Care Home: Ashfield Court

Similar services:

• Abbey The
• Snydale Care Home
• Hawkhills
• Larchfield Manor
• Beeches The - North Yorkshire County Council
• Staveley Birk Leas Nursing Home
• Carentan House

What the care home does well The manager and staff team provide a very good standard of care. The Registered Manager is proactive in all areas of the management of the home resulting in a positive attitude throughout the home. Feedback from people living at the home is very complimentary. These are some of the comments made, "The staff are friendly and listen to what you say" " The staff work so hard here to make sure everyone is comfortable" "We are always made to feel welcome when we visit we are offered tea when we arrive" "The food is getting better all the time" The care records are up to date and well maintained by the staff and peoples` health care needs are met. There are a range of interesting activities arranged for people to participate in and people are encouraged to pursue their own interests and their choices are respected. People live in an excellent environment with good quality furnishings and decor throughout. The home is well maintained and kept safe. Recruitment of staff at the home is done in a responsible way with checks being undertaken to make sure that people are safe to work at the home, this further protects people in the home by making sure the right staff are recruited. Staff are well trained and are positive about their work within the home, they also have good support by the manager of the home. The management team make sure people have a say in how the home is run. They talk to people and hold resident and family meetings to give people opportunity to have their say. What has improved since the last inspection? This is the first inspection. What the care home could do better: The service performed well in all areas and had identified within the AQAA where they wished to develop the service further. Key inspection report Care homes for older people Name: Address: Ashfield Court 3 Tewit Well Road Harrogate N Yorkshire HG2 8JG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Linda Trenouth     Date: 1 7 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ashfield Court 3 Tewit Well Road Harrogate N Yorkshire HG2 8JG Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Ann Brown Type of registration: Number of places registered: care home 45 Chalemere Limited Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 45 The registered person may provide the following category of service; Care home with nursing: Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category: Code OP, Physical disability: Code PD. Date of last inspection Brief description of the care home Ashfield Court is a large detached house which has been adapted. The home is situated near the Stray in Harrogate. It is in easy walking distance of the town centre with easy access to the local shops. The home provides nursing and residential care for up to 45 older people. The home has single and double bedrooms and there is disabled access into and throughout the home. Care Homes for Older People Page 4 of 29 Over 65 45 0 0 45 Brief description of the care home The accomodation is set on three floors and there is a passenger lift serving all floors. There are comfortable lounge areas and a conservatory to the front of the home. Current information about services provided at Ashfield Court is in the form of a Statement of Purpose and Service User Guide. Information provided by the Registered Manager on 17th November 2009 indicated that the current weekly fee for the home is from £600 to £800 per week, dependent upon the size and location of the room. Additional costs include; toiletries, hairdressing, chiropody, newspapers, and personal taxis. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the first inspection for Ashfield Court and was an unannounced key inspection. The site visit was completed on the 17th November 2009 by one inspector This visit was completed over 7 hours. The outcomes in four of the seven areas of the report are rated excellent. Normally this would mean that the quality rating for the service would be rated as 3 star i.e. excellent. Ashfield Court has recently registered as a new service and to meet the Care Quality Commission guidance can only attain the quality rating of 2 starts i.e. good. This is to fairly measure the outcomes over a longer period of time. If the service continues to deliver care at such a high level at the next key inspection they will be rated excellent. We looked at a selection of records, observed care practice and meal times, looked Care Homes for Older People Page 6 of 29 around the building and talked to people who live at the home, the staff and management. Before our inspection visit we reviewed all of the information we had received about the service since the last inspection and we asked the home to complete a self assessment. This was completed and returned to us on time. It provided the information we had asked for and told us what the home did well and what could be improved. We also sent a selection of surveys to the home, for the manager to hand out and ask people to complete and return to us. All comments received were positive and are included in this report. Information from the self-assessment is also included. The care of three people was tracked to help gain evidence as to what its like to live in the home. Various records were viewed during the inspection. Feedback was given to the Manager at the end of the visit. There were no requirements and recommendations made during this visit. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 29 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed and given good information before they decide to move into the home, this is important to make sure the home is right for them. Evidence: People were well assessed before they moved into the home and given good information from the service to help them make a choice that the home was right for them. We received 10 comment cards from people living and working at the home all were positive. These are some of the comments we received; The home is very friendly and has a homely atmosphere The staff are lovely here and go out of their way to help you Care Homes for Older People Page 11 of 29 Evidence: People living at the home all said that they had been given enough information about the home before they moved in, so that they could decide if it was the right place for them to live. We tracked the care of three people living at the home during the course of our inspection. One of those was a new admission to the home and the manager had visited the individual before they moved in to make sure the home could meet their needs. In the AQQA the manager told us that an initial needs assessment is always completed. This is to ensure prospective residents particular care needs can be met and that we have a base line for formulation of a detailed care plan on admission. People told us that they were invited to visit the home as were their relatives. On the day of the inspection a prospective relative arrived unannounced and was greeted promptly by the manager and shown around the home. The home offers a trial period of residence if required, so that individuals can experience life at the home before making the decision to stay permanently. This helps to avoid inappropriate admissions, and unnecessary disruption for the individual. People are given a contract stating what they can expect whilst living at the home, this is important to make sure they are aware of their rights whilst living at the home. Care Homes for Older People Page 12 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met, their privacy and dignity respected and the medication well managed. Evidence: The service has a good care planning system, which is person centred. This means that the individual is involved with all decision making about their care. The care plans show that where possible people are supported to be independent and that their privacy and dignity is respected. Staff were seen treating people with respect and approaching people sensitively. People living at the home told us, The staff always knock at the door, which is really important to me. The staff are always very polite and gentle when they care for you. Care Homes for Older People Page 13 of 29 Evidence: We can have a key to our room if we like, but I am happy not to have, people dont come in to my room unless invited Care plans seen have been reviewed regularly and any changes in need are reflected well, so that staff are kept up to date about the changing needs of people in their care. The home supports people to the end of their lives and provides palliative care. Facilities and resources are accessed to support people in all their health needs. Most of the qualified nurses have specialist training in Palliative Care and the care staff have training in health and social care. The care plan for one individual demonstrated that equality and diverse needs are taken into consideration to make sure that this individual is offered the same opportunities as other people living at the home. The plans showed that the staff consult regularly with health care professionals wherever advice is needed. They promptly deal with any health concerns for individuals at the home, one person told us, They sorted me out straight away, got the doctor in to see me the same day. I only have to say something once and I am listened to. Relatives told us, The health care is excellent, they are really well looked after here, they act quickly when they need to. A wide range of risk assessments have been completed for each person. This is to ensure that any potential hazards are identified and action taken to minimise risk. People living at the home have a choice of GP and additional health resources such as District Nurse, Dentist and Chiropodist. The service has a detailed Medication policy including guidance on the receipt, recording and storage, administration of medicines. The storage was reviewed at the visit and is well managed. Some people do choose to self medicate. They are provided with lockable facilities for safe storage, and a risk assessment is carried out and reviewed, to make sure that Care Homes for Older People Page 14 of 29 Evidence: these people still wish to, and are still able to, manage. Care Homes for Older People Page 15 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily routines of the home were flexible and people were encouraged to maintain their leisure interests and activities whilst living there, this is to ensure people experience a fulfilling life at the home. Evidence: People have a good choice of communal areas to spend their time and in the better weather there is a courtyard area, where people can sit outside. During the visit people appeared comfortable and relaxed and staff have good friendly banter with them throughout the day. Individuals told us that they get up and retire when they wish and spend time in their rooms or join in activities as and when they wish. I have breakfast in my room and come down late morning for coffee, I sometimes join in with the chair exercises. I like the occasional game of dominoes but mostly I like to watch the TV in my room. Care Homes for Older People Page 16 of 29 Evidence: The home displays a monthly schedule on the notice board and this also distributed to individuals. A good range of activities are provided, including board games and cards. There is a visiting library, aromatherapy and regular entertainers perform at the home. During the visit the hairdresser ran her, hair salon, on the first floor. The hairdresser visits twice weekly and is popular with individuals and their families. Outings are also organised with trips to Bettys of Harrogate and other places of interest. Special events and birthdays are celebrated and families are encouraged to join everyone in celebrations such as the forthcoming Christmas party. Communion is held in the home on a monthly basis and people are supported to participate and attend religious and cultural events of their choice. The AQAA tell us, We enable and encourage our residents to access their voting rights, by postal vote if appropriate; also to make contact with outside agencies, e.g., Age Concern, Citizens Advice Bureau etc. People tell us, I can vote if I want to, I think it is by post I have my mail delivered to my room and any personal discussion is done in private, confidences are kept which is very important. Arrangements for visiting are well published and organised. Visitors told us that they are made to feel very welcome at the home and are able to see people in private if they wished to do so. The home provides a good and varied menu. People say that generally the food is good and recently some good changes have been introduced. We joined in the lunch and the food served was well presented. The dining tables are pleasantly arranged and condiments available for people to help themselves. People are offered alternatives to the main meal and a range of desserts presented via a sweet trolley, for people to choose from. Care Homes for Older People Page 17 of 29 Evidence: People are supported with their independence by the provision of specialist cutlery and crockery. Where required individuals are being supported with their meals in a sensitive and dignified way. The chefs serve out the meals at each mealtime so that they can observe how successful the meal has been. Staff ask each individual what they would like to eat during the day from a range of choices, they are also at hand to offer assistance and more helpings. The kitchen facilities are made available during the night so that staff can prepare snacks for people if they become hungry. Breakfast time especially is very flexible to fit around peoples routine. Staff make sure that the people that they are allocated to care for get regular drinks throughout the day. Care Homes for Older People Page 18 of 29 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. People are able to express their concerns and procedures are robust to make sure people are safeguarded from harm. Evidence: The complaints procedure is clearly displayed within the home and included in the Service User Guide. This enabled people living at the home and their relatives to access relevant information about making a complaint if they wished to do so. People say they know who to speak to if they are not happy at the home and that they know how to make a complaint if they need to do so. One person wrote, I would talk to staff and If it was really important I would tell Matron. All staff who returned comment cards say that they know what to do if a person using the service, their relative or advocate has concerns about the home. There have been no complaints received by the Care Quality Commission (CQC) since the service was registered and non received by the home. Staff have training in adult protection and understand their role in the safeguarding of people in their care. Safeguarding policies and procedures are robust and accessible to the staff at the home, this is imprortant so that all staff are aware of the procedure Care Homes for Older People Page 19 of 29 Evidence: they must follow if they have concerns. The home makes sure it follows safe recruitement procedures to ensure that the right staff work at the home and that people are protected. Care Homes for Older People Page 20 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and comfortable environment for the people living there. Evidence: We toured the premises during the course of our inspection, and we viewed a randomly selected number of bedrooms and all communal areas. The home is very pleasant, providing lovely surroundings for people to live in. The quality of furnishings and decoration is of a high standard and the home is well maintained so that people are provided with a comfortable and safe place in which to live. Bedrooms are nicely decorated and furnished to peoples individual tastes. The home is clean and pleasant smelling. The communal areas are well furnished and tastefully decorated so that those choosing to spend their day in these areas can do so in comfort. One person living at the home told us that they are very happy with their bedroom and that it is very comfortable. Care Homes for Older People Page 21 of 29 Evidence: The home adheres to infection control practice. There are appropriate facilities throughout the home including hand gel for visitors to use on entry to the home. This is to make sure everyones health is protected. The environment is spotlessly clean, and a credit to the cleaning staff. It provides a range of communal facilities which people are free to make full use of. Relatives told us, The standard of cleanliness is always good. they provide really good accommodation There is a range of equipment available, including pressure relieving equipment, and hoists. There are also grab rails and a passenger lift, which help people to move around the building independently more easily. Care Homes for Older People Page 22 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service to make sure that people are supported in the best way to meet their needs. Evidence: The home has recently been taken over by the care group Maria Mallaband. The original staff team have continued to work at the home. It was positive to see that there has been a very low turn over of staff, which has promoted continuity of care. When staff were asked if there was anything else that they would like to tell us one of them wrote on the comment card, I have worked at the home for 25 years it has always been a caring home. New staff were safely recruited with thorough checks being completed on individual applicants. Induction training is then completed and other training put into place to make sure that staff are able to care for people safely. The duty rota was in place at the home and staffing levels were calculated in accordance with the assessed needs of those living at the home. When asked if staff were available when they were needed, people living at the home Care Homes for Older People Page 23 of 29 Evidence: said that in general they were. Staff spoken to and comment cards sent to us by staff indicated that, in general, there were always enough staff on duty to meet the needs of those living at the home. The service has a clear staff training audit which shows the training staff have completed and when they need to update or refresh their training. Staff told us that a lot of training was provided for them. The home has good in house training for all staff. This is important to make sure that people are cared for in a safe way by a well trained staff team. Care Homes for Older People Page 24 of 29 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 new manager supports the health, welfare and safety of the people living and working at the home very well. Evidence: The AQAA contains, clear, relevant information and this is supported by a range of evidence. The data section of the AQAA is accurately and fully completed. Quality assurance systems consist of an annual survey for people in the home to complete, regular residents meetings, care reviews, and reviews of the complaints and accidents records to identify any patterns etc. Residents meetings had highlighted areas for improvement and change which the manager had implemented. Food has been an area where the catering staff and manager have worked hard to improve the experience of individuals in the home. Care Homes for Older People Page 25 of 29 Evidence: A wide range of risk assessments and internal audits have been completed by the home to ensure that the standard of service provided was monitored and that the safety of everyone is promoted. Manager, staff and residents meetings are held regularly and minutes were retained so that those concerned are provided with relevant information. Accident records have been completed appropriately so that any incidents could be monitored and to ensure that people living at the home are as far as possible protected. Emergency fire procedures are widely displayed so that everyone in the home is made aware of what they should do in the event of fire. Comments from those living at the home include, I think the home is very good and I am lucky to be here. The manager is professional and approachable and I feel I can take any concerns to her. We were very close to the previous owners of the home but we havent felt that standards have changed during the time the new organisation have taken over. The area manager visits the home regularly and audits various aspects of the service. The Registered Manager told us about how she has organised staff supervisions to make sure they are carried out on time. Staff confirmed they receive regular supervision. The annual quality assessment questionnaire states that all Health and Safety are regularly monitored and checks up to date. The Electrical and Gas safety is reviewed and found to be well managed, it was evident that the home is kept well maintained. This is important so that everyone is kept safe. Care Homes for Older People Page 26 of 29 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 27 of 29 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 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!