Care Home: Burlington Court Care Home

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

What the care home does well A comprehensive "Welcome Pack", which includes a Service User Guide, a Statement of Purpose and guidance on making comments and complaints, is available to prospective Users. Care plans are clear and carers are well informed about the needs of people using the service. Personal care plans are person centredRisk assessments are in place and reviewed. People living at the service are supported to be independent and to take responsible risks. There is good information within their care plan to manage risks. There is a clear complaints procedure that is proactively managed. Good management information enables the staff to respond more effectively to the needs of people using the service. The care team are competent, and well trained. The menu is well planned and prepared to meet the needs of people using the service. What has improved since the last inspection? Detailed care plan are in place for each person that uses the service that ensure that needs are identified and met by care staff. Risk assessments for manual handling, falls, nutritional needs, aggression and pressure care are now included within care plans to ensure that the needs of people using the service are met. A controlled medication cabinet has been installed in the medication room to comply with new legal requirements. Staffing levels are being maintained during periods of absence to ensure that the needs of people are met. Good information is available to ensure that there is ongoing accessible to people using the service. Each unit within the home now has a manager to ensure that improvements in service are maintained. Staff morale has improved and there is a positive atmosphere across the home. What the care home could do better: The activities within the home need to be more person centred and meet individual assessed needs. CARE HOMES FOR OLDER PEOPLE Burlington Court Care Home Roseholme Road Abington Northampton NN1 4RS Lead Inspector Judith Roan Unannounced Inspection 9th February 2009 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burlington Court Care Home Address Roseholme Road Abington Northampton NN1 4RS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01604 250225 01604 887664 adam.turvey@rochmills.co.uk Burlington Care Homes plc Vacant Care Home 102 Category(ies) of Dementia - over 65 years of age (66), Old age, registration, with number not falling within any other category (36), of places Physical disability over 65 years of age (6) Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No one falling within category OP may be admitted into Burlington Court where there are 36 persons of category OP already accommodated within this home No one falling within category DE(E) may be admitted into Burlington Court where there are 66 persons of category DE(E) already accommodated within this home No one falling within category PD(E) may be admitted into Burlington Court where there are 6 persons of category PD(E) already accommodated within this home No person to be admitted to Burlington Court in categories OP, DE(E) or PD(E) when 102 persons in total of these categories/combined categories are already accommodated in this home 6th August 2008 Date of last inspection Brief Description of the Service: Burlington Court Care Home provides personal care for up to 102 service users when it is running at maximum capacity. The home currently caters for older people over the age of 65 years, including up to 66 service users with dementia. Burlington Court is located in Northampton, close to Abington Park, and is near the local shops and facilities of Wellingborough Road. Within the home there are lifts serving the first floor and the building is designed around landscaped gardens. There are three wings, namely Tudor, Saxon, and Windsor wings, each with ground and first floor accommodation, including lounge and dining areas. The first floor of Tudor wing caters for service users with dementia related needs. All bedrooms have en-suite facilities and there are only three shared bedrooms. For enhanced security there is a camera system monitoring the external areas of the home as well as electronic security gates leading to the visitors parking bays. Fees range from £400 to £550. Information about the service can be found in the homes Statement of Purpose and service users guide. A copy of the Commission for Social Care Inspection is kept in the entrance hall to the home. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three people who use the service and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The Inspector also met with and received comments from senior staff visitors/ relatives during the inspection. This provided positive feedback about the improvements made within the service and the quality of care. The homes acting manager had previously completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required to be completed by CSCI. The inspection was unannounced and lasted 8.5 hours. People using the service said that they feel safe. The food is good I have good support from staff they are very helpful I have been made to feel welcome I would like more to do A staff member said that they now enjoy their work and look forward to their day. What the service does well: A comprehensive “Welcome Pack”, which includes a Service User Guide, a Statement of Purpose and guidance on making comments and complaints, is available to prospective Users. Care plans are clear and carers are well informed about the needs of people using the service. Personal care plans are person centred Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 6 Risk assessments are in place and reviewed. People living at the service are supported to be independent and to take responsible risks. There is good information within their care plan to manage risks. There is a clear complaints procedure that is proactively managed. Good management information enables the staff to respond more effectively to the needs of people using the service. The care team are competent, and well trained. The menu is well planned and prepared to meet the needs of people using the service. What has improved since the last inspection? What they could do better: The activities within the home need to be more person centred and meet individual assessed needs. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information and preadmission assessment ensures that the personal care needs of peoples using the service can be met. EVIDENCE: The statement of purpose and service users guide that was reviewed last year is updated to ensure that information remains current. The documents state clearly the service available. The terms and conditions of residing at the home are contained in the contract that is issued to all residents and their families. The AQAA states that ‘People viewing the home are issued with a statement of purpose, brochure and service user guide which enables them to be informed of information relating to the home’. Copies can be found in the entrance hall at the home. It is evident from case tracking the records of new residents at the home that a through assessment of need was undertaken at the time of admission to ensure that individual personal care needs could be met. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 10 The assessments seen as part of the case tracking were detailed and gathered information from the individual person making the application, their family, health care professionals and the funding authorities. People spoken with confirmed that they had visited the home where possible prior to moving in. Individuals files held contracts made with the provider and the person receiving the service. An additional contract is made with the funding authority where applicable. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are person centred and demonstrate the involvement of people using the service. EVIDENCE: Care plans are in place for people who use the service and are reviewed on a regular basis or as required Good record keeping ensures that information is shared appropriately with care staff and unit managers ensure that the team are fully updated with any changes to care. Confidentiality is maintained with all carers understanding the importance of keeping personal information in secure files and on a need to know basis. All people using the service have access to their files if they wish and confirmed that care plans had been developed with them. The outcomes for people using the service are positive and that needs are being met within the systems in place at the home. In discussion with carers it was evident they are very knowledgeable about the needs of the people they support. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 12 In reviewing the files and in discussion with individuals using the service it was evident that they were being assisted to maintain their independence and to participate in everyday activities within the home. Risks have improved and are undertaken on an individual basis with plans made to minimise these for each person. The management team are working consistently across the home and have prioritised care plan activity to ensure that needs are met and maintained. In viewing files it was easy to identify the needs of individuals and to establish their priority. People using the service told the inspector said that they were well looked after and no one thought they were denied their choices. We case tracked two care records, which again clearly demonstrated that the ongoing needs of people using the service needs are being monitored and supported whilst living at the home. In discussions with individuals, viewing case files and in observations throughout the inspection it was evident that people make informed choices about their lives and are supported to have independent life styles within their ability. Discussions with staff supported these facts and demonstrated that they were up to date with information about people who use the service. It was evident that people using the service are supported to make decisions about their own lives wherever possible e.g. daily routines and how their personal needs are met. People using the service are positively supported to access local healthcare services and have regular health check. In discussion with the acting manager they confirmed that good relationships had been made with the doctors practice that support individuals living at the home. Care plans viewed indicate the health care needs of individuals are met and cover the management of personal care, skin care, nutritional intake and monitoring weight. Personal support is provided in a discreet manner and with people using the service preferences being a top priority. Medical profiles for people who use the service have clear information on medication taken. These would however benefit from details on the reason why it is taken and any contra indications are. All medication is stored in a locked facility and records were well maintained. A controlled drugs cabinet has been installed since the last inspection and records demonstrate that these records are maintained in accordance with regulations. Carers receive training in the management of medication and undertake refresher training using a distance learning pack. Training records supported this. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a range of activities available at the home, but these are not individual or person centred. EVIDENCE: A range of group activities is available every morning in the activity room, arranged by the activities coordinator. These activities are popular and enjoyed by those who attend. In afternoon, the coordinator visits units within the home to support people that have not been able to attend the morning sessions. In speaking with one person there visual impairment needs had not been addressed and social profile had not identified suitable activities that this person could join in with or be supported to undertake. The service has one coordinator, which is not adequate to meet the needs of people living at the home. It is recommended that a review is undertaken to ensure that both group and individual activities are promoted and person centred. Meals at home enable people living out the home to have a choice of two main meals at lunchtime with a hot or cold meal at teatime. Individuals can choose from, a wide range of foods at breakfast. On the day of the inspection the menu at lunchtime, consisted of first course soup, a choice Gammon, with Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 14 vegetables or an omelette for the main course. There is a choice of deserts. Specialist diets are prepared for people who require low salt, diabetic, or soft diets. Other diets can be accommodated on request. Families are welcome to visit their relatives living at the home at any time during the day or evening. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Practices within the service protect people who use the service and ensure that they are listened to. EVIDENCE: One safeguarding referral has been made since the last inspection relating to theft of money. Police have investigated the incident and have not resolved the loss. The acting manager has reviewed how money is secured at the home to ensure that large sums are not left in bedrooms. The service has comprehensive policies and procedures in relation to handling concerns and complaints. A copy of the complaints procedure is available in the entrance hall at the home. People who use the service were all clear about how to make a complaint saying they would speak with the manager or a member of their family. Carers undertake abuse awareness training as part of their induction/ foundation training. Several have completed this as part of their National Vocational Qualification. The inspector checked out their understanding during the inspection. The open approach of the registered manager enables people who use the service to feel comfortable if there was a need to make a complaint or express a concern. In discussions during the inspection it was concluded that people using the service felt safe and that carers had a good understanding of their role and were aware of policies and procedures. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 16 Robust recruitment checks also ensure that people using the service are protected as the service ensures that all applicants have two references and a criminal bureau check before commencing work at the home. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a warm setting with individual and communal space that is clean and hygienic. EVIDENCE: The home consists of several units that are decorated to a good standard. There is now a rolling programme agreed for redecoration. There are adequate rooms to enable everyone to have their own personal space. Several communal areas are used for joint activities and each bedroom has sufficient room for people to spend quiet and private time. Communal areas are comfortable and provide a range of areas where people can relax. Individual bedrooms are personalised comfortable and well maintained. Areas of poor maintenance in toilet and bathrooms identified at the last inspection have been addressed. Although in discussion with staff work does take a long time to be completed. The acting manager is to review how the maintenance team operated within the home to improve this area of the service. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 18 The housekeeping team maintain the home to a good standard of cleanliness and hygiene. The AQAA identifies that the management team have identified redecoration and refurbishment of carpets as areas to work on over the next twelve months. Standards of cleanliness and odour control in all areas of the home were good. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff skills and recruitment practices ensure that the needs of people who use the service are supported and that they are protected. EVIDENCE: The trained, competent and supported staff team ensure that the service is professional and meets identified needs of people using the service. Carers spoken with during the inspection were confident in their knowledge about people they were supporting and demonstrated a positive attitude their work. Staff morale has improved greatly and there is good teamwork. Staff stated that is was good to work at the home and that communication was good. They also felt valued. Recruitment procedures are robust as files seen contained all of the required documentation to confirm that security and employment checks had been undertaken. References and Criminal record Bureau checks were in place. The manager is due to submit their application to CSCI to become the registered manager. New carers undertake an induction programme and work alongside experienced members of the team to gain full knowledge about the needs of people using the service living at the home. There is evidence of a good communication system within the home by the use of direct communication from the unit managers, communication book, incident reporting and diary. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 20 Carers are offered a range of opportunities to train. The AQAA confirms that fifty four percent of care staff and managers hold an National Vocational Qualification or equivalent at level two or above. Supervision is available with the manager meeting with unit managers on a regular basis as well as one to one support. The staff team also meet to discuss development and day-to-day issues. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The service is effectively managed in the best interest of people who use it. EVIDENCE: The acting manager effectively manages the home in the best interests of people who use the service and the support workers. There was good feedback from people who use the service and support staff about the role of the manager. CSCI has now received an application from the acting manager to become registered. During the inspection a meeting with unit managers to share with CSCI an overview of the management changes implemented over the past twelve months and how this had improved practice within the service. One notable change was the positive atmosphere within the group and leadership skills demonstrated. The group hold regular meetings with the acting manager to Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 22 discuss issues arising from practice and identify areas for development. They also confirmed how they support each other and maintain the continuity of service throughout the home. The acting manager reviews the service through information from each unit manager that they complete weekly, together with face-to-face meetings. The service is reviewed by an independent agency that completes the Regulation 26 reports on behalf on the owner. Points raised at these visits are discussed and action taken. This has supported the continuous improvement within the service and adds to the quality assurance systems in place. All meetings at the home are recorded and demonstrate how the service is reviewed. The AQAA was reflective about the future development needs of the service and shows that the management team are proactive. The acting manager states within the AQAA , that the views of people are gained through Service user meetings to which relatives are invited too Service user questionnaires – every 6 months, feed back from external assessments of the home such as from questionnaire and feedback from CSCI and Social Services. The provider has undertaken all health and safety checks required. Clear records of all checks are well maintained. The AQAA also confirms the checks undertaken. Health and Safety Policies and Procedures are in place and carers are aware of these. Induction training ensures that all employees have knowledge and understanding of these. Policies on care practices are also available at the home and these are kept under review. Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP9 OP12 RFC19 Good Practice Recommendations Medication profiles would be enhanced by additional information on the reason for use and any contra indications. The activities within the home need to be more person centred and meet individual assessed needs. Maintenance within the home needs to be routinely undertaken with good systems in place to demonstrate monitoring of action taken Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Burlington Court Care Home DS0000029409.V374166.R01.S.doc Version 5.2 Page 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!