Care Home: Woodlands Court Care Home

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What the care home does well Residents are able to make choices and decisions about their daily lives; and they are involved in planning and reviewing their care. They are consulted about the meals and the activities that are provided for them. Staff receive training and support to make sure that they know how to care for the residents appropriately, and the registered manager makes sure that there are enough staff on duty to be able to meet their needs. What has improved since the last inspection? Since the last inspection there has been a lot of improvements in the home. Some areas of the home have been decorated and some bedrooms have had new furniture. Photographs and names have been added to some bedroom doors to help residents find their rooms more easily. Toilet and bathroom doors have been colour coded, again so residents can find them more easily. The garden space at the front of the home has been enclosed with fencing to help with security, and raised flowerbeds have been put in place so that residents can join in with garding. There is now an activity co-ordinators post, and a recognised activity-planning package has been implemented. A new format for assessments and care planning has also been implemented. As a result of a recent fire officer visit, which highlighted issues with fire safety, a new fire alarm system has been installed in the Rosewood building. Although Oakwood Lodge has a functioning fire alarm system, there are also plans to replace and thus update this. CARE HOMES FOR OLDER PEOPLE Woodlands Court Care Home Boston Road Kirton Boston Lincolnshire PE20 1DS Lead Inspector Wendy Taylor Unannounced Inspection 23rd January 2008 09:30 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 Woodlands Court Care Home DS0000066999.V357700.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. Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Court Care Home Address Boston Road Kirton Boston Lincolnshire PE20 1DS 01205 723572 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) sharon@lincsmail.co.uk Greenhold Care Homes Ltd Sharon Woodings Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (47), Physical disability (7) of places Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is 54. Date of last inspection 2nd April 2007 Brief Description of the Service: Woodlands Court is in the village of Kirton, Lincolnshire. The village has a number of shops and public houses. A wider range of facilities is available in Boston, approximately 5 miles away. Accommodation in Woodlands Court is arranged in two separate buildings. Oakwood Lodge is a two storey Victorian house, with accommodation for up to 23 residents, in ten double rooms and three singles. Stairs and a lift provide access to both floors. Rosewood is a purpose built single storey building, providing accommodation for 24 residents in twelve self-contained apartments. Each apartment has a kitchen diner, bathroom and two bedrooms. There is a communal dining and lounge area within the complex. A third building is currently being refurbished and is unoccupied. The home has large, well-kept grounds, with space for car parking. Fees range from £345:00 to £476:00 per week. Woodlands Court Care Home DS0000066999.V357700.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 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection took place on one day in January 2008 and lasted for approximately 6½ hours. The care and support received by four residents was followed in detail, using a method called case tracking. This method involves talking to the residents and observing the care and support they receive. It also involves looking at their care plans, medical records and daily notes. Some of the general house records and staff records were also looked at. Staff and the registered manager were spoken to during the visit, and information already held by the commission, such as a self-assessment and notifications, was also used as part of the inspection process. During the visit some of the residents were joining in with entertainment and others were receiving visitors. A resident said that they were settled at the home and felt safe. Staff said they enjoy working at the home. Other comments from residents and staff are contained in the body of the report. What the service does well: What has improved since the last inspection? Since the last inspection there has been a lot of improvements in the home. Some areas of the home have been decorated and some bedrooms have had new furniture. Photographs and names have been added to some bedroom doors to help residents find their rooms more easily. Toilet and bathroom doors have been colour coded, again so residents can find them more easily. The garden space at the front of the home has been enclosed with fencing to help with security, and raised flowerbeds have been put in place so that residents can join in with garding. Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 6 There is now an activity co-ordinators post, and a recognised activity-planning package has been implemented. A new format for assessments and care planning has also been implemented. As a result of a recent fire officer visit, which highlighted issues with fire safety, a new fire alarm system has been installed in the Rosewood building. Although Oakwood Lodge has a functioning fire alarm system, there are also plans to replace and thus update this. 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. Woodlands Court Care Home DS0000066999.V357700.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 Woodlands Court Care Home DS0000066999.V357700.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): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are assessment processes in place, which ensure that individual needs can be met within the home. EVIDENCE: New assessment formats are in place, which contain information about things like medication, culture and religion, social activity and end of life wishes. Admission and discharge sheets are also in place, which contain clear personal information such as next of kin, GP and medical history information. The registered manager said that herself or the deputy manager carries out pre admission assessments, and they include a visit to the person at home and discussions with anyone who is involved in the person’s life. The home does not provide intermediate care. Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 9 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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being involved in planning and reviewing their care, however record keeping should be reviewed to ensure it fully reflects the activity undertaken. EVIDENCE: Care plans cover needs such as medication, mobility, communication, mental health needs and social interests. They reflect those needs identified in assessments. The care plan formats are newly introduced and as such some are not fully completed. The registered manager said that as residents and keyworkers are completing the new formats they are taking time to do this. The varying amount of detail contained in the plans was discussed and the manager and she said that she would make sure that this was addressed. Care plan review dates are recorded monthly and there is also evidence of some annual reviews carried out by placing authorities. A recommendation has Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 10 been made to record full details of the reviews including any changes made to the plans. During the visit one resident was reviewing their care plan with a staff member and they said that they are always consulted about planning and development. Where they are able to do so, residents have signed to indicate their agreement with plans and reviews. There are now recording sheets for special care interventions e.g. at times of illness and visits from healthcare professionals; and there are lifestyle and interest sheets to record personal preferences. Injury recording sheets with body charts, and monthly weight recording have also been introduced. Risk assessments are in place for needs such as mobility and moving and handling, however in one file the assessment was not fully completed. The details of moving and handling needs were recorded in the care plan, as well as details of how to meet those needs. A recommendation has been made to review completion and updating of all risk assessments. Residents described good health care support from both the staff, their GP’s and District Nurses. Staff were able to demonstrate a clear understanding of how to promote privacy and dignity for residents, and they described how choices are encouraged in everyday life. They were also observed, for example, to speak to residents in a polite and friendly manner using their preferred names; and knocking on room doors and seeking permission before entering. Although a medicine round was not observed during the visit, administration records for the case tracked residents were looked at. One signature for administration of one tablet was missing from one record. The manager took action straight away to rectify the issue. A recommendation has been made to review all recording sheets. One resident is currently self-medicating and the risk assessment is signed by that person. The manager said that a new pre packed system for medication is being introduced in March 2008, along with training from the suppliers. Records show that staff have received medication training and they confirmed this during discussion. Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 11 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, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a balanced diet, and they enjoy a wide range of activities. They are able to make choices and decisions about their daily lives. EVIDENCE: An activity co-ordinator post has been funded since the previous inspection. This is currently filled by care staff on a rotational basis. They have implemented a recognised activity-planning package, and keep records of what activities residents have joined in. The records show group and individual activity. There is a 4 weekly activity guide planned with residents but residents and staff said that this is flexible. During the visit some residents were seen engaging in gentle exercises with staff in the morning, and an entertainer came to the home in the afternoon. Residents said that they enjoyed the activities provided, and one resident said that raised flowerbeds have been put in place so that people can garden when they want to. There was evidence of craft work in the conservatory area and various games and books were available. There was also photographic Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 12 evidence of outings and a summer garden party. Hairdresser and chiropody arrangements are advertised on the notice board. A resident also spoke about baking sessions. Visitors were seen around the home during the visit and were observed being greeted appropriately by staff. Residents said that they could have visitors whenever they wanted, and visitors confirmed this. Residents said that they have meetings so that they can say what they want, and minutes of those meetings show subjects such as activities, food/menus and environmental plans are discussed. Residents said that staff bring menus round so that they can make their choices for the next day. A four week menu is in place, which shows a choice of breakfasts, two choices for lunch, desserts and a hot an cold option for tea time. Likes and dislikes are recorded in residents care files. There are now two permanent cooks employed within the home. Residents said that the food was generally of good quality and they had choices if they didn’t like what was offered. One resident said they have asked for specific foods to replace those they don’t like and this has been done. Fresh fruit was freely available in lounge areas. The manager took action to address comments about meat sometimes being too chewy for some residents. There are picture menus currently being developed to help residents with their choices and decisionmaking, and they were seen during the visit. Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 13 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by clear policies and procedures; and staff who are trained and knowledgeable. EVIDENCE: There is a clear complaints policy contained within the statement of purpose for the home, and it is referred to in the service user guide. The manager said that she would display the procedure in the home so that visitors were also aware of the procedures. Residents said that they knew how to make a complaint or raise a concern, and some residents described situations where they had raised concerns with the manager. They said that the manager had dealt with the situation to their satisfaction. They also said that they could speak to staff if they had a problem, and made comments such as ‘they will do things to sort out what we don’t like’. One complaint has been made about environmental issues, which has been dealt with appropriately by the manager. As well as a complaints procedure there is a safeguarding adults policy, and a copy of the local authority guidelines. The manager and staff demonstrated very clearly that they knew what to do to protect residents from abuse, and Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 14 how to recognise various forms of abuse. Records show that staff have received training in this subject, and that further training is planned. The manager said that formal advocacy services are not used at present, and most residents choose family members to advocate for them. She demonstrated a good knowledge of recent legislation about decision-making, and said that care plans would be put into place to make sure guidance is adhered to. Woodlands Court Care Home DS0000066999.V357700.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, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents enjoy a comfortable and personalised environment, which helps them to maintain their independence. They are now protected by adequate fire safety arrangements. EVIDENCE: A partial tour of the home was carried out and there was evidence that decoration and furniture was being replaced and improved. The manager said that this is an on-going programme, and minutes of residents meetings show that they are consulted about the programme. Refurbishment of several bedrooms and a dinning room had been completed since the previous inspection. The manager described plans to refurbish bathrooms and provide baths that were more accessible to all of the residents. The manager said that Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 16 general maintenance is kept up to date and she agreed to develop a recording system that helps to monitor this. Lounges and dining areas were comfortably furnished, and the conservatory area in Oakwood Lodge is now being used for activities. Bedrooms were very well personalised and many of the rooms have residents names or photographs on them so that they are easily recognised. Some residents said that they had chosen not to have their names or photographs on the door and this wish had been respected. Doors to bathrooms and toilet areas have been colour coded, again so that they are more easily recognised. The home was clean and tidy throughout, and there was a pleasant temperature maintained around the buildings. Residents said that they felt comfortable with temperatures in their rooms and communal areas. There are extensive and well kept gardens, which residents said that they like to use in the summer. The gardens to the front of the home have been enclosed with fencing to help with security, and the manager described plans to have a bird feeding area. A recent fire officers visit to the home highlighted issues with fire safety such as the use of wedges and door hooks on fire doors; flammable material being stored under an outside stairwell, and fire escapes and corridors not being clear for evacuation. The manager said that she had addressed all of these issues on the day of the fire officer’s visit, and there was no evidence during the inspection visit of these practices having continued. It was also highlighted that emergency lighting had not been routinely tested, and the manager provided evidence that this is now in place. Although issues were raised about fire alarm systems, records show that the systems have been checked weekly from randomly chosen points. An engineer’s assessment in September 2007 highlighted issues with the systems that required work but this was not shared with the owners or the manager at the time. A new fire alarm system has now been installed in one area of the home, and certificates confirming that all systems are in working order are available. Woodlands Court Care Home DS0000066999.V357700.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment arrangements protect residents, and there are sufficient numbers of well-trained staff, to ensure that the current needs of residents’ are met. EVIDENCE: Rotas show that staffing levels have increased in Oakwood House in response to a requirement made at the previous visit. Both residents and staff say that there is now enough time to meet needs, and staff said that they are not rushed. There is also an activity co-ordinator in place during weekdays, and permanent domestic, maintenance and catering staff. Four staff files were looked at, and they contained recruitment information such application forms and criminal record bureau checks. Records also contained evidence of induction and on-going training. A nationally recognised induction programme has been introduced since the previous inspection, and records show that subjects such as choice, independence, communication and protection of vulnerable adults are included in the programme. The manager said that she has developed a three-day course for care staff about person centred approaches to dementia care, and one course has so far been undertaken. Domestic and catering staff have also been included in this training. Records show staff have received training in Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 18 medication administration and nationally recognised courses for care practice. They show that up date training is booked for subjects such as health and safety, first aid, fire safety and moving and handling. Staff said that they have a very good training programme, and they can discuss their training needs during supervision (see also Standards 31-38). They said that there is good teamwork and good communication; and all staff are now included in the shift handover procedures. They were able to demonstrate a good understanding of residents needs during discussions, and through observation of their practice. They said that they feel respected as members of staff and the manager has an open door policy for support (see also Standards 31-38). Woodlands Court Care Home DS0000066999.V357700.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, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and there are systems in place to help ensure the safety and welfare of residents. EVIDENCE: Since the previous inspection the manager has registered with the commission. She holds nationally recognised care and management qualifications and is soon to start studying for a further management qualification. Staff said that she is very approachable, and comments such as ‘can’t fault her’ and ‘she’s great’ were made. Residents said that they could talk to her whenever they want and she always listens. Staff said that the owners are also approachable, and the manager said that the owners are Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 20 attending in-house training sessions to develop their knowledge of care needs. Records show that staff have regular supervision, and they said that sessions are useful and help to develop their skills. There are minutes of monthly meetings between the owners and the manager, where things like residents and staff needs, office procedures, building works and regulation compliance are discussed. Records include information sheets about substances hazardous to health, servicing certificates for hoists and a fire risk assessment including evacuation procedures. The manager said that she is developing individual evacuation procedures that will be held in residents care plans. The owners also carry out regular monitoring visits and reports are available in the home. The manager described plans to carry out regular audits of care plans; and satisfaction surveys that are soon to be sent to residents, their relatives and staff were seen. Residents’ personal money is held securely in the manager’s office. There are individual records of income and expenditure with receipts attached. Records show that the manager and administrator carry out random checks of the balances. Woodlands Court Care Home DS0000066999.V357700.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 X X 3 X X 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 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 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 3 X 3 X 3 3 X 3 Woodlands Court Care Home DS0000066999.V357700.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. 1. 2. 3. Refer to Standard OP7 OP8 OP9 Good Practice Recommendations The details of care plan reviews should be fully recorded to enable any changes in need to be monitored more effectively. All risk assessments should be reviewed to ensure that they are fully completed and reflect current care needs. The systems in place to ensure that all medicines are signed for as they are administered should be reviewed. Woodlands Court Care Home DS0000066999.V357700.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 Woodlands Court Care Home DS0000066999.V357700.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. 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