Care Home: Meadow Lodge 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 There are suitable arrangements for meeting people`s healthcare needs. One person commented `The staff really look after us, if we needed a doctor they would get us one. They make sure we go to hospital visits.` People receive care and support in a way which promotes their privacy and dignity. One person said, "I know I need help getting dressed, I am happy how staff help me". People have opportunities to take part in a variety of activities. One person commented, `I like to go to the sing a longs and take part in a quiz. I do keep fit once a week and listen to the entertainer when he comes to sing to us.` People are able to have visitors who can take them out of the home. One person said, "My brother comes to visit me and I go to visit him at his home". People enjoy their meals and a number of positive comments were made including "I really enjoyed that, very good". The home was clean and tidy. One person commented, `The home looks clean, people work hard to keep it fresh.` One person said, `The staff are always very busy, but always manage to be there when you need them. Very efficient staff.` The majority of staff have either got, or are working towards, a professional qualification and have regular training opportunities. The manager is experienced and qualified to run the home. There are suitable management systems in place to help people manage their finances, seek people`s views on how the home is run and ensure people`s health and safety is promoted. What has improved since the last inspection? People have their needs assessed before they move into the home to make sure they can be met. one person commented, `My family came to look at the home and the staff came to visit me and talked to me all about Meadow Lodge and what it offers`. The complaints procedure has been updated and one person said a member of staff had explained it to her. Staff were aware of how to safeguard people in the event of any abuse. Staff were using protective clothing to prevent the risk of infection spreading. What the care home could do better: Information in care plans needs to explain clearly the help and support people require to meet their needs. Where possible people should have an opportunity to help prepare their care plans.Staff should always observe people taking their medication. When people have got a Protection of Vulnerable Adults (POVA) check, but not yet got a Criminal Records Bureau (CRB) check returned, they must only work if they are under direct supervision of another member of staff. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meadow Lodge Care Home 21-23 Meadow Road Beeston Rylands Nottingham NG9 1JP     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: Stephen Benson     Date: 1 5 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Meadow Lodge Care Home 21-23 Meadow Road Beeston Rylands Nottingham NG9 1JP 01159228406 01159228406 meadowlodge1@btconnect.com 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) : Mr David Teece,Mrs Margaret Ann Teece care home 25 Number of places (if applicable): Under 65 Over 65 0 25 dementia old age, not falling within any other category Additional conditions: 25 0 The maximum number of service users who can be accommodated is : 25 The registered provider may provide the following categories 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 fall within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Meadow Lodge is situated on a main bus route, close to a railway station and one mile from Beeston Town Centre. The home is registered to care for 25 older people, including those with Dementia, in two linked adjacent houses. Accommodation is in single and double rooms and is provided on two floors with two passenger lifts. There is a large dining room and four separate lounges. The patio and gardens are pleasant and well maintained. There is an enclosed garden that is accessible for all residents. The manager said on 15/04/09 the fees or the service range from £300 to £365 per Care Homes for Older People Page 4 of 30 2 0 1 0 2 0 0 8 Brief description of the care home week depending upon dependency needs. There are additional charges for hairdressing and chiropody. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2009. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. Care Homes for Older People Page 6 of 30 The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: Information in care plans needs to explain clearly the help and support people require to meet their needs. Where possible people should have an opportunity to help prepare their care plans. Care Homes for Older People Page 8 of 30 Staff should always observe people taking their medication. When people have got a Protection of Vulnerable Adults (POVA) check, but not yet got a Criminal Records Bureau (CRB) check returned, they must only work if they are under direct supervision of another member of staff. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People coming to the home will know their needs can be met, as they have been assessed. Evidence: The care file for a person with dementia recently admitted was seen, and this had an assessment completed by a senior member of staff prior to the person moving to the home. The assessment covered the persons physical abilities but did not assess their needs due to their dementia. There was an extended community care assessment completed by the Local Authority, which had been received at the home prior to the person moving into the home, which did assess the persons needs as a result of their dementia. Staff said they knew a senior carer went to assess the person and the assessment was available for them to look at. Care Homes for Older People Page 11 of 30 Evidence: The person concerned could not recall if someone had been to see him, but in our survey forms Have your say about... everyone said they received enough information about the home before they moved in and one person commented, My family came to look at the home and the staff came to visit me and talked to me all about Meadow Lodge and what it offers. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People cannot rely on their needs being met in an agreed manner recorded in their care plan. People receive the medical attention they need and their privacy and dignity is respected, but do not always receive their medication in a safe manner. Evidence: The manager has changed the care planning system used within the home in order to make it easier for staff to refer to. Whilst this was clearer than care plans seen previously the manager and staff spoke of care practices followed in supporting people that were not included in their care plans, these included toileting regimes and dental care. There were some entries seen in care plans that did not describe how a persons needs should be met, for example one entry stated .. suffers with Alzheimers disease. The manager said she would look again at the care planning system. Care Homes for Older People Page 13 of 30 Evidence: It was stated on the Annual Quality Assurance Assessment that care plans are compiled with the person and/or their relatives involvement, but the plans seen had not been signed by them to show this had taken place. Plans seen had been reviewed and updated, and staff said they do these monthly. In our survey forms Have your say about... five people said they always receive the care and support they need and one person said they usually do. Comments made included, The staff help me do the things I cant do, they help me in the morning and at night when I need help. I still like to do things myself and The staff are very helpful and good to me. They will always help people. Everyone also said that staff listen and act upon what they say. Comments made included, If I tell staff something they will listen and act upon it and The staff will do what I want them to do for me like help with my socks or putting my TV on. The manager said they access support from community based healthcare services when needed, including Community Psychiatric Nurses and were aware of the Mental Capacity Act. Staff said they notice any changes in people and tell these to the senior on duty who will call a doctor if needed. It was stated in the Annual Quality Assurance Assessment that anyone at risk of pressure sores is identified through a risk assessment and that The home is very good at ensuring that any resident at risk receives the best up-todate care available including whatever equipment is required to reduce the risk. In our survey forms Have your say about... five people said they receive the medical support they need and one said they dont require very much. One person commented, The staff really look after us, if we needed a doctor they would get us one. They make sure we go to hospital visits. One person said, I saw the doctor for a chest infection and am taking anti biotics. It was stated on the Annual Quality Assurance Assessment that We view the safe administration of medication as a very high priority and operate a very comprehensive policy on the receipt, safe storage, handling, administration and disposal of medication. The lunchtime medication round was observed where only two people received medication. The Medicine Administration Records were completed prior to giving the person their medication and staff did not observe if the medication was taken. The member of staff said afterwards that she knew she should have observed people taking their medication. Care Homes for Older People Page 14 of 30 Evidence: It was stated on the Annual Quality Assurance Assessment that Our staff are trained to respect our residents dignity and privacy at all times and to promote residents independence wherever possible. Staff said they respect peoples confidentiality, and they have any appointments in private. Staff said they use screens when providing personal care to people in shared rooms. One person said, I know I need help getting dressed, I am happy how staff help me. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to take part in activities both in and out of the home. There are opportunities for people to exercise choice in their lives and they are provided with a wholesome diet. Evidence: There is an activities book to record any group activity in, but there is not a record made of any activity that people take part in individually. There were posters advertising forthcoming activities, including keep fit, entertainers and a drama group who perform a play. There were pictures displayed in the corridors of recent activities including an Easter bonnet parade. The manager spoke of one person who had asked to be able to help do some ironing, so had done so under supervision of a member of staff. Staff said there are relatives who come and play card games and dominoes with people in addition to the organised activities. Care Homes for Older People Page 16 of 30 Evidence: In our survey forms Have your say about... people commented, I like to take part in the sing-a-longs and to take part in the keep fit, I can take part if I feel like it I dont always want to join in though and I like to go to the sing-a-longs and take part in a quiz. I do keep fit once a week and listen to the entertainer when he comes to sing to us. One person said, I just like to watch television It was stated on the Annual Quality Assurance Assessment that Visitors are welcome any time and are encouraged to join in the homes activities. One person said, My brother comes to visit me and I go to visit him at his home. Staff were seen asking people which of the lounges they wanted to use, and discussing one person who was having a lie in. Staff said people can choose what they like, if they dont want to join in an activity they can go to another lounge. There is a picture display of what is available for each meal outside the dining room. The cook was off ill so one of the staff was preparing a lunch of mushroom soup followed by minced beef and onions, creamed potatoes, swede, cabbage, carrots and gravy. There was sponge and custard for pudding. It was stated on the Annual Quality Assurance Assessment, We take great pride in our food and catering arrangements and our menus are set with input and suggestions from residents. We provide three meals each day and hot drinks and biscuits at supper time, there are choices at each meal, using fresh produce when available, special diets are catered for and snack and drinks are always available. It was also stated, Meals can be taken to residents rooms if requested, and if the weather is fine meals can be taken out on to the patio or our newly remodeled garden. The manager said that there is usually a choice of main dish unless it is a favourite meal. In our survey forms Have your say about... four people said they always like the meals at the home and two said they usually do. Comments made included, I like the food at the home it always looks good and I enjoy a good dessert, Food is always Care Homes for Older People Page 17 of 30 Evidence: good but a little more variation would be good and I enjoy the food we get a good choice and if we want something we can have it if we ask for it. One person who said she didnt want anything to eat was encouraged to have some soup and then a small dinner, after which she commented, I really enjoyed that, very good. Other people were heard saying to each other they had enjoyed their lunch. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place for people to raise any concerns and staff know how to safeguard people. Evidence: There have not been any complaints made since the last inspection however the manager said she had reviewed and updated the complaints procedure. Staff said they had discussed the complaints procedure and knew to refer any made to a senior or the matron. In our survey forms Have your say about... five people said they knew how to make a complaint, and one person said they did not, but they did now as a member of staff had explained it to them. Other comments made included people would say if they were not happy about something. Following the inspection there were a number of safeguarding incidents reported to the Local Authority, which resulted in one person moving to more suitable accommodation to meet his needs. Care Homes for Older People Page 19 of 30 Evidence: Staff said they had received training on safeguarding adults, and this was also covered in their National Vocational Qualification level 2. Staff said they had found the training useful and they are now familiar with terms such as whistleblowing. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortably and well maintained environment. Evidence: It was stated on the Annual Quality Assurance Assessment that A programme of annual maintenance is in place in this home which is proactive in nature and designed to ensure that we provide the highest quality home environment at all time. We try not to wait until something goes wrong and needs repairing before things get done, but have a rolling schedule of maintenance that means that things get addressed before there is a problem. Our staff are trained to report any defects or problems whenever they spot them. We strive to ensure that the home is always clean and free from odours, thereby reducing the risk of infection. Areas of the home seen were clean and tidy. In our survey forms Have your say about... five people said the home is fresh and clean and one person said it usually is. Comments made included I like to see Meadow Lodge clean and I like to help do a little cleaning as well, The home looks lovely and homely and comfortable for us and The home looks clean people work hard to keep it fresh. Care Homes for Older People Page 21 of 30 Evidence: Staff were seen using protective clothing and the manager said guidelines have been issued on which type of protective clothing should be used for different activities. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for and supported by sufficient staff who have been suitably trained to meet their needs. Evidence: There were four care staff on duty and staff said that this was sufficient to meet peoples needs. Staff were seen attending to people in good time and no one was seen waiting for staff assistance. In our survey forms, Have your say about... three people said staff are always available when you need them and three said they usually are. One person commented, They are always very busy, but always manage to be there when you need them. Very efficient staff. One person said, There is always someone here if you need them. It was stated on the Annual Quality Assurance Assessment that eight staff have completed National Vocational Qualification level 2 and the manager said a further two staff were working towards this qualification. Care Homes for Older People Page 23 of 30 Evidence: One member of staff said she had just about finished her course, and another said she had another eight or nine months to go. The files were seen for two recently started members of staff. This included the required pre employment checks, however as both staff had their Protection of Vulnerable Adults check returned, but had not yet had their Criminal Records Bureau checks returned, they are only allowed to work under the supervision of another member of staff. The manager said she had not appreciated the level of supervision required, and will ensure both staff are constantly supervised until their Criminal Records Bureau checks are returned. It was stated on the Annual Quality Assurance Assessment that All new staff go through an in-depth induction programme when they start which links into an ongoing training programme with regular updates and new training opportunities. Training records showed that regular training is provided and recent training includes Safeguarding adults, dementia awareness, falls in care homes, infection control and the Mental Capacity Act. Staff had attended a basic food hygiene course the previous evening. Staff said they had found the recent training interesting and had learnt things they did not know. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: It was stated on the Annual Quality Assurance Assessment that The manager has been in place for 25 years and is registered with the Commission. The registered manager is qualified, competent to run the home and meets its stated purpose, aims and objectives. She regularly updates her own training in all aspects of care. The manager ensures that the management approach of the home creates an open, positive and inclusive atmosphere. Questionnaires are sent out to gain feedback from service users, relatives, staff and professionals. The manager said recent surveys returned by people in the home had highlighted one person would like a boiled egg for breakfast, and this is now regularly provided. Care Homes for Older People Page 25 of 30 Evidence: There is a system in place to assist anyone who needs assistance in managing their personal allowances. The records for this were seen, and these showed that all transactions are witnessed and where possible receipts kept. In some cases money is paid out in advance and then an invoice is sent to relatives for reimbursement. It was stated on the Annual Quality Assurance Assessment that equipment is tested or services as recommended by the manufactures or other regulatory body. Staff were asked if they had any concerns about their or people living in the homes Health and Safety and they said they did not. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must contain 01/07/2009 details as to how peoples needs are to be met and where possible people should be involved in the preparation and reviewing of their care plans. This will ensure that people can receive their care in a manner they prefer. 2 9 13 People must not be left to take their medication unobserved. This will ensure that people receive the medication they require. 21/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 Staff should include information about peoples needs associated with their mental health when carrying out an assessment of their needs. Page 28 of 30 Care Homes for Older People 2 12 Make a record of any individual activities people take part in. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - 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!