Care Home: Udal Garth

Similar services:

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

What the care home does well The home undertakes good pre-admission planning, which ensures that anyone moving into the home can have his or her needs met. New service users and their representatives are provided with sufficient information to enable them to make an informed choice about whether or not Udal- Garth is somewhere they would like to live. The home undertakes a thorough assessment of need and writes a detailed plan about how the care should be delivered. This plan takes into account the persons wishes and their particular likes and dislikes. Wherever possible residents are consulted on issues regarding their daily routines and care arrangements. There are good behaviour management plans and on-going risk assessments to manage the risks associated with residents challenging behaviours. This enables residents to have a good quality of life while successfully managing behaviours. There is an individually planned scheme of appropriate activities for each resident. The home has invested much time and money into providing activities within the home setting. There is a large activities room, which contains sensory and craft equipment and a separate area for cookery and other 1 to 1 activities. The service continuously develops and monitors activities for each service user to maintain their presence in the community and to further improve their quality of life. There is a consistent staff team who have a good understanding of service users needs. The staff treat the residents with dignity and respect whilst providing a lively and fun environment appropriate to the needs of young adults. Staff feel valued and well supported by the their colleagues and management. The organisation has a good staff- training programme in place. What has improved since the last inspection? The manager has now been in post for over two years and has been successful in consolidating this service to the benefit of service users. Recommendations made at the previous inspection have been implemented. Policies and procedures have been updated and are kept under review What the care home could do better: No specific recommendations are made as a result of this inspection. The new regulator is now the Care Quality Commission. All documentation which details the Commission will need to be changed to reflect the contact details of the Care Quality Commission. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Udal Garth 2 North Road Torpoint Cornwall PL11 2DH     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: Ian Wright     Date: 1 4 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 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 28 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Udal Garth 2 North Road Torpoint Cornwall PL11 2DH 01752815999 01752815999 nb_udalgarth@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Peninsula Autism Services & Support Limited care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 8 Udal Garth provides care and accommodation for adults with a learning disability that falls within the autistic spectrum. The house is situated centrally in Torpoint. It is an older detached house with a garden whose boundaries have been made safe and secure for the service users. It offers accommodation on two floors in single rooms. There is communal space on the ground floor with additional areas that can be used for quiet or individual activities in portable buildings in the garden. Care Homes for Adults (18-65 years) Page 4 of 28 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 was an unannounced key inspection, which took place on 14th. April 2009 and lasted for approximately five hours. The purpose of the inspection was to ensure that service users needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that service users placements in the home result in good outcomes for them. Information received from and about the home since the previous inspection has also been taken into consideration in making judgements about the quality of outcomes for the service users living there. The inspection included observation of the service users. Members of staff were observed providing one to one care and there were opportunities to directly observe aspects of service users daily lives in the home and staff interaction with them. Care Homes for Adults (18-65 years) Page 5 of 28 Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the registered manager of the home. Case tracking of four service users involved a more in-depth review of how the home meets their needs, with particular reference to their age, racial and cultural origin, religion, gender, sexual orientation and disabilities. Information telling service users about the home is held on their personal files and is available in pictorial formats, if required. 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. Care Homes for Adults (18-65 years) Page 7 of 28 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective service users and their representatives with sufficient information for them to make an informed choice about where they live. The admissions process ensures that the home has adequate information to decide whether or not they can meet an individuals assessed needs. Evidence: The home had a statement of purpose and service user guide, which described the environment and services available. These documents are tailor made to suit the needs of the individual. A range of communication aids including signs, symbols and photographs are used to give any new residents information about the home and the support they could expect to receive. No new service users have been admitted to the home since the last inspection. The comments made at the last inspection therefore still apply. Records were tracked to establish the quality of the homes admission procedure, and the experience of all those involved in the move. Following referral a thorough pre-admission assessment had been completed by the home to confirm whether or not the individuals needs could be met. The service user then visited the Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: home on several occasions, and a weekend stay was arranged. A review meeting was then held to confirm the placement and to agree a transition plan. The pre-assessment information was used to develop an initial care plan for the home and a written contract was agreed and signed by all parties. Any restrictions imposed on the individual due to specific care needs had been agreed and documented prior to admission. The manager said that any restrictions and guidelines would be reviewed regularly as part of the homes care plan process. A similar process would occur with any new admission. Care Homes for Adults (18-65 years) Page 11 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear, consistent care planning process, which provides staff with the information they need to satisfactorily meet service users needs. Staff have a good understanding of how service users communicate and use this knowledge to encourage them to make choices and have control where possible about their care and lifestyle. Evidence: The care plans and records relating to three residents living in the home were looked at during the inspection. The information included good information about each individuals needs. Each area of care was supported by a detailed assessment, behaviour management guidelines, activities plan, risk assessments and information about any involvement from other agencies. The care notes for one service user highlighted the need for consistency and structure Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: to their daily routine. To support this need detailed records were available for staff describing the support required from when the service user wakes up to when they go to bed. Staff spoken to were familiar with these guidelines and recognised the importance of consistency when providing care to this person. Throughout the inspection staff were observed supporting residents to make choices about their daily routines. Care plans included detailed information about how each resident communicates. A range of communication tools are used dependent on the assessed needs of the individual. Several service users had pictorial timetables in their bedrooms, some of these had been adapted so that they could be used outside the home. Signs, symbols and photographs were available around the home to help service users recognise and understand daily routines, different rooms, and facilities in the house and the different staff members on duty. Risk assessments had been written for all activities inside and outside the home. These were found to be detailed, signed and included a date for review. All records inspected were found to be well maintained, up to date and stored safely. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have appropriate individualised activities to ensure a good quality of life while living at the home. The meals in the home are good, offering both choice and variety and catering for special dietary needs. Evidence: The atmosphere in the home was warm and welcoming. The manager and staff were able to talk in detail about the personalities of each resident and the activities that they enjoy. Care planning, and daily activity charts supported this verbal information. All the residents had individualised activities, taking place through support from the home. The service has continuously developed new Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: activities for each resident to maintain their presence in the community and to give the residents valued activity and good quality of life. In many cases this activity has contributed to the residents improved stability and reduced challenging behaviour. The home had a detailed process of recording and analysing the outcome of activities to ensure that they remain appropriate. Activities external to the house are thoroughly risk assessed and continuously reviewed to ensure that they continue to be safe. Two company vehicles are available to transport service users to and from their activities. There is a large secure garden area with swing seats and a trampoline, which service users can enjoy during the summer months. Also within the garden there are two large activity facilities. One is used for sensory and craft activities and the other for cooking. On the day of the inspection three service users were observed enjoying a session in the sensory room. Discussion with the manager and feedback from family confirmed that every effort is made to support residents to maintain their links with family and friends. Service users may occassionally visit other homes owned by the organisation and access social events and facilities in the local community. Where possible service users are involved in daily routines and domestic activities in the home. The manager said that staff are aware of the importance of these routines and consistency of support. We observed staff interacting with service users on a one to one basis in an appropriate and unobtrusive manner. A written weekly menu was available, which showed that residents are offered a wellbalanced and varied selection of meals. Any special dietary requirements or eating plans were documented with clear guidelines for staff. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support in the home is offered in a way that promotes and protects service users privacy, dignity and independence. Service users health care needs are regularly monitored and any changes are addressed with specialist input when necessary. Evidence: Service user records contained detailed information about their personal, emotional and healthcare needs. Information was documented in a way that helped staff understand their daily routines, likes and dislikes, and how they prefer to be supported. Records confirmed that residents are supported to attend regular routine health checks including hearing, sight and dental checks. The home has a consistent staff team who have a good awareness of service users needs. The manager said that this consistency and the homes daily recording procedures ensures that health needs are closely monitored and any concerns are dealt with promptly. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Throughout the inspection staff were observed treating service users in a respectful and dignified way. Despite the need for high staffing levels it was evident that staff were aware of residents need for privacy and personal space. Records confirmed that external advice and guidance was sought when necessary from local Health Care professionals and the specialist learning disability services. The home has written procedures for the receipt, storage and administration of medication. There is also a medication profile on each service users care plan. The home uses a monitored dosage system and administration records for this system are well maintained. There is clear information for care staff on the nature of the service users medication and any possible side effects. Care Homes for Adults (18-65 years) Page 17 of 28 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. Systems in the home ensure that all service users are listened to and any concerns or complaints are dealt with promptly and appropriately. Service users are protected from abuse, neglect and self-harm. Evidence: Neither the home nor the Care Quality Commission have received any formal complaints since the last visit. The manager said that due to the complex needs of service users living in the home they might not always express their views and concerns clearly to those providing care. She emphasised that a good understanding of each individuals communication methods and their behaviours and moods is crucial to ensure that any concerns are addressed. Staff were seen to respond promptly and sensitively to behaviours which without support and understanding may have escalated and caused distress. Daily recording, hand-over meetings and charts to record incidents/behaviour are used to monitor the well being of each individual and to ensure that staff are aware of any changes. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: The home has written adult protection procedures and a copy of the local Alerters guide. Staff spoken to had a good awareness of issues relating to abuse and said they were able to attend in-house and multi-agency Adult Protection training as part of the homes staff training plan. Files contained Behaviour management guidelines and these are regularly monitored and reviewed as part of the care plan process. The manager said that all the service users need support to manage their finances. The reason for this support and how the support is provided is well documented within care files. Service users have their own bank account and a clear, up to date record was available for all in-coming and out-going expenditure. Service users pay an agreed mileage for the use of the homes transport and are sent an invoice on a monthly basis. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within this home is good providing residents with an attractive, homely and safe place to live. Evidence: On the day of the inspection the home was found to be clean and hygienic throughout. The home has been organised so that service users can partake in individualised activities in different parts of the house. There is a large activity facility in the rear garden. This facility has been divided into a quiet sensory area and separate craft/activity room. Staff were in the process of supporting some service users to use this facility as part of their daily activity programme. A further garden room houses cooking equipment. During the inspection service users were relaxing with staff or engaged in activities thus utilising all areas of the home. The majority of bedrooms were seen during the inspection. The decor and fixtures in individuals room varied dependent on individual needs and personal preference. One of the bedrooms seen had minimal furnishings and few personal possessions, another presented as being extremely personalised. The manager explained that bedrooms were to individuals taste and within a behaviour risk management system. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Since the last inspection there has been some general redecoration throughout the house including the dining room and some of the bedrooms. It was noted that the tables and chairs in the dining room have been renewed. Several items of specialist equipment had been purchased to meet the assessed needs of service users and to ensure their on-going safety. These included, alarm pads and specialist mattresses for service users who suffer from epilepsy. The reason for this equipment and guidelines for use were documented within service user records. Laundry and kitchen facilities are satisfactory and previous inspections have shown that infection control procedures are in place. Care Homes for Adults (18-65 years) Page 21 of 28 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. Residents needs are met by a sufficient number of competent, well-trained and motivated staff. Evidence: Staffing rotas were available, which confirmed that sufficient numbers of staff were available to meet the assessed needs of the service users. Staffing levels are high as most service users have been assessed as requiring 1 to 1 or 2 to 1 to access opportunities inside and outside the home. Throughout the inspection staff were observed responding sensitively and respectfully to service users requests, and were able to use their knowledge of each individual to encourage choice and independence whenever possible. Staff were friendly and goodnatured. They interacted with residents and as well as being courteous and respectful were also humorous and fun, which the residents clearly enjoyed. There is a generally consistent staff team and the manager said that as consistency is very important the home makes every effort to avoid the use of agency staff. The staff spoken to were very clear about their role, and the role of others within the team and the organisation. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: A thorough training programme is run by the organisation to ensure that residents needs are fully met by skilled staff. Records confirmed that all staff undertake regular health and safety training as well as a range of specialised training courses relevant to service users needs. A sample of staff records were seen and confirmed that the homes recruitment procedure is robust and ensures the protection of residents. Records confirmed that structured, 1 to 1 supervision sessions take place every 6 to 8 weeks. Records indicated that 43 per cent of the support workers have attained an Nvq qualification. This will rise to 66 per cent when those currently undertaking the course achieve completion. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management approach is open and inclusive, providing clear leadership and guidance. Service users rights, health, safety and welfare are protected and promoted. Evidence: The manager is well supported by the companys senior management team who visit the home on a regular basis. She holds the NVQ 3 in children and young people, NVQ 4 in care and the Registered Managers award. She is now in her third year of a masters degree. Throughout the inspection the manager demonstrated a Person Centred approach to planning care for service users, and was keen to discuss areas where the home could continue to improve and provide an increased quality of life for service users. Staff were aware of their roles and had a good understanding of the needs of the service users. Staff said they felt well supported by management and other members of the team. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The home currently holds an, Investors in People award and is inspected by the National Autistic Society. Records and discussion confirmed that the home regularly liaises with relatives and other professionals. All records inspected were found to be well maintained and up to date. Records were organised in a way that made it easy for us to get a picture of the individuals needs, and to understand how their needs were being met by the home and other agencies. The information passed to the Commission prior to the visit confirmed that the home had carried out recent health and safety checks, including, Legionella, Gas and electrical appliances and fire equipment. Radiators and pipes had been covered and thermostatic control valves had been fitted to all hot water outlets. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - 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!