of the four most recently employed members of staff were seen. These gave evidence of a thorough and robust procedure that minimises the risks of abuse to people living at the home. People living at the home were extremely complimentary about the staff who supported them. Comments included staff here are marvellous, staff are magnificent, all staff are extremely caring and thoughtful and Nothing is ever too much trouble for the staff, they do everything they can to help you. One health and social care professional wrote The carers are all pleasant and have time for each individual. Staff observed and spoken with during the inspection demonstrated a genuine commitment to providing a high quality service, all were professional and respectful in their interactions with people living at the home. Care Homes for Older People Page 23 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 home is effectively managed and there are systems in place to seek the views of people living at the home and other interested parties. There are a variety of quality assurance systems in place to monitor the quality of care and to ensure ongoing improvements. Evidence: The registered manager is Madeleine Flanagon. She has many years experience of working with older people and has obtained appropriate qualifications including the Registered Managers Award (NVQ level 4.) Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA.) This gave an overview of the homes achievements in the last 12 months and their plans for the coming year. The registered manager was not at the home at the time of this inspection, but the deputy manager and area manager were available throughout the day. Care Homes for Older People Page 24 of 28 Evidence: There is a clear management structure in the home giving clear lines of responsibility and accountability. There is always a senior member of staff on duty who gives support and guidance to less experienced staff. In addition to this all staff receive formal recorded supervision on a regular basis. There are various quality assurance systems in place to seek the views of people living at the home and to monitor the quality of care. Some people living at the home said that they would like more opportunities to discuss issues with the manager on an informal basis. The company send out questionnaires annually to seek peoples views. Returned surveys are audited and action taken to address any issues raised. Copies of the last audit showed a high level of satisfaction with the service and facilities offered. There are also meetings for people living and working at the home. Minutes from these meetings showed that there is a varied agenda and people are free to express their opinions and ideas. The responsible individual carries out unannounced monthly visits as part of the quality assurance procedures. The home does not act as a financial appointee or power of attorney for anyone living there. There is a facility for people to deposit small amounts of money for safe keeping and records are kept of these monies. The administrator was able to explain the system and demonstrate that there was a robust procedure in place to protect peoples personal monies. The AQAA gave evidence that equipment in the home is regularly tested and serviced. A sample of these records were viewed and confirmed this. Fire alarms are tested weekly in house and serviced regularly by outside contractors. All lifting equipment, such as assisted baths and portable hoists, are serviced on a six monthly basis. Staff receive regular training in health and safety issues. The home has been awarded 5 stars (excellent) by the environmental health officer. Up to date certificates of insurance and registration are displayed in the home. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 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 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 1 7 The manager should ensure that care plans are personalised to give clear information about individuals likes and preferences to ensure that people receive support in their chosen manner. Risk assessments in respect of people who self medicate should be regularly reviewed in line with the homes policy. The home should ensure that people do not wait for an excessive amount of time for meals to be served. The timing of breakfast should be flexible so that people are able to begin breakfast when they get up. 2 3 9 15 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 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. 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!