Inspection on 23/06/05 for 10 The Crescent

This inspection was carried out on 23rd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

10 The Crescent 07/09/07

10 The Crescent 21/11/06

10 The Crescent 13/02/06

10 The Crescent 17/11/04

10 The Crescent 08/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Crescent The (10) 10 The Crescent Pewsey Wiltshire SN9 5DP Lead Inspector Alison Duffy Announced 23 June 2005 rd 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Crescent The (10) Address 10 The Crescent Pewsey Wiltshire SN9 5P 01672 562266 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Landlace Care Homes Ltd Mrs Nanette Lance Care Home 4 Category(ies) of LD Learning Disability (4) registration, with number of places Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 2004 Brief Description of the Service: 10 The Crescent is a residential care home which accommodates four service users with a learning disability. An additional room has been registered since the last inspection and therefore in the past the home could only accommodate three service users. 10 The Crescent is one of three residential care homes owned by Landlace Care Homes Ltd. Mrs Nan Lance is the responsible individual and also the registered manager. Mrs Lance undertakes shifts as part of the working roster and also covers shifts within the organisation at times of annual leave or sickness. 10 The Crescent is located within a residential area of Pewsey and is within walking distance of local amenities. The property is semi detached and furnished to a good standard. Service users have single room accommodation on either the ground or first floor. The home has two members of staff on duty throughout the waking day when service users are at home. At night sleeping in cover is provided. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 10 The Crescent is one of three care homes owned by Landlace Care Homes Limited. As all homes are similar in nature it was agreed to undertake the announced inspections of all services over a period of three days. This inspection took place from 9.30am – 5.30pm on the 23rd June 2005. Initially, Mrs Lance was given feedback from the other two inspections. Discussion then took place regarding 10 The Crescent and previous requirements and recommendations. Time was spent with one service user and care planning information and daily records were viewed. Medication systems and the management of service users’ personal money were also examined. Three service users were spoken with on their return from day services and various discussions were held with Mrs Teresa Pound, Support Worker during the day. Mrs Lance was also available throughout the inspection. Common themes to the three care homes, such as personnel and training records and policies and procedures were viewed initially on the 21st June 2005. Such findings were added accordingly to each report. All service users gave positive feedback regarding their lives and important aspects of such. Friendships were important and service users reported enjoying their day services and the other activities undertaken. Enjoyment was reported from being involved with housekeeping tasks and going out on the bus. As part of the announced inspection process, seven comment cards were received. Four were from service users and three were from family members. One service user reported that their privacy was sometimes respected and they would like to be more involved in decision-making within the home. Two other service users reported that they would like to be more involved with decision- making and another stated that they would like to be more involved ‘sometimes.’ One family member reported ‘I am generally quite pleased with the present arrangements’ and another stated ‘XX has only just started living in Pewsey, so far we are very pleased with everything.’ Three relatives said they were not aware of forthcoming inspections and two reported not being aware of the home’s complaint procedure. Two relatives did not have access to the home’s inspection report. What the service does well: 10 The Crescent is relaxed, welcoming and very much considered the service users’ home. Service users are encouraged to follow their preferred routines and spend their time as they wish. Day service provision is supported and high levels of opportunity and friendships are promoted through this. Staff Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 6 encourage service users to take such opportunities and be involved with external activities. A positive annual holiday to another country has become established practice. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 The admission procedure is well managed and promotes successful placements. EVIDENCE: Since the last inspection there has been one new admission. The service user reported that they were able to visit the home and meet with service users and staff before their admission. The service user also reported that they had settled in well and staff had been friendly and helpful which helped a lot. A full written assessment was on file and such matters were addressed within an individual plan of care. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Care planning is up to date and of a good standard enabling service users’ needs to be met. Residents’ safety is safeguarded through appropriate risk taking. Decision-making is promoted yet could be further developed in relation to individual need and wishes. EVIDENCE: Since the last inspection, all care plans have been updated. All contained detailed information and were well written. Certain matters identified within assessments were clearly addressed within the plans. One service user spoke in depth of their care plan and how they had assisted to write it. Within discussion with the service user, important matters and preferred routines were identified in written form. Service users are encouraged to make decisions and be involved with aspects of the home. Within service users’ comments cards however, it was noted that all service users would like to be more involved. One service user reported that she enjoys housekeeping tasks and often assists when she can. Other service users were seen assisting with the preparation of the evening meal. One service user has a vegetable plot within the garden. This was spoken of with enthusiasm and later in the afternoon, strawberries were picked. Homegrown Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 10 radishes also formed part of the salad for the evening meal. Developments have recently been made regarding service users contributing to the menus. Risk taking is encouraged although Mrs Lance is clear regarding the safety of all tasks undertaken. Service users do not go out unattended. Involvement with outside activities is encouraged despite conditions such as epilepsy. The home has a new ‘absent without leave policy.’ This would benefit from clarity with particular attention to police involvement. Developing the policy on an individual basis would also be of benefit. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 and 17 The home is relaxed with positive relationships and hospitality evident. A recent increase in staffing levels gives service users greater opportunity. EVIDENCE: Two service users attend a day service each day during the week and another attends a day service and sheltered employment. The fourth service user, who is new to the home, is expected to commence such activity in September. Service users reported being happy with their routines and activities undertaken. On the evening of the inspection some service users were going to Gateway club and others were planning to go swimming. Some service users recently enjoyed a holiday to Lanzarote and trips to the cinema and the pub are also undertaken. It was reported that the recent increase of staffing has enabled greater flexibility with external events. Visitors are welcomed within the home and on the day of the inspection hospitality was evident. Family contact is promoted and varies according to personal circumstances. Service users spend time with others within the organisation and also have a wide circle of friends due to their attendance at day services and additional clubs. Special friendships are supported. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 12 The home has a menu, which is in the process of being fully developed by service users. Service users are able to help themselves to breakfast and a packed lunch is taken to the day service. The main meal is served in the evening and is either eaten in the kitchen/dining area or outside in good weather. The menus appeared varied and gave a good balance of healthy eating and service users’ preferences. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users’ health care is well managed. Well-organised medication systems minimise the risk of errors to service users. EVIDENCE: Service users require varying levels of staff assistance and supervision with daily living tasks. This is fully documented within care planning information. Daily records demonstrated recognition of ill health and appropriate follow up action. Input from other professional services was evident. On the day of the inspection the inspector observed the process of giving ‘prn’ medication to one service user. This was fully explained and agreed with the service user. Service users do not have the ability to self medicate. All medication was stored securely in a locked cupboard. Records demonstrated receipt, disposal and appropriate administration of medication. Mrs Lance was recommended however to ensure that two members of staff sign any written medication instructions. A GP has signed a homely remedies policy and information sheets are available for each medication used. Information from the internet has also been gained. There is a clear medication policy in place. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Complaint information is readily accessible to service users. The home’s adult protection systems are insufficient at this time to fully protect service users. Attention must be given to the management of service users’ personal monies. EVIDENCE: A copy of the home’s complaint procedure is located within each service user’s file. One service user reported that they would always tell ’Nan’ if they had a problem. Within relative/visitors comment cards it was noted that two family members were not aware of the home’s complaints procedure. Mrs Lance was therefore advised to send them a copy. The home’s adult protection policy has been updated and gives a line of command for reporting a suspicion or allegation of abuse. At the last inspection a requirement was made to ensure all staff were aware of their responsibilities by undertaking specific adult protection training. Such training has not been undertaken and therefore the requirement is repeated. Service users do not manage their financial affairs and all have appointees with their placing authorities. A small amount of money is kept for safekeeping on behalf of service users. Greater clarity of expenditure when undertaking group outings is required, as the receipts did not tally with the identified expenditure. Service users had also borrowed from each other, which is not acceptable. The home has an unwritten policy for transport, contributing to gifts and subsidising staff when out. Within the balance sheets however, this was unclear and therefore Mrs Lance was informed of the need to formalise such. The cash tins contained a number of old receipts although the balance sheets Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 15 had been filed. It was therefore recommended to attach all receipts to the balance sheets and file both together. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 28 The home is comfortable, homely and well maintained. All areas are furnished to a good standard yet consideration must be given to service users’ safety with radiators. EVIDENCE: All service users have a single room on either the ground or first floor. Rooms are individual in style and have been personalised to varying degrees. All have a range of personal entertainment equipment that is regularly used. The home has a large kitchen with dining area and a separate lounge. The lounge has patio doors leading to an outside seating area. Service users at this time do not smoke so the home operates a non-smoking policy. The hot water is centrally regulated and since the last inspection, hot water temperatures are monitored and recorded appropriately. Radiators are at this time uncovered and risk assessments could not be located. Discussion however gave evidence that there may be an element of risk especially in terms of service users with epilepsy. Mrs Lance reported that consideration would be given to the installation of covers. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 and 36 Increased staffing levels have enabled service users greater opportunities. Further training and formal supervision would promote staff development and service provision. Poor recruitment procedures place service users at risk. EVIDENCE: The home has recently increased its registration from three service users to four. As a condition of the variation, Mrs Lance was required to increase staffing levels to two members of staff at all times during the waking day when service users are at home. This increase has taken place and greater flexibility is now available. At night one member of staff provides sleeping in provision. Since the last inspection, one member of staff has commenced employment. An application form was undertaken although this was not fully completed and the dates did not correspond. The space to record references was not filled in and references were not gained. A POVAFirst check was also not undertaken before commencement of employment. Mrs Lance was informed of the need to ensure a robust recruitment procedure and therefore a requirement has been made to address such. The home currently has a staff team of three members and Mrs Lance is also undertaking a high level of shifts. An additional staff member from another of Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 18 the care homes within the organisation is also covering some shifts. One member of staff has completed NVQ level 2 and another is undertaking level 3. Two members of staff have a first aid certificate and three have undertaken epilepsy training. When viewing the training records it was noted that one member of staff has not undertaken first aid and there were shortfalls within food hygiene training. Another member of staff planning to cover a number of shifts within the home has not received epilepsy training. Due to two service users suffering with epilepsy, this shortfall needs to be addressed. At the last inspection a requirement was made to develop and implement formal supervision. To date this has not been fully accomplished. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 40 Documentation is well written, yet some clarity to relate information to the home is needed. A formal system, to monitor service provision and its development is required. EVIDENCE: Since the last inspection Mrs Lance has given significant effort to developing policies and procedures. All are well written, informative and easy to read. Some policies however require clarity for the service. For example, within the management of aggression policy, information is given regarding panic alarms, which is not relevant to the home. Others recognise matters such as the need for annual training yet there is no evidence of this. There is a copy of the GSCC Code of Conduct within the policies and procedures file. At the last inspection a requirement was made to further develop quality assurance within the home. This standard was not fully assessed on this occasion as Mrs Lance reported that no further work has been undertaken. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 20 Further clarity was however given and a self-audit format was recommended. The requirement identified at the last inspection is therefore repeated. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x 3 x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Crescent The (10) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 2 x x x D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 22 No Are there any outstanding requirements from the last inspection? 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. 1. Standard 23 Regulation 13(6) Requirement The Registered Person must ensure that all staff receive adult protection training. This was identified at the last inspection. The Registered Person must review current practice and regularly monitor the management of service users personal monies. The Registered Person must ensure that service users personal money within safekeeping is not loaned to other service users. The Registered Person must ensure that a policy is devised regarding payment of transport and staffing costs when out. The Registered Person must ensure that any risk to a service user from a radiator, identified within the risk assessment process, is addressed through the fitment of a cover. The Registered Person must ensure that a fully completed application form and two written references are received before a prospecitive member of staff commences employment. This was identified at the last Timescale for action 30th September 2005 31st July 2005 2. 23 13(6) 3. 23 13(6) From 23rd June 2005 4. 23 13(6) 31st July 2005 31st August 2005 5. 24 13(4) (a)(c) 6. 34 19 From 23rd June 2005 Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 23 inspection. 7. 34 19 The Registered Person must ensure that a POVAFirst check is undertaken before a prospective member of staff commences employment. The Registered Person must ensure that all staff have sufficient training to demonstrate competence within their role. This must include first aid, food hygiene and epilepsy training. The Registered Person must ensure that a formal system of recorded staff supervision is developed and maintained. This was idenitified at the last inspection. The Registered Person must continue to develop a system for monitoring and improving the quality of care provided in the home. From 23rd June 2005 8. 35 18(1) (a)(c)(i) 30th September 2005 9. 36 18(2) 30th September 2005 10. 39 24 30th September 2005 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. 4. 5. Refer to Standard 7 9 20 23 39 Good Practice Recommendations The Registered Person should give consideration to matters identified within comment cards such as more involvement within decision-making. The Registered Person should ensure that the missing person procedure is developed on an individual basis and police involvement is clarified. The Registered Person should ensure that a member of staff countersigns any written medication instruction. The Registered Person should ensure that all old receipts are removed from service users money tins. The Registered Person should ensure that a self audit system is devised as a tool for further improving care provision. Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 24 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB National Enquiry Line: 0845 015 0120 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 Crescent The (10) D51_D01_S28316_CRESCENT(10)_v205734_230605_Stage4.doc Version 1.30 Page 25 - 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!