Care Home: Halcyon House

Similar services:

• 2 Perhaver Park
• The Vicarage
• St George`s
• 5 Seafield Road
• Radfords
• Honeybourne House
• 32 Beaumont Way

What the care home does well The home continues to update and maintain the decoration of the home and upgrade the environment as needed. Mencap and the manager encourage staff to undertake regular updated training and development ensuring that people who live at the home receive the best possible service. The home arranges a wide selection of daytime activities to encourage peoplesindependence. What has improved since the last inspection? The home has ordered new lounge furniture and waiting for delivery. The lounge has also benefited from being repainted, new lighting fitted and a new large TV with a games consul fitted for the enjoyment of all. Mencap has purchased a large garden shed that will be converted to an activities centre. What the care home could do better: All care plans should be regularly updated and reviewed to ensure staff are aware of any changing needs of people living in the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Halcyon House Halcyon Road North Prospect Plymouth Devon PL2 2PJ 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: Kim Fowler Date: 1 4 0 5 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 29 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Halcyon House Halcyon Road North Prospect Plymouth Devon PL2 2PJ 01752605541 NOFAX h5058@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Royal Mencap Society care home 9 Number of places (if applicable): Under 65 Over 65 9 9 0 0 learning disability physical disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home The home is a single storey purpose built detached building within a row of ordinary semi detached houses in the North Prospect area of central Plymouth. A full range of amenities and facilities are within walking distance. The home has its own vehicles and the central shopping area of Plymouth is accessible by public transport. The home can accommodate up to nine people with a learning disability. The home is fully accessible to the people that live at the home and visitors who use wheelchairs. There is a garden and patio to the rear of the building and which is fully accessible. The service offered by the home is for men and women with a learning disability between the ages of 18 and 65. Some of the people that use the service have substantial mobility needs and most have complex needs. The present fees range from a minimum of 614 pounds to 1252 pounds but may vary dependent on individual needs. 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 Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home The unannounced inspection took place over 1 day on the 14th May 2009 and started at 9:30am and finished at 2:30pm. The new manager was available throughout the inspection. We made a tour of the building and spoke to some of the people living at the home. Documentation relating to the care planning process and the management of the home were examined. We also spoke to the manager and some of the staff members on duty during the inspection. Any comments received during the inspection are in the relevant section of the report. What the care home does well The home continues to update and maintain the decoration of the home and upgrade the environment as needed. Mencap and the manager encourage staff to undertake regular updated training and development ensuring that people who live at the home receive the best possible service. The home arranges a wide selection of daytime activities to encourage peoples Care Homes for Adults (18-65 years) Page 7 of 29 independence. What has got better from the last inspection What the care home could do better All care plans should be regularly updated and reviewed to ensure staff are aware of any changing needs of people living in the home. Care Homes for Adults (18-65 years) Page 8 of 29 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Kim Fowler 33 Greycoat Street London SW1P 2QF 02079792000 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 Adults (18-65 years) Page 9 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 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, 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 . Prospective new admissions referred to the home can be assured that they will be provided with sufficient information for them to make an informed choice about living at this care home. Evidence: The last inspection highlighted that the homes Statement of Purpose and Service Users Guide would benefit from being in a video format. The new manager confirmed that the home still plan to carry out this task and plans are currently being prepared to complete this video. No one new has been admitted to the home for a number of years. A prospective new admissions family were looking around the home during this inspection and they were able to confirm that they had received information about the home prior to their visit on that day. Both the family and the home confirmed that the next process would be to arrange trial visits. The admission process was discussed with the manager and deputy manger and it was clear that they were fully aware of the process and had prepared the necessary forms Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: for this possible new admission. Halcyon House is part of national Mencap and this company have a Policy and Procedure in place that includes pre-admission forms that are comprehensive in detail, one of which had been completed for the prospective new admission. The information prepared for prospective admissions is important to assure that not only can their health care needs but also their physical needs are managed and met by the home. The homes AQAA returned to the Commission under, our plans for the next 12months said, To move towards supported living. Care Homes for Adults (18-65 years) Page 12 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 . People are encouraged and supported to make daily decisions about their own lives to maintain their independence as much as possible. Evidence: The files for three people living at the home were examined. All held comprehensive information on meeting personal care needs and also holds information in photographic form on how these needs would best be met to assist the staff. These care plans show a breakdown of the services and facilities provided by the home as well as current needs, specialist input and guidelines for staff to manage individuals. Each file also held information in photo format of individuals likes and dislikes, family members and how each person preferred way of taking medication. However all care plans require updating with some showing no update since 2006. The new manager is committed to completing this task and has a format already planned and ready to use. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Completed plans would ensure all aspects of health, personal and social needs would be met. Due to the complex needs of people currently living in the home they are unable to make major decisions. However observations throughout the inspection were staff assisting people to make decisions about everyday issues. This included any trips out that day and one person planning lunch and the choices available. The manager stated that each person is given options, as much as is possible, about were to go on holiday or day trips and then the options available are discussed and destination chose. The homes AQAA states that the improvements over the last 12 months is, Better evidencing and record keeping. All care plans held risk assessments to cover all aspects of risk. These risk assessments included independent living skills and for trips out into the community. Each file also holds a risk assessment on managing risk with individuals. This information is important to minimise risk. The money held for individuals was discussed with a staff member on duty and records showed a clear audit trail on money held, income and expenditure for individuals. The money checked for two people was correct. One person currently living in the home is planning to move to supported living. The care staff within the home is supporting this transition with this person. And the manager confirmed that this is being done at the person own pace with full support from other professionals including the learning disability team. Care Homes for Adults (18-65 years) Page 14 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 . The people living in Halcyon House can be confident that the home will promote and provide support for them to access the local community and leisure activities as much as possible. Evidence: Staff spoken with was able to confirm that the home has its own transport and when possible use this transport to go out on different day trips. The home has a detailed list available on the homes notice board of the activities planned for each day. Observation during the inspection was one person discussing their trip out and what they would like to do and were they would like to go. One-person file held information on a planned holiday for later this year. The home has plans to have a Sensory room fitted and the letter agreeing the funding and the architects plans were also available for inspection. The manager confirmed Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: that building regulation would be sort on completion. The home displays a detailed list of what activities are happening each day and updated accordingly. This list currently showed people attending shopping trips, day centres, swimming and housekeeping tasks. One person also attends a local day centre. Evidence was recorded in the files examined of input from relatives and friends. The staff confirmed that several people have regular visits from family members and some people visit the families at home. Observation showed one person discussing with the staff about a future planned trip to see their relative. Observation throughout the day was people living in the home participating in daily routines including preparing the tables for meals. Information held on files is used to promote the respect, privacy and dignity of each person living in the home and the home is assessable to all. The duty cook was spoken with and confirmed that they received sufficient provisions to plan a suitable menu to meet peoples needs. The cook has also completed a Healthy Eating course and has worked at the home for many years so is able to prepare meals to suit individuals choices. We sat with the people present in the home at lunchtime for their lunchtime meal. The atmosphere was good and the food was good quality. Further observation during this meal served provided evidence that everyone has staff support and specialist equipment if required and this promotes independence at meal times. The main meal served at lunchtime consisted of, fresh tuna, fresh vegetables and potatoes, with a choice of dessert. The cook was also observed preparing freshly baked cakes and biscuits for everyone to enjoy. The staff confirmed that there is a menu available but it is changed when needed and discussed with the people living in the home if possible. One person has a special diet and all this information is available in their individual plan. Care Homes for Adults (18-65 years) Page 16 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 . Staff were observed promoting individuals independence and providing good personal support promoting privacy and dignity at all times.Access to health care is maintained to promote the wellbeing of all who live in the home. Evidence: All personal support is recorded into individual care plans and these are easily accessible for staff. People who require assistance with personal care have clear instructions recorded to assist the staff were needed. However the manager agreed that all the care plans and personal support information requires updating and has plans to carry out this task. These details updated would ensure consistency in the care provided. Guidance on personal care is clearly recorded into individual files and this ensures that staff are aware of peoples needs and will promote consistency in care. Other professionals involved in the home include the Learning Disability team and evidence on their input is recorded into individual plans. One persons file examined held guideline, produced by the Challenging Behaviour team, to assist one individual Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: and the staff. Each person has information on their file of all medical and professional visits including visits from GPs, chiropodist and learning disability team. A completed form is held on each file showing important information that may be required in an emergency and showing current health care needs. The homes AQAA states under what they do well, Listen to service users and respect their wishes wherever possible. The home uses the blister pack administration system and currently holds controlled drugs. The home controlled drug record was checked and provided evidence that this was clearly recorded and the correct amount held. A staff member was observed administrating medication and showed a clear audit trail of administration administered, recorded and dispensed. The home holds clear records on staff designated to administer medication and have received medication training and one staff member confirmed that they had received medication training. Care Homes for Adults (18-65 years) Page 18 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 . The people living at Halcyon House can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. Evidence: Each person has a complaint procedure held in their individual file and all people living in the home have family input that visit weekly and are able to discuss any issues of concern. The complaints procedure is displayed in the main entrance hall for all visitors to access and there is a sign in individual bedrooms showing who and how people can make a complaint. However due to the needs of people living in the home most are unable to make a formal complaint. The manager confirmed that staff members record any changes in behaviour and how this is investigated. Neither the Commission nor the home has received any complaints. The manager confirmed that all newly employed staff undertakes the Safeguarding training within 6 weeks or commencing employment. The staff on duty confirmed that they had completed the Safeguarding training with Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: the local authority. A Safeguarding alert was made to the safeguarding team and after the investigation was completed it was recorded, no case to answer and no further action required by the safeguarding team. The issues raised were dealt with within the Mencaps discipline procedures. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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 . Halcyon House continues to update and upgrade a clean and suitable environment for its stated purpose and people living at the home can be assured that they will live in a comfortable home that is regularly maintained. Evidence: This home was purpose build and is suitable for its stated purpose. A full tour of the premises showed the home is well kept, safe and accessible for all the people currently living at the home. The manager was able to confirm that all maintenance and repairs are ongoing as is the general update of the home. The manager confirmed that some new lounge furniture has been ordered and due at any time. The lounge has also benefited from being decorated and a new TV purchased with a game consul for people to enjoy. The homes AQAA says, To continue with refurbishment, internal and external. Individual bedrooms showed that peoples rooms contained personal items including furniture, ornaments and pictures that reflect their personality and interests. All bedroom doors have locks fitted and also have a safe fitted to secure valuables. The home has purchased a large shed erected in the garden that will be used as an activity centre and plans have been made to convert one room to a sensory room. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The process for the removal of clinical waste was discussed and was satisfactory dealt with the manager confirming a contract with a local company paid for by the home. A certificate was held on one staffs file confirming they had undertaken Infection control training. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, 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 . People living in this home are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Staff training is carried out regularly for all staff to ensure that all assessed needs of the people living at the home are met. Evidence: Throughout the inspection the staff on duty were observed responding sensitively and respectfully to each person living in the home and were able to use their knowledge of individuals to encourage choice and independence as much as possible. All staff were observed to be friendly, good-natured, courteous and respectful at all times. They interacted well with the people living in the home and some of the activities observed being planned showed that staff and the people living in the home having a good relationship and relaxed in each others company. Some of the staff spoken with confirmed that there was sufficient staff on duty to met the current needs of people living in the home. On the day of the inspection there was the manager, deputy manager, 4 support workers, a cook and a domestic. The home provides a waking night staff and a sleep in staff with a on-call system for the management. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Observation showed that the staff members on duty were aware of individuals needs and how best to support them. Most of the people living in the home have limited communication however observation showed that the staff team were very good and it was evident that there was a good rapport between everyone living and working in the home. Examination of staff files showed that all staff had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. Discussions with manager and the staff showed that all staff participate in and update training course when needed. The training recorded in individuals files show that Safeguarding, medication, Fire Safety and National Vocational Qualifications (NVQs) and courses related specifically to working with people with learning disabilities is regularly undertaken. The homes AQAA records under what they do well, All staff trained to a high standard. Several staff members were spoken with during this inspection and all confirmed regular training was offered. These staff also felt that they were able to express their view at staff meetings held in the home. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the homes aims and objectives, philosophies of care and promotes consistency and improvement. Care Homes for Adults (18-65 years) Page 24 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 management of this home is very good and is committed to updating all records. And the staff team are well trained to meet the needs of people living at the home. Evidence: The home has a new manager in place and they have started the registration process with the Commission. The new manager is aware that they need to complete the Registered Manager award and an NVQ in care. One staff member stated that the new manager had started to change things for the better. The manager confirmed that the home has completed quality assurance surveys sent by the home. However they were currently with head office and not available for inspection on this occasion. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment i.e. hoist ensuring all have been checked. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Gas and electrical appliances were being routinely serviced and checked. The fire protection system was well maintained. Maintenance checks are being carried out. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies and many staff were attending a fire safety training course during the inspection. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes  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 Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 All care plans should be updated and review. Care Homes for Adults (18-65 years) Page 28 of 29 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 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!