Care Home: Barn Close

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well Barn Close provides a welcome pack to all enquiring about accomodation for themselves or a family member. This contains an up to date statement of purpose, service user guide, copies of the latest inspection and Annual Service Review reports. The pack also contains an application for accomodation. All prospective residents are fully assessed prior to admission into Barn Close. The assessment covers all activities of daily living, relevant healthcare needs and medication, diet, mobilty, likes and dislikes and what activities are enjoyed. End of life care is also discussed if this is felt to be appropriate and the people involved are agreeable. All those living in Barn Close have an up to date care plan that is relevant to the initial assessment of needs. The care plans ensure that staff are aware of the needs and aspirations of those living in the home and how these needs can be met. Work is ongoing to ensure every care plan is centred around each individual. The manager and staff work hard to ensure there are plenty of meaningful and relevant activities for the residents to enjoy. Residents` meetings are held and the provision of leisure time is discussed during the meetings. Residents are encouraged to take part in the local community, which includes tea dances and coffee mornings and services at the local church. External entertainers are also invited to the home. Barn Close is extemely well maintained with the Henry Lonsdale Trust, responsible for the home, ensuring that standards are consistently high. There is an annual programme for repairs and renewals and all furnishings and fitting are of excellent quality. The gardens are well maintained so that residents can enjoy the space during the summer months. There are good systems in place for the recruitment and retention of staff, dealt with at the Trust`s head office situated at the other home in the group. There are processes in place to monitor the home`s performance with information gathered through annual serveys and residents` meetings. Policies and procedures are in place to ensure complaints are dealt with in a timely and appropriate manner and staff have completed `protection of vulnerable adults` training. There is a very good standard of catering in the home and residents remarked that they `enjoyed their meals very much`. Staffing is sufficient to meet assessed needs and although there are some vacant hours at this time these are covered by existing staff or those from the other home in the group. Agency staff are never used and this means there is continuity of care for those using this service. Comments about the staff included `The girls are lovely and so helpful`, `I don`t have to worry about mum as she is so well cared for`. What has improved since the last inspection? The home remains very well maintained through the annual progamme. A new `state of the art` assisted bath has been purchased and installed. The kitchen area and servery have been refurbished and a new staff kitchen has been installed. Carpets for the hall and corridors have been laid. What the care home could do better: During our visit we found that the manager and senior team are open to any suggestions that will improve the care and support provided and the lifestyle of those living in Barn Close. There were no requirements made and only one recommendation made as a result of this visit. There was nothing of concern we considered needed to be dealt witth at this time. Key inspection report Care homes for older people Name: Address: Barn Close Well Lane Stanwix Carlisle Cumbria CA3 9AZ     The quality rating for this care home is:   three star excellent 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: Margaret Drury     Date: 1 8 1 2 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 26 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 26 Information about the care home Name of care home: Address: Barn Close Well Lane Stanwix Carlisle Cumbria CA3 9AZ 01228521085 01228540303 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Henry Lonsdale Trust care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC 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 The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief description of the care home Barn Close is owned by The Henry Lonsdale Charitable Trust with Mrs Mary Styth being the responsible individual. The registered manager, Mrs Jean Feddon, runs the home on a day- to-day basis. The home is situated in a residential area close to the centre of Carlisle and all its amenities. Barn Close is an older property that has been adapted, extended and renovated for its present use as a care home. Accommodation for the residents is on two floors, the upper storey being served by a passenger lift and stair lift. There are thirty-four single rooms and three that are registered as double rooms. All rooms are currently used for Care Homes for Older People Page 4 of 26 Over 65 40 0 0 7 1 2 2 0 0 8 Brief description of the care home single occupancy, with the majority having en-suite toilet facilities. There are four communal areas providing lounge and dining facilities for all residents to use. The toilets and bathrooms are equipped for people with a disability and there are handrails on the corridors to assist with movement around the home. There are large, well kept gardens and car parking is available. Care Homes for Older People Page 5 of 26 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: three star excellent 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 site visit to Barn Close forms part of a key inspection of this service. We, the Care Quality Commission (CQC) visited the home on the 16th and 18th of December 2009 and we were in the home for a total of 6 hours. As an Annual Quality Assurance Assessment (AQAA) was completed less that 12 months ago we, CQC, did not request another but took information from the one received in April 2009. The AQAA is a self assessment and dataset that is completed by all registered providers. It is one of the ways in which we gather information from the provider about their service and how they believe they are meeting the assessed needs of those people living in their home. The AQAA also asks for information relating to both staff and residents, outlines achievements of the past year and any plans for the future. Survey questionnaires were sent to residents, their families and to visiting healthcare professionals. We received a good response all with very positive comments about the care and support provided . We quote from surveys and dicsussions in this report. Care Homes for Older People Page 6 of 26 We looked at information sent to us by the manager informing the Commission about any events relevant to the running of the home. This information is required under the Care Home Regulations. We reviewed any information received from other agencies regarding complaints or adult protection issues but no such information has been received. Whilst in Barn Close we observed the interaction between staff and residents, spoke to those living in the home, visitors and staff and discussed the running of the home with the registered manager. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: During our visit we found that the manager and senior team are open to any suggestions that will improve the care and support provided and the lifestyle of those living in Barn Close. There were no requirements made and only one recommendation made as a result of this visit. There was nothing of concern we considered needed to Care Homes for Older People Page 8 of 26 be dealt witth at this time. 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 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 26 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 26 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. There is a good system in place to introduce people to the home, with information provided and a needs assessment completed. This ensures all who are admitted know their needs can be met in an appropriate way. Evidence: The home has an up to date and relevant admissions procedure, which starts as soon as an application for accomodation is made. There is a welcome pack available that contains all the relevant information and copies of previous inspection and/or Annual Service Review reports. Staff are available to show visitors the facilities on offer and the manager should always ensure that those involved realise the importance of this part of the admissions procedure. All prospective residents are fully assessed by the manager or a member of the senior team before a place is offered. This process ensures the home is able to meet all the needs in a way that is acceptable to the resident. The residents have a written contact and terms and conditions of residency advising Care Homes for Older People Page 11 of 26 Evidence: them of the facilities on offer and their personal rights. The fees charged are in line with those agreed by Social Services with extra charges for private chiropody, hairdressing and dry cleaning. Care Homes for Older People Page 12 of 26 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. People who live in Barn Close are involved as far as possible with the management of their individual care plans so they receive the care and support they need in a way they prefer. Evidence: Every resident has an individual plan of care based on the initial assessment of needs with all risk assessments in place and up to date. The manager and senior staff ensure that each care plan is up to date so that each resident receives the right amount of care and support to meet their needs. The information in the care plans covered such areas as mobilty, dietary needs and preferences, health needs and medical history, personal history and social and religious preferences. Nutritional screening and weight monitoring is in place and all healthcare needs are met through visits from the various professionals. Each resident has access to optical, chiropody and dental services. When we looked at the care plans for three of the people living in Barn Close we found them to also show what is important to the individual and how any objectives would be met. We looked at the records for the receipt, administration and disposal of medication. Care Homes for Older People Page 13 of 26 Evidence: These were well kept and showed that all residents received the appropriate medication at the correct time. During the past 12 months a new system of medication has been introduced which, after the initial trial period, is proving to be an easy and safe way to administer the prescribed medicines. Regular stock checks and audits are completed. We observed the way in which staff interacted with residents and found this to be in a calm and relaxed manner. We spoke to some residents during our visit and they were all complimentary about the attitude of the staff and caring, kind and very considerate were some of the comments made. We also met with visitors and thy were equally complimentary and told us they were always made very welcome and also kept up to date with information about their family member who lived in the home. Care Homes for Older People Page 14 of 26 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. Social activites and meals are both well managed and provide daily interest for people living in barn Close. Evidence: There has always been a full programme of activities for residents to choose from if they wish to take part. There was a programme for the month of December displayed in all parts of the home. There were carol concerts, musical entertainment and visits from schools arranged. At other times of the year residents attend tea dances in Brampton Community Centre, a three-weekly service and coffee morning at the local church as well as trips out to places agreed by the residents. Staff from Tuille House museum in Carlisle visit the home with memory boxes and there are sometimes exhibitions of residents work on display in the museum. One of the favourite activities is the scrabble tournament which is entered with enthusiasm. Whatever the activity or entertainment the residents are always asked if they wish to join in. Some prefer their own company but the majority enjoy some or all of that organised. Church services and Communion are available for those wishing to attend. Relatives and friends are welcome to visit Barn Close at any time and the visitors we spoke to during our visit confirmed this. One lady who was visiting her mother said she was always offered refreshments while she was in the home. She also remarked Care Homes for Older People Page 15 of 26 Evidence: on the kindness of the staff and the care they gave to her mother. She was especially appreciative as she lives some distance from Barn Close. There are some residents who are responsible for their own personal finances but most receive assistance from family members or solicitors. Comments about the menus and meals were all very positive. Those we spoke to very much enjoyed the home cooking and baking. Provisions are purchased from local suppliers and prepared by a team of catering staff. Copies of the daily menu were on each dining table and showed a choice at each meal. Any meal can be taken in the residents own room although most are encouraged to eat in one of the dining rooms as this gives the opportunity to meet and chat with the other people living in the home. Special diets can be catered for and all residents have a regular weight check and nutritional assessment in place. Care Homes for Older People Page 16 of 26 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. Good safeguarding procedures help tp ensure people remain safe in this home. The complaints procedure is clear and accessible, meaning that people using this service know any concerns will be listened to and acted upon. Evidence: There are suitable policies and procedures in place for dealing with complaints and concerns. Each resident is given a copy of the procedure on admission and this is also outlined in the homes Statement of Purpose. We spoke to a number of residents and visitors during the inspection and all of them were aware of the procedure to follow if they had a reason. They all told us they would speak to the manager or one of the care officers. However thay also said they had never had any reason whatsoever to complain about the service they received. There are clear procedures in place regarding safeguarding of vulnerable adults and training in this subject is updated on a regular basis. It is also discussed during the induction programme, staff supervision and staff meetings. Those staff we interviewed knew what to look for and what to do if necessary. There is a copy of Cumbrias policy in the home for staff to refer to if they wish. Care Homes for Older People Page 17 of 26 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. Barn Close Residential Home provides a safe and comfortable home that is very well maintained and decorated and furnished to a high standard. Evidence: Barn Close is a large detached property that has been extended and adapted for its present use as a care home. It stands in landscaped gardens overlooking one of Carlisles large parks. The home is on a bus route and close to the centre of Carlisle as well as local shops and churches. It is one of two homes run by The Henry Lonsdale Trust, a registered charity. The interior of the building has retained many of the original features such as fireplaces and listed bathroom tiles. There are 34 single rooms and 3 registered as double rooms, one of which is occupied by a married couple. Most have en-suite toilet facilities. The home is extremely well maintained with an annual plan for repairs and renewals. This ensures that the environmental standards remain very high. Since the last inspection there have been a number of further inprovements to the facilities on offer. A new state of the art assissted bath has been purchased and installed, which has proved to be beneficial to residents and staff. New carpeting has been laid and the ongoing programme of redecoration ensures all bedrooms and communal areas are decorated to a high standard. The servery and main kitchen area have been refurbished and the old smoking room Care Homes for Older People Page 18 of 26 Evidence: has been converted to a new staff kitchen. All the bedrooms are well appointed with personal items brought from residents own homes. Both residents and their family members told us that they were delighted with their accomodation. One lady commented, I love my room as I have a view over the garden. The communal areas are spacious and airy with good quality furniture and fittings. The bathing facilities are suitable for people who may have a physical disability and there are sufficient communal toilets, suitably situated ,for those living in the home to use. The kitchen facilities are very good with recent improvements to the main area and servery. There is plenty of space for food storage. The home has policies and procedures in place covering infection control and there is an ample supply of protective clothing for staff to use. This helps to reduce the risk of cross contamination. The home was extremely clean and sweet smelling on the day of our visit. Care Homes for Older People Page 19 of 26 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. The people living in this home are supported by well trained caring staff who have been correctly recruited. This means that peoples needs are met and they are safe from possible harm or poor practice. Evidence: Staffing numbers are, overall, satisfactory for the number and dependency levels of those presently living in Barn Close. On the day of our visit there were some vacant staff hours but these were being covered by existing staff or staff from the other home in the group. Agency staff are never used and this provides continuity of care. There are also catering, kitchen and domestic staff employed. The numbers and skill mix of the staff ensure that the residents are cared for, supported and, wherever possible, kept safe at all times. Staff training is ongoing with an annual plan in place. The trust employs a training manager that is responsible for organising training for staff in both homes. Courses have been completed in a number of subjects that include, moving and handling, person centred thinking, palliative care, emergency aid, diabetes, medication, adult protection, dementia care and health and safety. There is 86 of staff currently qualified to National level 2 or above with others working towards the award. Recruitment and retention of staff is dealt with at head office and no new staff start work before all the required checks and references are completed. The manager should always ensure she is available to be part of the selection process in respect of Care Homes for Older People Page 20 of 26 Evidence: staff that will be working at Barn Close. Residents and visitors spoke highly of the staff and comments such as, the staff are wonderfully kind, the staff take really good care of my mum and I love the girls. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective management and quality monitoring help support people using this service and procedures are in place to safeguard their interests and promote their health and safety. Evidence: Barn Close has a qualified and very experienced manager who is responsible for the day to day running of the home and is registered with The Care Quality Comission. Prior to her appointment she worked for a national organisation involved in the welfare and support of older people. She has completed her registered manager award. She works closely with the management team and staff to ensure the home is run well and in the best interests of the residents and their families. The residents we spoke to, together with visitors, said that one of the reasons they chose Barn Close was because of the caring attitude of Jean (manager) and she always keeps me up to date with news of my mum and if there are any concerns. She greatly appreciated this as she lives some distance from Carlisle. Staff supervision is completed every 2 months with details held on file for inspection. Care Homes for Older People Page 22 of 26 Evidence: Annual quality assurance audits are completed through surveys and residents and staff meetings, which are seen as another forum for obtaining opinions about the running of the home. The manager tries, wherever possible, to put in place any suggestions made by those living in the home. There is a procedure in place for the handling of residents personal finances, though there are only reasonable amounts of cash held on behalf of residents. There is a full set of policies and procedures in place that are updated to ensure they are kept up to date with current legislation. Records and servicing contracts indicate that the home arranges for all equipment to be serviced under annual service level agreements and the relevant certificates were up to date and available for inspection. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 It is recommended that all staff involved in the admissions process are aware of the importance of showing prospective reaidents and their families round the home. Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!