Inspection on 10/08/07 for 1 & 2 Turnbull Place

This inspection was carried out on 10th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

1 & 2 Turnbull Place 20/06/06

1 & 2 Turnbull Place 10/01/06

1 & 2 Turnbull Place 01/10/04

1 & 2 Turnbull Place 23/04/04

1 & 2 Turnbull Place 11/03/03

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE 1 & 2 Turnbull Place Riding Lane Hildenborough Tonbridge Kent TN11 9LN Lead Inspector Christine Lawrence Key Unannounced Inspection 10 August 2007 10:45 X10029.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 1 & 2 Turnbull Place DS0000023804.V349026.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 and Care Homes for Adults 18 – 65*. 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. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 & 2 Turnbull Place Address Riding Lane Hildenborough Tonbridge Kent TN11 9LN 01732 838876 01732 838876 Turnbull.Place@theavenuestrust.co.uk www.theavenuestrust.co.uk The Avenues Trust Ltd 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) Bridie Kennedy Care Home 5 Category(ies) of Learning disability over 65 years of age (5) registration, with number of places 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users from the minimum age of 60 years may be accepted for the existing category of registration 20/06/06 Date of last inspection Brief Description of the Service: 1 & 2 Turnbull Place is owned by The Avenues Trust Ltd who have a number of care homes in the south east. The home provides personal care and support for 5 older people with learning disabilities. The home consists of two bungalows on the same site. One bungalow is currently unoccupied as the building is being refurbished. Three people are living in the other bungalow. They all have single rooms and there is a lounge/dining area. There is room for several cars to park off road. 1 & 2 Turnbull Place is located in a country lane about one mile from the village of Hildenborough where there are some shops, a library and bus services to Tonbridge and Sevenoaks. Hildenborough also has a train station. The home’s current fees are £1316.23 per week. Information about the home, including the previous inspection report from the Commission for Social Care Inspection, would be made available on request. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 10.45 and finished at 15.30. I looked at various records in the home. Information from the previous inspection is also used for this inspection. I spoke with two of the residents and was invited to see some bedrooms. I also joined residents for lunch. A tour of the rest of the building was undertaken. I made observations of staff interacting with and supporting residents. Staff chatted informally with me and I had a brief discussion with the manager on her return from a meeting. She also provided me with a copy of the Annual Quality Assurance Assessment (AQAA) form which she had completed, when I explained that the commission had not received it, probably due to an emailing problem. Information from that form is also used for this report. What the service does well: What has improved since the last inspection? What they could do better: Although there are no formal requirements from this inspection the manager and the organization have identified the following things for improvement:reassess each person’s needs regarding their understanding and communication to make sure their decisions and choices are supported; create a new activity folder as a useful tool for staff to offer different things to residents; maintain and improve recording to help ensure a consistent approach; on completion of the refurbishment of 2 Turnbull Place, plan any redecoration needed for 1 Turnbull Place; recruit new staff, including a deputy manager’s post; encourage and enable all staff to gain NVQs. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 6 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. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed and they can be confident that the home judges that it can meet their needs. EVIDENCE: The individual records for the three people currently living in the home were looked at for this inspection. No new residents have been admitted for some time but it is clear that new residents would only be admitted after a detailed assessment process which includes getting information from the placing authority’s representative. The assessment information is used to compile a 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 9 care plan. The format being used in the home is based on person centred planning and focuses on an individual’s wishes as well as their needs. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to with respect for their privacy. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three individual records were looked at for this inspection. There is a lot of information on each person and therefore it is separated out by an index. A broad range of subjects is assessed and monitored through daily records and separate observation sheets, including communication and choice, weekly plans, finance and cultural needs. Information is used to identify any personal goal that the staff are trying to support the resident to achieve and this is noted in a Personal Planning Book. Specialist advice is sought for particular needs and the home also operates a key worker system. The support plans are regularly reviewed. Health care needs are particularly highlighted where necessary and each person has a Health Action Plan. Each resident had a financial section in their individual record and examples were noted of people being enabled to be as independent as possible. Each person has assessments of any risk which is individual and focuses on benefits to the individual with steps to reduce any risk rather than simply avoiding an activity that has a degree of risk. There are clear guidelines for staff to enable an activity to take place. One resident currently has problems with mobility and this was fully noted. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will be enabled to maintain contact with friends and family. Wherever possible, within the limitations of an individual’s disability, residents are given opportunities to make choices, therefore allowing for some level of control over their lives. The meals in this home offer both choice and variety and catering for special needs. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 13 EVIDENCE: The records seen for this visit, as well as information provided by staff, the manager and residents all reflect that residents are enabled and encouraged to take part in appropriate activities both within and outside the home. This includes household activities and responsibilities (which varies according to residents’ individual abilities), aromatherapy, gardening, using local day opportunities provision, Age Concern day centre and all sorts of local amenities such as shops, restaurants, pubs and cinema. Two of the residents gave lots of examples about how they make decisions about their daily lives. The record of the other resident, plus observations made during this visit, reflected that choices are facilitated. Relationships are supported and examples were noted of staff facilitating contact through the use of letters and card writing on behalf of residents, supporting people to use the phone and making residents’ visitors welcome. There are daily plans for each person which contain clear guidance for staff about routines, preferences for personal care and any particular support needs for eating. I joined the residents that were at home for lunch. This was a sociable time with the staff joining in as well. The three residents all chose something different to eat. I was informed that residents’ preferences are known and any planned meal reflects residents’ choices and this is recorded on the menu sheet. One resident is currently being supported with a ‘soft’ diet and supplements. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints would be handled objectively and in keeping with the home’s appropriate procedures and residents/their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Residents are protected from abuse EVIDENCE: The procedures for making complaints are appropriate and one example was noted of the organization taking residents’ concerns seriously. Most things are dealt with at a ‘problem solving’ stage before they become a complaint. The recordings reflect a professional attitude. Staff have received training regarding safeguarding adults and the organization has a range of relevant policies and procedures. Staff spoken to were clear about their responsibilities towards the residents and confirmed that they were aware of the procedures for whistle blowing. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and safe for the residents. EVIDENCE: Not all of the home was inspected because 2 Turnbull Place is being refurbished. The bungalow that is still being used was very homely and there was nothing noted during my tour of the building that needed immediate 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 16 attention. The home has identified for itself that the bathroom needs attention. Although some parts of the garden are still being improved with new paving and fencing, the residents have access to a very attractive deck and garden to the other side of the house. There are no outstanding requirements from the local environmental health department or the fire safety officer. The home was clean and fresh on the day of this visit. Although the laundry facilities are sited in the kitchen they are satisfactory and staff have received training in various aspects of health and safety relating to infection control. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sound recruitment procedures and training provided to staff will have a beneficial impact on residents. EVIDENCE: The staff on duty at the time of the inspection were knowledgeable about the residents and their individual needs such as communication. One member of staff was from an agency but she is regularly used by the organization and is familiar with their ways of working as well as the individuals in 1 & 2 Turnbull Place. A Cultural Needs Assessment has been completed for each person which helps staff to understand any particular need relating to the individual such as their religion. The manager explained that some bank staff as well as an occasional agency staff member are currently being used. There will need to be further recruitment when the refurbished bungalow is being used. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 18 The manager and staff confirmed that the process of recruiting new staff includes a criminal records bureau check, two written references, application forms and interviews. Staff have written terms and conditions of employment and are all given a copy of the General Social Care Council’s code of practice. There is a programme of training, including induction training which covers a range of subjects relating to the care of people with learning disabilities, physical disabilities and age related needs. Training regarding valuing diversity is provided to staff also. Two people have achieved a national vocational qualification (NVQ) and one is currently undertaking this. The manager said that more people will be signing up for NVQs soon. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager is qualified and experienced and keeps up to date with periodic training. The organization seeks the opinions of residents and their representatives about the home. They carry out visits under Regulation 26 ie they visit the home regularly to undertake their own checks on quality. Policies and procedures are regularly reviewed. The training programme covers a range of aspects of health and safety such as first aid, food hygiene, manual handling and fire safety. The fire safety checks are appropriately carried out. The organization has relevant and appropriate policies and procedures and information provided in the AQAA regarding maintenance and service contracts showed that these were satisfactory and up to date. 1 & 2 Turnbull Place DS0000023804.V349026.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 X 2 X 3 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 X 36 X 37 X 38 3 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 1 & 2 Turnbull Place DS0000023804.V349026.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!