Inspection on 20/02/07 for Yolanta House Care Home

This inspection was carried out on 20th February 2007.

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

Yolanta House Care Home 06/01/10

Yolanta House Care Home 04/12/07

Yolanta House Care Home 19/07/06

Yolanta House Care Home 12/10/05

Yolanta House Care Home 04/07/05

Yolanta House Care Home 10/03/05

Yolanta House Care Home 30/04/04

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 Yolanta House Care Home 1/3/5 Herbert Road Sherwood Rise Nottingham NG5 1BS Lead Inspector Joanna Carrington Key Unannounced Inspection 20th February 2007 09:30 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 Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yolanta House Care Home Address 1/3/5 Herbert Road Sherwood Rise Nottingham NG5 1BS 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) 0115 962 6316 0115 969 3122 apvt29@dsl.pipex.com Mr Jozef Sekowski Mrs Jolanta Sekowski Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2006 Brief Description of the Service: Yolanta House is a care home for nineteen older people and older people with dementia. A majority of the residents and a large number of the staff are of Polish origin, although there are residents from a range of ethnic backgrounds. The home is located within a residential area of Nottingham close to shops, health centres and other amenities. The local Polish community centre and Catholic church are within walking distance. The home is converted from three large houses and the residents’ accommodation is on two floors. There are two double rooms and the rest are single bedrooms. There is an en-suite bedroom on the ground floor. There are five bathrooms; four with baths and one containing a shower room plus separate toilet facilities. Most residents use the assisted bath on the ground floor. There is no passenger or stair lift installed therefore unless the bedroom was situated on the ground floor the home would not be suitable for residents with mobility problems. There is ramped access to the home and garden. The fees per week are £267 or £307 for residents with very dependent needs. These fees also apply to residents that pay privately. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over six hours on 20th February 2007. The main method of inspection was called ‘case tracking’ which meant selecting three residents and tracking their care and support by checking their records, discussion with them and with staff and observation of care practices. Altogether three residents and a staff member were spoken with. A partial tour of the premises took place in order to assess environmental standards. One new staff member has commenced employment since the last key inspection. Their file was checked for recruitment records. Training records were also examined to ensure that the staff team are trained in meeting the needs of residents. Information received prior to the inspection has also been used as evidence to reach judgements made in the report. Both owners, of which one is the registered manager, were available for discussion and feedback throughout the inspection. What the service does well: There is a very homely and relaxed feel at Yolanta House. The environment is comfortable for residents and is kept clean and hygienic. Residents are treated with dignity and respect. There are activities provided in the home for residents such as hand massages, board games and bingo. There is also an activity called ‘Chat and Chew’ which gives residents one to one time with a carer, to chat and eat cake. The home has polish owners, that run the home and a large number of residents at the home are either Polish or Ukraine. The cultural and religious needs of residents are well catered for. Polish newspapers are provided free of charge. Other ethnic minorities live at the home too and it is evident that their needs are met. Residents were seen enjoying their mealtime and menu records show that a wholesome varied diet is offered to residents. The home does well at enabling residents to maintain contact with family and friends. Staff help residents to make phone calls and relatives are made to feel welcome when they visit. There is also the facility for family that live far away to stay overnight. Before prospective residents move to the home there is information available about the home so that people can make an informed decision about where to live. Either the placing authority’s community care assessment is obtained or the home carries out their own assessment before offering a place to ensure that the home is suitable in meeting individuals’ needs. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 6 There are good links with other healthcare professionals such as community and continence nurses and occupational therapists. This helps ensure that the health and personal care needs of residents are properly met. The views of residents and relatives are listened to and taken seriously. There are feedback questionnaires sent out to residents and there is a complaints procedure for responding to concerns and complaints. Staff know what they must do if they have any concerns. Staff training is good. A lot of the staff at the home are Polish. So that these staff are able to succeed in mandatory training like First Aid, Moving and Handling and Food Hygiene they do English literary courses. Staff receive an induction when they start working at the home. The health, safety and welfare of residents is promoted and protected. There is an up to date fire risk assessment in place, and fire tests and drills are regularly carried out. Water systems are tested for the prevention of legionella. What has improved since the last inspection? What they could do better: They could do better at protecting residents by ensuring that new staff do not commence employment until the return of two written references and a criminal record bureau check. This is now an outstanding requirement from the last inspection. They could do better at promoting the health of residents, and staff, by making sure that when residents have mobility problems a risk assessment for moving and handling is carried out. Meeting the needs of residents could be done better by ensuring there are care plans that cover all identified needs and what appropriate support is to be given. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is good. There are good admission arrangements in place, which ensure that the home is suitable before admitting anyone that chooses to move there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The placing authority’s community care assessment was seen on the files of all three residents’ case tracked. The information on the assessment is used to decide if the home is suitable in meeting individuals’ needs. Information from the placing authority was seen for a prospective resident that will soon be moving to the home. An up to date Statement of Purpose and Service User Guide were seen and contain all the necessary information about the home and meets with the National Minimum Standards. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. There are adequate arrangements in place for meeting the health and personal care needs of residents. Some improvements to documentation will help this process. Residents’ right to dignity and respect is promoted and upheld and medicine management has improved at the home, which promotes the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual plans of care that cover aspects of health, personal and social needs were seen for all three residents’ case tracked. An ethnic need in terms of how hair is styled and presented was seen included in a relevant care plan. There is evidence on the files that plans are reviewed on a monthly basis, so that any changes in needs are identified. However, where a need is identified in review notes then how this need is to be met must be added to the relevant care plan. For one of the resident’s case tracked a behavioural issue around continence was identified but then there was no mention of this behaviour in the care plan or what support could be put in place. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 11 It was evident from the daily records and care plans seen that specialist health and social care professionals such as continence advisor and community nurses are accessed when necessary. One resident case tracked has had a series of falls. An occupation therapist has since visited, and supplied aids and made a referral for a physiotherapist. There are clear guidelines for the treatment of pressure sores. The pressure sore risk assessments were however at least over a year old. The risk assessment for one of the resident’s case tracked confirmed a low risk, but this was the resident that is currently having treatment for pressure sores. It was noted how two of the residents’ case tracked have some assistance with transfers and mobilising but do not have risk assessments for moving and handling. These are required to ensure the health and safety of both those residents and all staff. Residents spoken with said that staff treat them with respect and always knock on their bedroom door before entering. This was observed during the inspection. The care plans seen refer to maintaining dignity and promoting residents right to make choices. A pharmacist visited the home last November 2006 to audit the medication system. The report was seen and showed there to be no serious concerns. With the assistance of the pharmacist there is now a homely remedies policy in place waiting to be signed by the GPs. There are good risk assessments in use for assessing residents’ ability to self-medicate. Medication administration records (MAR) were looked at. No gaps were seen on the records and for the three drugs that were audited instructions were clear and remaining quantities of medication tallied with what had been signed as given. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. The home offers a varied wholesome menu, a range of activities and staff help residents to maintain links with friends, relatives and the local community and to exercise choice and control over their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a weekly activities programme for the home. This includes ‘flex and stretch’, board games and cards, bingo, listening to music, film club, reminiscence and going for walks. The home also provides polish newspapers free of charge and there are regular opportunities for residents to have one to one time with a staff member for chat and a piece of cake. Cultural and religious needs are identified in care plans and every month a polish priest visits the home to perform mass. Polish newspapers and polish television are supplied free of charge. On the day of the inspection a relative came to take their relative-in-care out for the day. Daily records show that residents are supported to write letters to their family and are able to make telephone calls in private. There is also the facility for family or friends who live far away to stay overnight at the home. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 13 From reading records, observing practice and discussion with staff and residents it is apparent that residents are helped to exercise choice and control in their lives. Residents spoken with explained that they can go to bed and get up when they choose to and some residents were observed spending time with others in the lounge or being assisted to their rooms so they could spend time on their own. A staff member spoken with gave examples of how they ensure residents have choices: what to wear, what to eat and what activities to participate in. Menu records show that there are always two choices, usually one polish and one other dish with a range of meat, fish and vegetable dishes. Residents were seen enjoying their meal together and residents that required assistance with eating were treated with dignity and respect. The meal on the day of the inspection was shepherds pie or beef burgers with vegetables and pancakes for dessert, to celebrate Shrove Tuesday. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Concerns and complaints are taken seriously and acted on. Staff are aware of their responsibilities in accordance with local Safeguarding Adults procedures, which helps ensure residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure in place and copies are available within the service users guide. Residents spoken with are aware how to make a complaint and confirmed they are confident their concerns would be taken seriously and acted on. Since the last inspection there has been one complaint and the record made indicates that this was responded to appropriately. There have been no disclosures or allegations of abuse concerning residents in the home. Nonetheless, staff spoken with demonstrated an understanding of their responsibilities to whistle blow, in accordance with the home’s procedures and the Nottinghamshire Committee for the Protection of Vulnerable Adults (NCPVA) Policy and Procedures. Training on adult abuse is included in the Skills for Care Induction that all new staff members attend. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 and 26 Quality in this outcome area is good. Residents live in an environment that is safe, well maintained and clean and hygienic throughout. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On a tour of the premises it was evident that the home is kept clean and hygienic. The sluice facility and laundry facilities are appropriate to meeting the needs of residents and are sited away from any areas that prepares or serves food. There is a homely and traditional feel and communal areas are nicely decorated with domestic furnishings and fittings. There are hallways throughout the building leading to bedrooms and communal areas. There are signs used in Polish and English on some doors, which enables residents to be orientated in their own surroundings. The bedrooms seen are personalised with individuals’ own belongings. Good quality furniture is provided by the home unless residents choose to bring their Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 16 own when they move to the home. Since the last inspection a couple of bedrooms and a bathroom has been redecorated. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. Staff are well trained and competent and staffing numbers are appropriate in meeting the needs of residents. Recruitment practices are still placing residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents’ spoken with stated that there is always assistance from staff when needed. The rota shows that set minimum staffing levels are always covered and it was evident from discussion with staff that the team are supportive of one another and will help out in covering holidays and sickness. The registered manager has recently developed a Workforce Training plan with assistance from Skills for Care, in order to update their policies for staff development. Two staff members have National Vocational Qualification (NVQ) level 2, one staff member has NVQ level 3 and five staff are in the process of doing level 2. Polish staff have opportunities to do English literary courses so that they can undertake all their training at ease. The training records seen show that staff are appropriately trained, four staff are booked in to do their food hygiene and the registered manager reported that courses on medication and nutrition are being booked through the County Council. Dementia training is accessed is for all staff, which is essential for meeting the needs of residents with dementia. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 18 One new staff member has commenced employment since the last inspection. There was evidence on their file of two written references and a criminal record bureau check however the criminal record bureau check was issued after the staff member commenced employment. The registered manager reported that there were problems with the umbrella body losing forms of identification and the CRB application form. This cannot be taken into account because the regulation to make sure checks are carried out before a staff member commences employment has still been breached. This was made a requirement at the last inspection and is therefore now identified as outstanding and compliance must be achieved to avoid possible enforcement action by the commission. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. Health and safety and the home in general are managed well and improvements made to record keeping means residents’ rights and best interests are safeguarded better. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A staff member spoken with reported that the registered manager and owners are very kind and supportive. Residents spoken with also commented that the registered manager and staff are “very nice”. Residents spoken with confirmed that they have access to money when they need it. The registered manager does not act as appointee for any residents. This is usually a relative or a solicitor has financial responsibility. All residents have a personal finance plan, which states who ultimately assists the resident with their finances and whether or not the home manages that resident’s Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 20 personal allowance. Residents have their own lockable facility if they wish to look after money themselves or money can be held securely on residents’ behalf. Every year satisfaction surveys go out to residents, so that they can feedback on the quality of care at the home. The survey covers areas such as cleanliness, décor, choice of meals, making complaints and social activities. As recommended at the last inspection, surveys have gone out to relatives, for residents unable to fill one out themselves. Accident records are no longer being left in the accident book, which is against data protection. A new system has been developed which helps in monitoring the types of accidents that are occurring. Complaints records and daily records are now also being recorded in a way that meets with data protection and safeguards residents’ right to confidentiality. The incident records seen indicate that all the required notifications to the Commission have been made since the last inspection. A risk assessment for the prevention of legionella in the water systems was seen along with certificates for sterilisation. A comprehensive fire risk assessment was seen, which has been updated since the last inspection. The fire log shows that all the required fire alarm testing and drills have been carried out. Daily fridge and freezer temperature records were also seen, important in helping prevent food poisoning. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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. 1. Standard OP7 Regulation 12, 15 Requirement Timescale for action 01/05/07 2. OP8 12(1)(a) 13(4)(c) 3. OP29 19 Ensure all residents have an individual plan of care that covers all aspects of their needs and how support is given in meeting those needs. This refers to the resident that has a behavioural / continence problem, for which appropriate support must be identified. Ensure all residents that have 01/05/07 assistance with mobilising have a risk assessment for moving and handling. This is to promote and protect their health, and also the health and safety of staff. Ensure no staff member 22/03/07 commences employment until the return of a satisfactory Criminal Record Bureau check and two written references. This is an outstanding requirement from previous inspection, initial timescale not met. This requirement must be complied with, with immediate effect. Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Yolanta House Care Home DS0000002226.V329309.R01.S.doc Version 5.2 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. 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