Care Home: The Rookery Cottage

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What the care home does well This is a well run happy home where the residents are well looked after by a team of caring professional staff. The staff team work well together and are liked and trusted by the residents. The Manager takes time to listen to the opinions of residents and staff and is quick to respond to any comments or suggestions. Residents are encouraged to try new things and are provided with a range of interesting activities that meet their needs. They live active and fulfilling lives and can make choices about how they spend their time. The home makes sure that residents stay in touch with their families and have the opportunity to make new friends. The records in the home are well written, easy to understand and help staff to provide residents with the right type of care. What has improved since the last inspection? Since the last inspection the home has reviewed its policy and procedure and staff training in safeguarding adults. It is now in line with the Berkshire multi-agency strategy. A gate has been fitted at the front of the house to protect residents from the road. It is now kept shut. Maintenance works have been undertaken including refurbishments of the kitchen, repair to the fire door, radiators are now covered, a replacement floor has been fitted to a bedroom, paper towel holders have been fitted in the kitchen hand wash area, repair to a broken window in the kitchen and a toilet bowl has been replaced where cracked. The garden is now suitably maintained by a professional gardening team. What the care home could do better: It is a recommendation of this report that the home is well maintained at all times. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Rookery Cottage 249 Shinfield Road Reading Berkshire RG2 8HE     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: Julie Willis     Date: 2 1 0 2 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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 27 Information about the care home Name of care home: Address: The Rookery Cottage 249 Shinfield Road Reading Berkshire RG2 8HE 01189872278 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) : Milbury Care Services Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Rookery Cottage is a large, detached, listed building with an extension added at a later date. It is a few miles from Reading town centre and is situated on a busy main road. The house is set back from the road and has a large garden. The home is close to public transport and offers easy access to all local amenities. A range of shops is within walking distance of the home. Rookery Cottage is a residential home for up to six adult service users with a learning disability, some of whom have additional mental health needs. Fees range from 1065.96 to 1387.72 per week. This fee does not include personal toiletries, clothing, magazines, entrance fees to outings, holidays or hairdressing. Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection took place on a Saturday afternoon. It was a thorough look at how well the service is doing. It took into account detailed information provided by the services manager and any information that has been received since the last inspection. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for the residents, staff and any visiting professionals such as doctors and nurses. Consideration has been given to other information provided to the Commission since the last inspection. The inspector toured the building, examined records and met all of the residents. They Care Homes for Adults (18-65 years) Page 5 of 27 appeared happy and relaxed in the care of the staff. The inspector was unable to speak at length to all residents about the quality of the service, because several residents have no verbal communication. From evidence seen and comments received the inspector considers that this service has a good awareness and understanding of equality and diversity issues and would be able to provide positive outcomes for residents in the areas of race, ethnicity, age, gender, sexuality, disability and belief. The inspector gave feedback about her findings to staff on duty and later to the Service Manager by phone. There were no legal requirements made as a result of this inspection and only one good practice recommendation was made. The CSCI has received no information about complaints about the service since the last inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 7 of 27 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 8 of 27 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 residents are fully assessed prior to admission to ensure that their needs can be met effectively by the home. Evidence: Evidence from documentation and discussion with staff and management confirmed that the home has a comprehensive admissions policy in place, which details the holistic assessment undertaken prior to admission. The home clearly demonstrated that it understands the need to fully involve the prospective resident, their family, advocates and a multi-disciplinary team of professionals in the admission process. The assessment identifies clearly the needs of the resident so that facilities, staffing and specialist services can be put in place before admission. The service is efficient at obtaining up-to-date information about the prospective resident at the point of referral, including a copy of the Care Management needs assessment and care plan. The care plan and admission assessment for the most recently admitted resident was Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: examined. It was evident from the records that the residents transition into the home had been managed effectively and in a staged way. This enabled the resident to get used to the home, staff and residents and to gradually settle in to their new routines. Admissions to the home only take place if the service is confident that staff have the necessary skills and knowledge to meet the residents need. Consideration is also given to the needs of other residents in the home before the prospective resident is admitted. Care Homes for Adults (18-65 years) Page 10 of 27 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. Care is provided flexibly and residents are supported to make choices and decisions in relation to everyday life. They take an active part in planning their care. Evidence: Examination and case-tracking of two residents evidenced that the records were up-todate and well documented. The care plans were comprehensive and holistic in detail and provided sufficient information for staff to provide the appropriate care. Person centred plans (PCPs) fully involve the residents in choice and decision making. The content was up-to-date, individualised and accurate. Residents in the home are mainly non-verbal. The plans were a collation of information from professionals, family members, advocates and staff. Much of the detail was based on the staffs in-depth knowledge of the residents likes and dislikes and observation of their non-verbal responses, behaviours and gestures. The residents are supported to make decisions about their lives on a daily basis. They Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: are encouraged to participate in the activities of daily living within the limits of their individual capabilities. Several residents have chosen to participate in laundering their personal clothing, shopping, laying tables and cleaning their own bedroom and it forms part of the individual care plan. Examination of care records and risk assessments indicated that adequate support and supervision is provided whilst involving residents in activities that could pose a risk to their safety. Management of risk takes account of the special needs of the resident balanced against their personal aspirations for independence, choice and normal living. One resident told the inspector that they liked to help out in the home and liked to do certain chores and help out the other residents. Care Homes for Adults (18-65 years) Page 12 of 27 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. People who use services are able to make choices about their lifestyle and are supported to develop life skills. Social, cultural, educational and recreational activities meet individuals expectations. Evidence: From examination of the care files and activity schedules for residents it is clear that they are provided with a range of stimulating activities, which encourage independence and the acquisition of life skills. Residents are involved with the activities of normal living and this is a well-documented part of their individual care plan. All residents attend local day services either Wokingham Stepping Stones or Reading Day Services run by Voyage as part of their activity programme. One resident is in paid employment one day a week doing leaflet drops supported by Its working staff. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Residents frequently access local services and community use is promoted. Residents are frequent visitors to local shops, sports facilities, cinemas, pubs and restaurants. Transportation to activities is either by house vehicle or local public transport. All residents have the opportunity to participate in an annual holiday. One of the residents chooses not to go away but instead chooses day trips out. In the past year residents have been to Jersey, Blackpool and Cornwall and plans are well underway for this years vacations. One of the residents told the inspector that they were hoping to fly to Spain later in the year supported by staff. Attention is given to spiritual needs. One of the residents regularly attends Church as part of their care plan. They said that they enjoyed attending and had made some new friends. Residents are encouraged to maintain their relationships with friends and family. Most residents have regular visitors and several stay with members of their families for weekends. Two of the residents recently had special birthday parties for their 30th & 50th birthday respectively. A hall was hired for the occasion along with a disco and friends and family were invited to the celebrations. The home regularly has parties and barbeques to celebrate special occasions and residents frequently attend parties outside the home. Care Homes for Adults (18-65 years) Page 14 of 27 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. Peoples physical and personal support needs are well met at this home by well-trained and competent staff that administer medication safely and appropriately Evidence: From examination of care records it is evident that residents physical and personal care needs are well met by the home. All care given is documented in the daily records and the content fully validated the care plan. Observation of staff and resident interaction demonstrated that care was provided in a manner which maintains the residents right to dignity, privacy independence and choice. Staff are fully aware of the needs of residents and are able to interpret residents nonverbal signals and gestures appropriately. Staff ensure that personal support is provided flexibly and consistently and is responsive to the changing needs of residents. Staff respect residents rights to express choice and preference when providing personal care and in particular intimate care. Staff are aware and put into practice the organisations cross-gender care policy. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Examination of residents documentation and discussion with staff and management evidenced that all residents are registered with a local doctor. Regular health checks and routine screening are offered by the GP practice. Residents attend specialists appointments at the local hospitals and clinics supported by the staff. Details of residents changing medical needs and treatments are well recorded. Residents also have regular dentistry, chiropody and attention to their vision and hearing and their attendance at these appointments is recorded. The home has in place a robust medication policy and procedure. From examination of staff records it was evident that all staff are fully trained in the administration of medicines as part of their induction and later in refresher training. The system used for the administration of medication is the monitored dosage system. This system reduces the likelihood of drug error and provides an accurate record of administration. Care Homes for Adults (18-65 years) Page 16 of 27 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. People who use the service are protected by the policies and procedures in place for dealing with concerns, complaints and protection. Evidence: The service has a complaints procedure which is clear and accessible to the residents. Residents are provided with information on how to make a complaint to the home, the time scale for response and the stages and process of the Organisations complaint procedure. Examination of the complaint records indicated that there has been no complaints made to the home since 30th October 2007. The CSCI has not received any information about complaints about the home since the last inspection. Discussions with the Manager and staff indicated that feedback is sought from residents and their families on an on-going basis. One resident told the inspector that they had never had to make a complaint but if anything was wrong they would talk to the Manager about it and she would sort it out. The home a copy of the inter-agency safeguarding adults strategy and staff are aware of its content and how to respond to suspected abuse. Records evidence that all staff have received the necessary training to protect residents from harm. One resident said Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: they liked living at the home and felt that staff were caring and kind. They said they felt safe living at the home. Care Homes for Adults (18-65 years) Page 18 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable place to live. There is however, a need to carry out some essential maintenance to several areas of the home to promote the health & safety of residents. Evidence: The home was clean and hygienic throughout. Communal areas were spacious and comfortably furnished. All bedrooms were personalised to reflect the interests and preferences of the individual resident. The garden was well kept and is well used by residents in the clement weather. There is a need however to ensure that the home is satisfactorily maintained as some areas of the paintwork were shabby and worn. A number of bathroom tiles were cracked in the ground floor bathroom and a soap dispenser needed re fixing to the wall. There was a broken drawer front in the laundry that needed repair or replacement. In one of the upper bedrooms the window restrictor was faulty and required repair or replacement. The Manager undertook a temporary repair to make it safe and said that Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: the matter would be reported to maintenance as a matter of urgency. This matter is therefore not subject to requirement. The driveway is awaiting renovation and was subject to requirement in the previous inspection. The inspector was informed that the home has received an estimate for the job and renovation works are due to start within the month. This was later confirmed by telephone with the Service Manager. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are trained, skilled and in sufficient numbers to support the people who use the service effectively. Evidence: The rosters at Rookery Cottage are designed to ensure that there are sufficient staff on duty at busy times of the day or to accommodate residents various activity schedules. Agency use has been quite high at the home recently, due to staff shortages. The AQAA stated that 95 shifts had been covered by agency workers in the three months prior to inspection however, this is due to significantly reduce due to a successful recruitment drive. There are currently no vacancies at the home for staff. Examination of the recruitment files for three workers evidenced that staff are appropriately recruited, inducted and trained. Selection and recruitment procedures at this home are robust. Records evidence that all essential checks are carried out on staff to ensure that they possess the necessary attributes to be effective in their caring role. One resident said that they thought staff were lovely girls, kind and caring. Observation of practice confirmed that staff had built a rapport with the residents. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Staff worked well together as a team. The staff files evidenced that staff have undergone a formal induction and have the opportunity to attain National Vocational Qualifications at levels 2, 3 & 4. Five of the permanent staff hold a professional qualification in care at level 2 or above. Staff are also provided with a range of training some of which is mandatory. On file were certificates for fire safety, manual handling, infection control, safeguarding adults, food hygiene, first aid, NCVI (non-violent crisis intervention), diet & nutrition and medication administration. The Organisation has introduced El-box training which enables staff to keep up-to-date with their mandatory courses whilst at work. The end of the courses are assessed and certificated. The AQAA states that there are opportunities for staff to train as trainers in manual handling and fire safety awareness and staff at Rookery Cottage are keen to participate. All staff are formally supervised at least six times a year and appraised annually. Records examined as part of this inspection evidenced that staff were being supervised monthly. They also have the opportunity to express their views during the regular house meetings and in staff hand-over which are in the main resident focused. Responses to CSCI staff surveys confirm that staff feel well supported by management and they are keen to participate in further training to enhance their skills and knowledge. Care Homes for Adults (18-65 years) Page 22 of 27 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 home is safe and well managed by a competent manager and professional staff team. The home seeks and focuses on the views of its residents on an on-going basis. Evidence: There has been a change in management since the last inspection. The new manager Rena King has an NVQ 3 & 4 and holds the Registered Managers Award. She has recently undertaken the Organisation Management Development Programme to further enhance her skills and knowledge. She is supported in her task by a team of committed and caring staff. Staff say that the Manager is an effective leader and is open and approachable. Quality Assurance is being monitored during the Proprietors Representative monthly visits (carried out to comply with Regulation 26) and regular home audits. The visits seek the views of residents and staff and help to identify any shortfall in service. A full operational review was undertaken by the homes manager and senior management in January 2009. An action plan has been drawn up as a result which identifies key areas Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: for improvement in the forthcoming year. In addition a full health and safety audit is undertaken at monthly intervals. Examination of a number of health and safety records indicated that all necessary checks and servicing of equipment is undertaken on a regular basis to safeguard residents from harm. Unnecessary risks to users are identified using a comprehensive risk assessment. So far as possible the risks are reduced or eliminated by putting in place effective guidelines, policies and procedures. Care Homes for Adults (18-65 years) Page 24 of 27 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 Adults (18-65 years) Page 25 of 27 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 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 24 There is a need to ensure that the home is fully maintained to provide residents with a safe and comfortable place to live. . Cracked tiles in the bathroom should be replaced . Woodwork and paintwork should be clean and well maintained . The drawer front in the laundry needs repair . The bedroom window restrictor should be repaired. Care Homes for Adults (18-65 years) Page 26 of 27 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 27 of 27 - 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!