Care Home: Corner House Residential Home Ltd

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well A service user said "I like living here". The managers and staff support individual needs. They successfully support the complex health and mobility needs of one service user and they assist two others to maintain a high level of independence. Another service user is helped to manage his behaviour and stay safe in the community. What has improved since the last inspection? The home has changed to a simpler medication administration system. The kitchen has been refitted and refurbished to a high standard. The home has responded to some previously made requirements. They now have a copy of the local authority safeguarding procedure in the office and a fire risk assessment has been completed. What the care home could do better: The home must address the restated requirements for a robust quality assurance system and a business plan. The policies and procedures regarding safeguarding need to be amended and staff must have adult protection training. There must be data sheets for all Control of Substances Hazardous to Health (COSHH) products stored at the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Corner House Residential Home Ltd 131 Stokes Road East Ham London E6 3SF     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: Anne Chamberlain     Date: 0 6 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 29 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Corner House Residential Home Ltd 131 Stokes Road East Ham London E6 3SF 02074743033 02074743033 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Salamut care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 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: Learning disability Code LD Date of last inspection Brief description of the care home Corner House is a residential care home offering support and accommodation to five adult residents who have learning disability without challenging behaviour. The home has five bedrooms and occupies a corner plot in a residential street in East Ham. The accommodation comprises entrance hall, large lounge with TV and comfortable seating, a kitchen diner, downstairs bathroom and ground floor bedroom. Access to the first floor is by stairs only. On the first floor there are a further four bedrooms, a bathroom with WC, a separate WC and the office. To the front of the property the area is paved with access to a ramped side entrance. To the rear there is a small garden. At the time of the inspection the home had no vacancies. The home is located close to the A13 main road and the Becton shopping area. Bus links to East Ham shopping area and Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home facilities are close by. The range of fees for residents at the home is between #826.44 and #1124.16 Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The manager submitted to us an Annual Quality Assurance Assessment (AQAA) with helpful information about the service. The site visit of the inspection lasted for some five hours and was undertaken by the lead inspector. The terms we and us are used within this report to indicate that the inspection activity was undertaken on behalf of The Commission for Social Care Inspection (CSCI). We spoke with two service users and a member of staff and were assisted by the deputy manager. We viewed the files of two service user, and two staff members, as well as key documentation and records. We inspected the arrangements for the administration of medication and made a tour Care Homes for Adults (18-65 years) Page 6 of 29 of the premises excluding all but one service user bedroom. We spoke to the manager of the service on the telephone. We would like to thank the service users staff and managers of the home for their assistance and co-operation with the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. The needs of prospective service users are adequately assessed and they would have opportunties to try out the home. Evidence: The home has not admitted any new service users since the last inspection. We looked at the assessment information for two service users. It mainly dates back to their admissions. It was satisfactory. The manager states in her AQAA that any prospective service user would have a comprehensive assessment and an opportunity for trial visits. We are confident that should the home admit any new service users they would be properly assessed. Care Homes for Adults (18-65 years) Page 10 of 29 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Service users are able to make decisions and take risks. Their individual needs are described in their care plans. Evidence: The two service user files we viewed had new care plans for the service users. These were of a high quality, detailed clear and comprehensive. One service user had 13 elements to her plan. Care plans were in a user friendly format and service users had signed their plans. Both files showed evidence of review of care plans, one fairly recently but one on 15/3/07. If social services do not call a review the home must ensure that there is a review of the care plan at least annually. Ideally this should include the service users, their family, day centre. If social services cannot attend then the review must nevertheless take place. A requirement has been made. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: There was evidence that service users are encouraged to make decisions for themselves and their lives. They attend day centres where they have choices of activities. Their home weekly activity plans state that they choose their own activities for the evenings, watching TV, listening to music, playing games visiting the cinema etc. One service user had recently attended an Elvis concert. We noted that service users had good risk assessments to cover a variety of situations. One risk assessment however had nothing written in the staff actions box. We brought this to the attention of the deputy manager who agreed to write appropriate actions in the box. Risk assessments had not been signed by service users and we have made a requirement around this. The manager must go through their risk assessments with service users and ask them to sign them to show that they understand and agree. Care Homes for Adults (18-65 years) Page 12 of 29 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Service users enjoy meaningful activities and a range of leisure and recreational opportunites. They have choice in their daily routines and what they like to eat. Evidence: The manager states in her AQAA that the home has a policy on equality and diversity and they ensure that staff are able to take days off for religious festivals. It was postiively noted that care plans, risk assessments and other important documents have been produced in a user friendly format. It was positively noted from the file of a service user that he had attended sexuality training and had had a girlfriend in the past. The service users and staff at the home are a culturally diverse group and one service user is a regular church attender and active in the life of his church. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Two service users as mentioned above, attend day centres where a range of opportunites are offered. Two service users work, and one service user attends college and has other recreational but home based activities. The manager stated that the service users all had a holiday in Hastings this year. He also stated that one service user is booked to go to America in January 2009 to visit Gracelands in Memphis. Contact with families is encouraged and supported. One service user speaks to family abroad every two weeks on the telephone, one goes home to see her mum and sisters every day, another has visits from his brother and another has telephone and letter contact with her family. One service user although quite independent was vulnerable in the community and the home have with his parents agreement successfully altered his daily routine to reduce this risk. The deputy manager stated that service users take it in turns every day to choose what they would like to eat for dinner that evening. As part of the kitchen refurbishment there is a new dining table and chairs with attractive lowered lighting overhead. The deputy manager went out with a service user at lunchtime and they came home with a takeaway each. This is their normal practice and the service user chooses what he would like each day. Care Homes for Adults (18-65 years) Page 14 of 29 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Personal and healthcare support is offered in an individualised and sensitive manner. Medication practice is sound. Evidence: Care plans evidenced that service users are offered personal support in a sensitive and individualised way. The home provides waking overnight staff and daily records evidenced that they had provided support to service users overnight. The home has developed good health action plans which we viewed in two files. It was noted that there are completed sheets for medical appointments which have been attended. One service user has complex health needs and she is supported to access specialist help from a range of professionals. We noted that weight monitoring information remained in the main file although the information is now kept up to date in the health action plan. We asked the deputy manager to ensure that this information is only kept in one place to avoid confusion and duplication. A recommendation has been made. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: We also pointed out to the deputy manager that there was conflicting information regarding the weight of one service user. She was stated to weigh 65kgs and also 8.5 stones. These are not equal weights. The home has changed to a blister pack medication system which they find simpler, and which helps eliminate medication errors. We checked a medication each for the two service users whose files we viewed. There were no discrepancies. There are photographs on the front of the service users medication packs to identify them. We also viewed the book which lists medications returned to the pharmacy. We noted that the last medication returned had been signed for by the pharmacist. Care Homes for Adults (18-65 years) Page 16 of 29 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. 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. Service users are safeguarded and any complaints dealt with appropriately. However some amendment of documents is needed. Evidence: The home has a complaints procedure which gives the old address of the CSCI local office. This must be amended. The service user guide has a version of the complaints policy and procedure which gives the correct address of the CSCI but the old telephone number which predates the contact centre. The number must be changed to that of the contact centre which is 020 729 0330. The home must ensure that all their complaints information gives the up to date contact information for the CSCI. The home has a safeguarding policy. It states that the consent of the service user must be sought as part of the procedure. It is not necessary to have the consent of the service user to progress a safeguarding referral and this should be clear. It also states NCSC instead of CSCI. It states that the CSCI will investigate Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: safeguarding referrals which is incorrect. The local authority is the lead agency (unless a crime has allegedly been committed and the police are more appropriate) for safeguarding. The policy/procedure must state that in the first instance social services must be alerted of any safeguarding issues. We saw a copy in the managers office of the local authority adult protection procedure. However the homes policy does not state that they will follow this policy in conjunction with their own, and it must do so (this was required previously with a timescale of 01/10/06). The home assists all the service users with their finances and holds cash for them. We checked the arrangements for two which were satisfactory. Care Homes for Adults (18-65 years) Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, 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. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is homely, safe, comfortable and clean. Evidence: We inspected the environment of the home. The front and rear gardens were neat and tidy. The kitchen as mentioned previously is bright, clean and functional. The decor in the house is generally good but there were some minor shortfalls. The dark blue carpet which covers the hall stairs and landing and the bedroom of one service user, has a big stain in the service users bedroom and another stain outside of the bathroom door. It is also threadbare in the hall and now needs replacing. The grab rail at the front door was very marked with dirty finger marks. The back of the bathroom door (which is a sliding door) needs washing down. The home supports a service user who is incontinent and a policy and procedure for incontinence was viewed. There were no unpleasant odours in the home. The washing machine is in a utility room and not housed in the kitchen. Care Homes for Adults (18-65 years) Page 19 of 29 Care Homes for Adults (18-65 years) Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Staff are safely recruited and competent to care for service users. However they do need some additional training. Evidence: The staff group at the home is stable. Some staff members have undertaken NVQ qualifications and one staff member is a trained nurse. The staff care for the service users competently. The staff files evidenced robust recruitment procedures including Criminal Records Bureau disclosures. We viewed the files of two staff members. They had undertaken various relevant training courses, not including adult protection training. The staff at the home must undertake adult protection training and a requirement has been made. Care Homes for Adults (18-65 years) Page 21 of 29 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The conduct and management of the home is good. However there are shortfalls regarding quality assurance and safe working practices which must be addressed. Evidence: The manager has told us in her AQAA that she is a first level registered nurse with a degree in health management. She is qualified to run the home. She also states that there are no other businesses linked to the company and the home is therefore the prime focus. The day to day responsibilities are delegated to the deputy manager who now has considerable experience. The CSCI has had no incidents, complaints or safeguarding issues reported since the last key inspection. A requirement was made at the previous inspection with two elements that the manager develop a plan for the development of the home, linked to the Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: progress of residents that the manager design a quality assurance tool to measure progress towards the goals set. The timescale given was 01/01/2007 - one year and eight months ago. The manager states in her AQAA that a robust quality assurance system is in place also that questionaires are used to obtain the in depth views of residents, also that annual surveys are carried out. Unfortunately there was limited evidence to substantiate this on inspection. The manager stated on the telephone that she has orderd a CD Rom to help her design a quality assurance programme. Our past experience of the manager is that she addresses requirements in a thorough considered way. However if the requirement is not met in the new timescale the CSCI will be forced to consider statutory enforcement action to achieve compliance. We viewed the COSHH substances which are kept safely locked away. At the last key inspection the manager was asked to improve the arrangements for COSHH by obtaining data sheets for all products used. There are some data sheets but not for all of the products kept. The manager stated on the telephone that she has had difficulties obtaining manufacturers data sheets for all the products they use. She must ensure that she has data sheets to correspond to the products used even if some of these are of a generic nature. A requirement has been made. During the course of the inspection, (five hours), a smoke alarm on the first floor peeped intermittently. The deputy manager tested the battery and it did not need replacement. He said he didnt know why the smoke alarm kept peeping. The manager must ensure that the cause of the malfunction is discovered and resolved. We inspected safety records including: Gas safety certified on 14/1/08, Electric circuits safety certified May 2007, Portable appliance testing undertaken on 26/3/08 The home has a fire risk assessment and the records showed regular checks on fire protection equipment and drills. The last drill was carried out on 21/6/08, the previous one on 01/03/08. Care Homes for Adults (18-65 years) Page 23 of 29 Care Homes for Adults (18-65 years) Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 22 13 The manager must ensure that the abuse policy makes reference to the local authority policy. 01/10/2006 2 39 24 The manager must develop a 01/01/2007 plan for the development of the home linked to the progress of residents. She must design a quality assurance tool to measure progress towards the goals set. Care Homes for Adults (18-65 years) Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Care plans must be reviewed 19/12/2008 annually. To ensure that the changing needs of service users are met. 2 9 13 Service users must be asked 19/12/2008 to sign their risk assessments. To show that they understand them and agree with them. 3 22 22 The complaints information must be accurate and give up to date contact details. So that service users can contact people when they need to. 28/11/2008 4 23 13 The safeguarding policy/procedure must not imply that the permission of service users is needed before a safeguarding alert can be made. It must be amended to 28/11/2008 Care Homes for Adults (18-65 years) Page 26 of 29 delete NCSC and replace with CSCI. It must not state that CSCI investigate safeguarding matters. It must state that in the first instance a referral must be made to local social services safeguarding. It must state that the policy/priocedure is followed in conjuction with local authority safeguarding procedure(previous timescale for this element 01/10/06). So that people are safeguarded in the most effective way. 5 24 23 The dark blue carpet inthe 31/03/2009 hall stairs, landing and the bedroom of one service user must be replaced. The dark blue carpet inthe hall stairs, landing and the bedroom of one service user must be replaced. 6 35 18 Staff must all undertake adult protection training. So that they can adequately protect service users. 7 39 24 The manager must develop a plan for the development of the home linked to the progress of residents. She must design a quality assurance tool to measure 19/12/2008 30/01/2009 Care Homes for Adults (18-65 years) Page 27 of 29 progress towards the goals set (previous timescale of 01/01/07 not met). So that service users do not mark time but make progress towards identified goals. 8 42 23 The manager must ensure that the home has data sheets to correspond to the products used. So that service users and staff are safeguarded against hazardous substances. 9 42 23 The malfuntioning smoke alarm must be repaired. For the safety of all in the home. 31/10/2008 19/12/2008 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 19 Information regarding weight monitoring should be kept all in one place to avoid confusion and duplication. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 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 Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!