Care Home: Bernadette House

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bernadette House The Old Vicarage South Park Lincoln LN5 8EW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Dawn Podmore     Date: 1 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Bernadette House The Old Vicarage South Park Lincoln LN5 8EW 01522521926 01522521928 bernadettehouse@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Beullah Bernadette Brown care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 1. The registered person may provide the following category/ies of service only: Care home only Code PC 2. The maximum number of service users who can be accommodated is: 30 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 Dementia Code DE Date of last inspection Brief description of the care home Bernadette House was originally an old vicarage that has been subject to a change of use. The home is registered to provide personal care for 24 people over the age of 65 years and six with a diagnosis of dementia; accommodating 30 residents in total. The Care Homes for Older People Page 4 of 27 Over 65 0 24 6 0 Brief description of the care home home stands in approximately one acre of secluded landscaped grounds, surrounded by large trees and it is situated on the edge of South Common, close to local facilities. Care parking is available to the front of the premises. The home has four double rooms, twenty single rooms, fourteen of these rooms are en-suite and there are five lounges. There is a conservatory that offers the opportunity of privacy for meetings and visits. The majority of the single bedrooms are located in an extension that was built approximately five years ago. The homes service users guide states that, our continuing aim is to provide a professional and efficient service to meet requirements of care and enhance the quality of life of residents by helping them lead a full and active life as possible. The current scale of charges at this home is from three hundred and fifty one pounds to four hundred and seventy pounds. Information about these and the day to day operation of the home, including the last inspection report, are available at the home. Care Homes for Older People Page 5 of 27 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 key inspection was unannounced and took any previous information held by C.S.C.I about the home into account. Throughout this report the terms we and us refers to the Commission for Social Care Inspection (CSCI). Before the the visit the provider had returned an Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans for improvement over the next twelve months. We also sent out surveys to residents and staff, 6 of which were returned in time to be included in this report. The main method of inspection used was called case tracking. This involved selecting a proportion of residents and tracking the care they received through the checking of records, discussions with them and the staff who care for them, and observation of Care Homes for Older People Page 6 of 27 care practises. A partial tour of the home was also conducted, which included looking at some bedrooms, communal areas and bathing and toilet facilities. Documentation was sampled and the care records of the three people being tracked were examined. We spoke with 6 residents, 3 relatives and 5 members of staff, including the deputy manager and the administrator. They shared their views about how the home operated on a day to day basis and the care and facilities provided. The manager and owner, Mrs Brown, was also present for part of the visit. The outcomes of the visit were discussed with the deputy manager at the end of the inspection. On the day of the visit 30 people were living at the home. What the care home does well: What has improved since the last inspection? What they could do better: No requirements were made following this visit but the areas highlighted below would benefit from some attention. Care plans should be developed further so that they include more information about peoples likes and dislikes, how they prefer their care to be delivered and their abilities. This will help to make sure that staff have a good awareness of how to meet peoples individual needs. They should also contain more information about recent legislation that is designed to protect peoples rights and choices. This is so the home can show that they have looked at the effects the legislation has on the residents lives and planned their care accordingly. Staff should receive appropriate training in this subject Care Homes for Older People Page 8 of 27 so that they know their role in supporting people. The information collected as part of the assessment of potential risks to residents should be incorporated into their care plans in more detail, so that staff have a clearer picture of how to minimise them. Staff should be reminded that handwritten additions on medication records should be checked and signed by 2 people to help to make sure that the information recorded is accurate. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 27 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 27 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 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 people with good information about how it operates and what facilities it can offer. The admissions procedure includes an initial assessment, which helps to make sure that the home can meet the needs of the people admitted. Evidence: The home provides people with various information to help them decide if it is the right place for them to live. As well as the Statement of Purpose and the Service Users Guide, both of which are available in various formats, they have also produced a DVD so that people can look at what the home offers. A review of all information available prior to the visit to the home, and the content of peoples care records, showed that the home does not admit residents without a comprehensive assessment of their needs being completed. The AQAA also says that people are encouraged to visit the home before making any decisions and trial stays can be arranged. Care Homes for Older People Page 11 of 27 Evidence: We spoke to some relatives, a new resident and staff on duty, all confirmed that a satisfactory process was being followed. One person said that they had been provided with good information about the home and staff had showed them round and made them very welcome. Another told us that they had come on a 2 weeks trial before making a decision. The deputy manager said that although people come to the home for short stay placements the home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are being met by staff who understand their needs and deliver care in a respectful manner. However some care plans do not contain enough information to make sure that individual needs and preferences are always fully met. There are systems in place to make sure that medications are administered safely. Evidence: We looked at the care records of 3 people living a the home choosing people with different needs. They contained detailed information about peoples main care needs, however they were general and lacked detail about the residents individual preferences and abilities. For example offer bath and if the resident has their own teeth encourage regular check ups with the dentist, therefore they failed to tell staff the exact level of support each person needed. Residents, relatives and staff confirmed that they had been involved in the planning of care. Residents said that staff provided care the way they wanted it delivering. Assessment for potential risk areas, such as manual handling and risk of pressure damage, had been carried out and the information used to formulate care plans. Care Homes for Older People Page 13 of 27 Evidence: However the minimising strategies for these identified risks had not always been fully incorporated into the plans in sufficient detail. Files contained reference to the Mental Capacity Act, but it was a standard statement rather than an assessment of the residents capacity to make decisions. This is new legislation that is aimed at protecting peoples rights and choices. The deputy manager said that training was to be provided to all staff to enable further development in these subjects. Records and peoples comments indicated that residents had access to outside health professionals such as doctors and specialist nurses. Peoples health care was being monitored and equipment such as pressure relieving mattresses were in use. A daily record of how people were progressing had been maintained and care plans had been evaluated regularly. Staff were knowledgeable about the people they supported and how they preferred their care delivering. During a tour of the home, and at tea time, they supported people in a cheerful manner and were responsive to their needs and preferences, as well as respecting their privacy and dignity. Residents and relatives we spoke to, as well as the people who returned surveys to us, said that they were happy with the level of care and support provided. One person said, staff are very attentive. Another commented, the control of her medication has made a marked improvement in mums wellbeing. Records and observations demonstrated that the home has satisfactory policies and procedures concerning the receipt, storage, administration and disposal of medications. A discussion with a senior carer and observation of part of the medication round confirmed that medications were being handled safely. It was however noted that some handwritten entries on the medication administration records had not been signed by two members of staff. This helps to confirm that the entry is correct. The pharmacist had carried out regular audits of the homes systems. Care Homes for Older People Page 14 of 27 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 home provides a varied activities programme which people enjoy. Residents are enabled to maintain and develop links in the local community and relationships of their choice. People receive a nutritious and varied diet that meets their individual preferences and health requirements. Evidence: The home has employed an activities coordinator to provide stimulation for the people who live at the home. The activities programme for the week was displayed around the home so that people knew what was available each day. Various activities take place on a regular basis. These included bingo sessions, crafts, cooking, beauty therapy and films. An Easter raffle was under way and people had made easter bonnets, baskets and cards. Photographs had been taken and were to be displayed in the home. Residents and 3 relatives said that they were happy with the activities provided. Outside entertainers also visit the home, this included a reminiscence group who visited monthly, a theatre group who had performed a pantomime at Christmas and other shows and music for health who also visit monthly.The activities person told us that a wild animal workshop had been arranged for the near future. People were also Care Homes for Older People Page 15 of 27 Evidence: enabled to go out on trips to places like local garden centres. Religious services are held twice a week and people can choose to attend or not. People we spoke with and those who returned surveys told us that they were happy with the activities that took place and said that they could choose not to join in if they preferred not to. They said that relatives could visit at anytime and that they were always made welcome by the staff. Relatives spoken with also praised the staff and the warm welcome they received at the home. At teatime the atmosphere in the dining room was calm and relaxed, with staff assisting some people to eat in an unhurried manner. People said that alternatives to the main menu and special diets were also available. People told us that they enjoyed the meals at the home. Comments included, meals, I love them, good meals, wonderful food and the food is excellent. At the last visit by the Environmental Health Officer the kitchen was awarded a 4 star rating, the highest rating being 5 Star. Care Homes for Older People Page 16 of 27 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. Residents are protected by clear policies and procedures for handling complaints and allegations of abuse. Evidence: The home has a complaints procedure, this is displayed in the home and included in the Service User Guide, which is given to people when they come to live at the home. The AQAA said that no areas of concern had been raised, but a system was in place should any complaints be made. People said that they knew how to make a complaint and would be comfortable highlighting any issues. Residents and relatives consulted raised no concerns or complaints. The home has procedures concerning the protection of vulnerable adults. An alert made to the safeguarding team by the home had been appropriately reported. Staff demonstrated a satisfactory knowledge of what to do if they suspected abuse could be occurring. Staff had received training in this subject. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained, clean, comfortable and homely environment, which offers a good standard of decor and furnishing. Evidence: We took a partial tour of the home looking at the bedrooms of the people being case tracked, communal areas and bathing facilities. The general atmosphere of the home was welcoming and homely. Bedrooms had been personalised by the resident or their relatives with photographs, mementos and small items of furniture. Improvements to the home over the last year included the redecoration of the lounge area near the office. This area had also been re-carpeted. There is a conservatory and 2 lounge/dining rooms, one at each end of the home, where people can sit quietly or entertain visitors. Most bedrooms have en suite facilities, with 12 also having showers. People told us that they were happy with their rooms. They said, the premises is very clean and tidy, its beautiful, there are no odours and I feel very comfortable at the home. The garden and car park were well maintained and seating was available. Ramps are in place to enable easy access to all areas. Care Homes for Older People Page 18 of 27 Evidence: Three housekeepers are employed, they maintain the cleanliness of the home and do the laundry. There were no unpleasant odours detected at the home. Care Homes for Older People Page 19 of 27 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. Residents are safeguarded by the homes robust recruitment procedure, which helps to ensure that staff are suitable to work with vulnerable people. Residents receive care from staff who are knowledgeable about the people they support and have received training to meet their needs. Evidence: The deputy manager showed us how he monitors the number of staff needed for each shift against the dependency levels of the people who live at the home. The rota and peoples comments showed that usually there were 5 care staff on duty in the morning and 4 in the afternoon, this did not include the manager or her deputy. At night there are 2 waking staff on duty. Residents and relatives spoken with, and those who returned surveys, raised no concerns about the staff and felt that there were enough staff available to meet their needs. One person told us, they are very good here. A relative said that she often listened to staff interacting with residents, she commented, it is always good, amazing, and the 3 male carers make a nice mix. The staff spoken with said that they felt that the current staffing levels were good, allowing them time to spend with residents. Observation showed that staff supported people in a calm and relaxed manner and had time to sit and talk to people or offer Care Homes for Older People Page 20 of 27 Evidence: additional activities such as ball therapy. We checked the files of 2 new staff and these showed that their recruitment had been carried out correctly with essential checks, such as written references and C.R.B. (Criminal Records Bureau) checks, being undertaken. Records and staff comments demonstrated that new staff received a satisfactory induction to the home. One person told us, it was thorough and provided a good foundation. The home has a training programme which includes essential subjects such as manual handling, protection of vulnerable adults from abuse, fire safety and essential first aid. Specialist training such as dementia awareness, palliative care and diabetes had also taken place. Staff had been made aware of the Mental Capacity and Deprivation of Liberties Acts, which are aimed at protecting peoples rights and choices. The deputy manager said that formal training was planned for the near future so that they had a better understanding of their role in supporting people. The company encourage staff to complete an N.V.Q (National Vocational Qualification) in care. Information provided showed that out of 20 care staff 18 have attained an NVQ and the remaining 2 were currently doing the award. The Activities person has also been enrolled on an N.V.Q. level 3 in Provision of Activities. Residents said that they were very happy with the way staff supported them. Their comments included, they are absolutely wonderful, the ancillary staff are also friendly and on the ball, they are good, cheerful and very helpful, the staff are superb, I am very happy with everything and they are all very approachable with clearly defined roles. Staff said that they felt well trained and supported and they demonstrated a very good knowledge of the people they were caring for. One person said, staff work closely with health professionals and families to ensure the best possible care. Care Homes for Older People Page 21 of 27 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. Good leadership and guidance is provided to staff to ensure that care is delivered in a consistent manner. The home is managed in the best interest of the of the residents. There are systems in place to make sure that the health, safety and welfare needs of the residents are met. Evidence: The home is managed by Mrs Brown, who is also the owner of the home. She is supported by Martyn Heginbotham, who is the deputy manager. Both have experience in managing a care home and have achieved the Registered Managers Award. Comments from residents and relatives indicated that they felt that the home was well run and that the manager was helpful and supportive. They said that the home cared for people well and that they also supported relatives too. A resident told us, its perfect for me. One relative said, its like a big family, I would recommend the home unreservedly, shes so safe and happy. Another one said since mum moved in she has felt comfortable and above all safe, her quality of life has improved 100 . Care Homes for Older People Page 22 of 27 Evidence: The staff said that the management team were informative, supportive and approachable. One person said that they had clear expectations of very high standards. When asked what the home did well a staff member told us, they provide the users with independence, dignity and safety, it empowers people to live as normal a life as possible. Another carer said, I have never worked in a place like it, management is clear and fair. Staff said that they felt supported in their work. Records and what people told us showed that they were receiving regular supervision and appraisal sessions. The home has a quality assurance system so that they can gain the views of the people who use the service. The AQAA said that this included surveys, a suggestion box and meetings. Surveys had been recently sent out to staff and the results analysed to provide an action plan to address any ideas or issues they had raised. The deputy told us that surveys to residents, relatives and other stakeholders were currently being issued. The home does not hold any monies in safe keeping for residents as the home invoices people directly. The financial records were examined with the administrator who explained how people were billed for services like hairdressing and chiropody and an audit trail maintained. The home has health and safety polices and procedures to guide and instruct staff. There is also a programme in place to service and maintain equipment in the home on a regular basis. Information provided in the AQAA and sampling on the day of the visit demonstrated that regular checks on equipment, such as fire equipment and hoists, had taken place as scheduled. Care Homes for Older People Page 23 of 27 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 27 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 1 7 15 Care plans must contain detailed information about peoples capabilities and individual preferences. This will help to make sure that they receive person centred care and support that meets their individual needs. 22/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Information gathered as part of the risk assessment process should be incorporated into care plans in more detail. This will then provide staff with clearer information about how to minimise potential risks. Care plans should include reference to the Mental Capacity Act, 2007 and the effects it has on individual residents lives. This is to help to make sure that their rights and choices are protected. Handwritten entries on medication records should be signed by two people to confirm that the correct information has been documented. Page 25 of 27 2 7 3 9 Care Homes for Older People 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 4 30 Staff should receive formal training about the content of new legislation, such as the Mental Capacity Act and Deprivation of Liberties Act, so that they have a better understanding of supporting people appropriately. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!