Care Home: Silverlea Residential Home

Similar services:

• Snydale Care Home
• Abbey The
• Hawkhills
• Larchfield Manor
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

What the care home does well The admission procedure is thorough and the manager will not admit people unless she feels that the staff can provide the level of care and assistance they require. The manager and staff are approachable, have a caring attitude and try hard to create a homely atmosphere. Comments from relatives include "Silverlea is a very friendly home, which I would recommended to anyone considering moving in to residential care" and "my mum receives loving care and wonderful support from all members of staff." The home provides a comfortable place for people to live and all concerns/complaints are taken seriously, and action is taken to resolve matters.The home responds to individual needs and choices and wherever possible encourages people to exercise control over their daily lives. People were very complimentary about the standard of meals served at the home. What has improved since the last inspection? The service user guide has been updated and now provides good information about the service, which helps people to decide whether or not the home can meet their needs. People living at the home are now encouraged and supported to participate in a range of social and leisure activities, which helps to motivate them and improve their quality of life. The home now monitors people`s nutritional intake better and seeks professional advice if individuals experience significant weight loss. Since the last inspection the provider has made a substantial financial investment in refurbishing the home. Although there continues to be some work outstanding the home is generally decorated and furnished to a good standard and provides people with a pleasant environment in which to live. The manager is in the process of registering with us and is due to start studying for a recognised management qualification early in 2009. A range of quality assurance monitoring measures have been put in place, which means that shortfalls in the service are quickly identified and we do not have to bring them to the attention of management through the inspection process. What the care home could do better: The ongoing programme of refurbishment must be continued to make sure that standards are maintained and improved and people live in a safe and comfortable environment. The registered provider and manager must continue to build on the work they have started and make sure the home is run affectively and in the best interest of the people living there. CARE HOMES FOR OLDER PEOPLE Silverlea Residential Home 3 First Avenue Bradford Moor Bradford West Yorkshire BD3 7JG Lead Inspector Steve Marsh Key Unannounced Inspection 22nd December 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silverlea Residential Home Address 3 First Avenue Bradford Moor Bradford West Yorkshire BD3 7JG 01274 661700 01274 660611 silverleacare@btconnect.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Kevin Casey Vacant Post Care Home 35 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (3) Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st January 2008 Brief Description of the Service: Silverlea Care Home is a large detached adapted property, located in the Bradford Moor area, overlooking the park and about one mile from the city centre. The home is registered to provide personal care to thirty-five people in both single and double bedrooms, situated on all four floors of the building. There are steps to the front of the home however level access is available to the rear of the property and there is a passenger lift to all floors. Externally there is a patio area to the front of the property, which people are able to use during the summer months. The home is on a main bus route from the city centre and there is street parking to the front of the property. The fees range from £341:18p to £377.79p per week (£395.00 for self funding clients). Additional charges are made for services such as hairdressing, newspapers, private chiropody, outings and the sweet trolley. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is Two Star. This means the people who use this service experience good quality outcomes. The inspection process included looking at records, observing staff at work, talking to people living at the home and visitors, talking to staff and looking around the property. Before the visit we had provided some people living at the home, their relatives, staff and other health care professionals with survey questionnaires so that they could share their views of the service with us. We received two questionnaires back from people living at the home, four from relatives, seven from staff and two from health care professionals. The information they provided has been used as evidence in the body of the report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Feedback was given to the acting manager at the end of the visit. No requirements or recommendations have been made as a result of this inspection visit. What the service does well: The admission procedure is thorough and the manager will not admit people unless she feels that the staff can provide the level of care and assistance they require. The manager and staff are approachable, have a caring attitude and try hard to create a homely atmosphere. Comments from relatives include “Silverlea is a very friendly home, which I would recommended to anyone considering moving in to residential care” and “my mum receives loving care and wonderful support from all members of staff.” The home provides a comfortable place for people to live and all concerns/complaints are taken seriously, and action is taken to resolve matters. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 6 The home responds to individual needs and choices and wherever possible encourages people to exercise control over their daily lives. People were very complimentary about the standard of meals served at the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 and 5 – Standards 6 is not applicable to this service. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The admission process is thorough and people will not be admitted unless staff are able to meet their needs. People are provided with good information about the service and are encouraged to visit and see the facilities at first hand before deciding if the home is right for them. EVIDENCE: The home has produced a service user guide and statement of purpose, which are made available to all people considering using the service. Both documents have recently been updated and provide good information about the service, which helps people to decide whether or not the home can meet their needs. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 9 At the current time the information is only available in English but the manager confirmed that it would be made available in different languages and formats on request. Records show that peoples needs are always assessed before they move into Silverlea either in their own home or temporary place of residence. Needs identified during this pre-admission assessment visit form the basis for the initial care plan, which is completed on admission. People are invited to visit the home before admission to see at first hand the facilities provided, meet the staff and other people living there and stay for a meal if they wish to do so. People are also able to move in to the home on a trial period if they are still undecided. This is good practice and shows that people are supported through the admission process. The home tries not to admit people on an emergency basis however if this is unavoidable a full assessment of their needs is completed on the day of admission. Feedback from people shows that they feel the information they received about the home before admission was very good and the initial visit was helpful and informative. One person recently admitted from another residential home said that she was pleased with the care and support she received at Silverlea and would have no hesitation in recommending the home to anyone considering respite or long-term care. Feedback from people also clearly shows that they feel there is a good mix of skills within the staff team and staff had a good understanding of their needs. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care records provide accurate and up to date information, which means that people receive the level of care and support they require to meet their personal, health and social care needs. EVIDENCE: Since the last inspection improvements have been made to the care planning system and care plans now cover all aspects of peoples personal, health and social care needs. Care plans are drawn up with the involvement of the person using the service and/or their relatives and form the basis for the care to be provided. The four care plans reviewed were completed to a good standard and gave clear guidance to staff on how peoples needs were to be met. Care plans are reviewed at least monthly or sooner if there are significant changes in the individuals circumstances. The manager encourages all staff to become involved in the care planning process, which is good practice and makes sure that the care plans are used as working documents. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 11 Moving and handling and nutritional assessments are routinely carried out for all new admissions and risk assessments are completed where areas of potential risk to peoples general health and welfare are identified. All people living at the home are registered with a general practitioner and are supported in having access to the full range of NHS services. The input of other healthcare professionals is clearly recorded in the documentation available. This shows that staff are seeking advice if they have concerns about peoples health. Concerns were raised at the last inspection about the home not appropriately monitoring people’s dietary intake or taking action when significant weight loss had occurred. However, on this visit we found that steps had been taken to address this matter and staff were now more aware of their roles and responsibilities in this area of their work. We received survey questionnaires from two health care professionals, which indicated that the home provides a good standard of care and peoples needs are being met in line with their care plan. Feedback from people living at the home clearly shows that staff always treat them with respect and are kind and caring. Comments included “We are all well looked after and the staff are lovely” and “all the staff are kind and caring.” Survey questionnaires returned by relatives show that they feel the home provides people with good health care and keeps them informed of any significant changes in their health or general welfare. Comments included “my mum has needed a doctor several times and the home has been quick to act” and “the home is very good in keeping me informed of any events concerning my mum’s welfare.” We reviewed the medication system and no concerns were raised about the storage and recording of medication entering the home. This means that people can be confident that medication is being administered as prescribed. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are offered the opportunity to take part in a varied range of social and leisure activities that take account of their preferences and abilities. EVIDENCE: The manager said that the daily routines are flexible and wherever possible people are encouraged to make choices about how they will spend their time whilst living at the home. Since the last inspection the home has employed a part time activities coordinator who is responsible for organising activities, entertainment and outings for people living at the home. Through discussion with the activities co-ordinator it is apparent that she gets a great deal of job satisfaction from her role and is very enthusiastic about giving people the opportunity to lead a full and active life. A weekly activity programme is on display however the manager confirmed that ultimately it is the people living at the home that decide what they want to do on a daily basis. A range of social and leisure activities have been Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 13 arranged over the Christmas period including carol singers, a party and a trip to the pantomime. People told us they were now pleased with the level of activities and outings made available to them. Comments included “If you want to join in there is always something to do” and “I look forward to the entertainment and trips out.” People said that they are able to see visitors in their own room if they wish to do so and confirmed that visitors were always made to feel welcome and offered light refreshment. People described the meals served at the home as very good and said that they were always offered an alternative if they did not like what was on the menu. Comments included “the food is tasty and well cooked” and “I enjoy all my meals – the cook’s do an excellent job.” During the course of the day we observed that staff showed a good awareness of people’s needs and preferences and offered assistance discreetly to people who were not able to manage to eat independently. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are suitable systems in place to make sure that complaints are dealt with appropriately and people are protected from abuse. EVIDENCE: There is a clear complaints procedure in place and the manager confirmed that no complaints have been received since the last inspection visit. People living at the home said that they were aware of the complaints procedure and would have no problem at all in approaching the manager or registered provider if they had any concerns about the standard of care being provided. Adult protection (safeguarding) policies and procedures are in place and all staff receive training in the recognition and reporting of allegations of abuse. The manager confirmed that the home operates a zero tolerance approach when dealing with complaints and safeguarding issues. Feedback from staff indicates that they are aware of the homes policy on whistle blowing and knew what to do if they suspected that people were being abused or working practices at the home were not in the best interest of the people living there. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24 and 26 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a safe, comfortable, clean and well-maintained environment that is suitable for their needs. EVIDENCE: Since the last inspection the provider has made a substantial financial investment in refurbishing the home. Although there continues to some work outstanding the home is generally decorated and furnished to a good standard and provides people with a pleasant environment in which to live. Both the communal areas and bedrooms have been decorated and new furniture has been purchased, which has made the home look much more bright and airy. Comments from one relative included “the home has recently had extensive re-decoration, which has improved the environment immensely.” Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 16 People living at the home said that they were now very happy with the standard of accommodation, and felt safe and secure living at the home. Comments included “the home is now warm and comfortable” and “the home is so much brighter.” All communal areas used by people including the lounges and dining room are situated on the ground floor of the home, conveniently close to toilet facilities. Communal bathrooms and toilets are conveniently situated around the home and some work is still ongoing to bring them up to the required standard. Bedrooms are situated on all four floors of the home and consist of both single and double rooms. There is a small passenger lift available to assist people with mobility problems. The manager confirmed that on admission people are encouraged to bring personal possessions into the home to personalise their room and it was evident during the tour of the building that many people had done so. On the day of the visit the standard of hygiene and cleanliness throughout the home was good and no unpleasant odours were noted. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff employed to make sure peoples needs are met and staff are supported in developing the skills and knowledge they need to care for people properly. EVIDENCE: The staff rota showed that sufficient care staff are employed on day and night duty to meet people’s needs. To support the care staff the home employs catering and cleaning staff to make sure that peoples dietary needs are met and the home is clean, tidy and free from offensive odours. Recruitment and selection procedures are in place, which include checking the Protection Of Vulnerable Adult (POVA) register and obtaining at least two written references and a Criminal Record Bureau (CRB) report before new staff are permanently employed. We looked at the employment files of three recently appointed staff. The files were in good order and we found that all the required checks had been completed before people had started work. All staff have job descriptions and the home is currently in the process of issuing them with new terms and conditions of employment. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 18 The manager confirmed that all new care staff receive induction training using the Skills for Care Common Induction standards. These are nationally agreed induction standards designed to help new staff get the skills and knowledge they need to care for people. Following induction training there is an expectation that care staff will study for a National Vocational Qualification (NVQ) at either level two or three depending on the post they hold. The home has employed a part-time training officer who is responsible for developing the staff-training programme and making sure staff update their training on a regular basis. A copy of the staff-training matrix is on display so that people living at the home, their relatives and visitors are able to see at a glance what training the staff have undertaken. This is good practice and shows that management has an open approach to the running of the home. Staff said that the level and quality of training provided is good and confirmed that the manager is committed to ensuring that people benefit from having a trained, skilled and experienced workforce caring for them. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,3335,36 and 38 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed and people are supported in making decisions and exercising choice. EVIDENCE: Mrs Jean Marlow was appointed manager of the home in February 2007 although she is still not registered with us. It is anticipated that the registration process will be completed early in 2009. The home has been without a registered manager since October 2005. Mrs Marlow has many years experience in the caring profession and this is the second time she has managed Silverlea Care Home. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 20 Due to unforeseen circumstances Mrs Marlow has not yet achieved a recognised management qualification but will commence studying in the near future. Feedback from staff, people living at the home and their relatives shows that the manager is approachable and operates an open door policy, which means that they are able to speak to her at any time if they have any concerns. Staff confirmed that they have one-to-one supervision with the manager on a regular basis and felt generally well supported by the senior staff team. Staff meetings are held to make sure there are clear channels of communication within the home. There is a range of quality assurance monitoring measures in place including auditing different aspects of the service on a monthly basis. This means that shortfalls in the service are quickly identified and we do not have to bring them to the attention of management through the inspection process. The home also sends out survey questionnaires to people using the service, their relatives and other healthcare professionals. The questionnaires give people the opportunity to express their views of the service and are an important part of the quality assurance monitoring process. The home holds small amounts of money in safekeeping for a number of people and financial transaction sheets are in place showing income, expenditure and a balance. Only senior staff deal with transactions and receipts are always obtained for purchases made on behalf of people. Policies and procedures are in place to make sure staff follow safe working practices and all equipment in use is serviced in line with manufacturers guidelines. People can therefore be sure that their health and safety is not being compromised. Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 X 3 Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Silverlea Residential Home DS0000061674.V373763.R01.S.doc Version 5.2 Page 24 - 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!