Inspection on 08/11/07 for 13 Longmeadow Road

This inspection was carried out on 8th November 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

13 Longmeadow Road 20/06/06

13 Longmeadow Road 17/01/06

13 Longmeadow Road 20/07/05

13 Longmeadow Road 19/01/05

13 Longmeadow Road 24/06/04

13 Longmeadow Road 04/03/04

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 13 Longmeadow Road 13 Longmeadow Road Saltash Cornwall PL12 6DW Lead Inspector Brendan Hannon Unannounced Inspection 8th November 2007 10:30 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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 13 Longmeadow Road DS0000008977.V349868.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 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. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 13 Longmeadow Road Address 13 Longmeadow Road Saltash Cornwall PL12 6DW 01752 841680 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) info@michaelbattfoundation.org Michael Batt Foundation (Valued Life Projects) Post Vacant Care Home 1 Category(ies) of Learning disability (1) registration, with number of places 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 1 adult with a learning disability (LD) Total number of service users not to exceed a maximum of 1 Date of last inspection 20th June 2006 Brief Description of the Service: 13 Longmeadow Road is a care home providing accommodation and personal care for one person, aged 18 - 65, with learning disabilities/mental health support needs. The Michael Batt Foundation (Valued Life Projects) established the home in 2001. It is a not for profit organisation providing services for people with a range of needs who require support to live in the community. The house is near the centre of Saltash and within easy each of Plymouth either by private or public transport. The aim of the service is to provide the individual with as much independence and choice as possible with support from the team of staff. Any restriction of personal choice has been discussed with the person that uses the service and relevant professionals. All the homes bedrooms are single. None of the bedrooms have en suite facilities. The home has a bathroom and a separate toilet. There is a dining area attached to the kitchen. There are two lounges on the ground floor. The home has a front and a rear garden. The weekly fees for this service are calculated on an individual basis depending upon the person’s support needs. Information relating to the services provided by the Michael Batt Foundation can be obtained from their Head Office at Third Floor, Poseidon House, Neptune Business Park, Cattedown, Plymouth, PL4 OSJ, telephone number 01752 310531. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on the 8th November 2007. The home manager, Paula Bryant and the Quality Assurance Auditor were present. The person that lives at the house was away during the inspection. A tour of the building was made and documents relating to the support needs of the person that uses the service were examined. A visit was also made to the Michael Batt Foundation’s head office on 11th October 2007 to examine staff personnel records from all of the Foundation care homes in Plymouth. We were present in the home for 3.5 hours and at the foundations head office for 2.5 hours. What the service does well: The person that lives at the house can decide with staff help what food to buy and cook. The person that lives there has enough things to do to be happy. There are always enough staff to help and the person that lives at Longmeadow Rd gets all the help they need. The person that lives at the house can have their rooms just as they want them. The staff know how to help him and the staff do their best. If the person that lives at Longmeadow Rd has a problem it is easy for him to get help. The staff are safe to be with. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The person that uses the service has lived at the home for some time, and the service is geared to meeting their needs and capabilities. EVIDENCE: The man that lives at this home has used the service since it was established for him in 2001. He has received a basic Service User Guide. A new Individualised Service User Guide is being developed for him. The Foundation can provide a Service User Guide in different formats, including pictorial format and audiotape, depending upon a persons needs and abilities. The Foundation has an appropriate admission policy and procedure. Documents relating to pre-admission assessments are held at the Foundation’s head office. A new ‘Statement of Terms and Conditions’ format is being developed by a Registered Manager from another of the organisation’s services. When it is complete it will be used as a template for ‘Statements’ for the other people that use the Foundations services. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The person that uses the service is enabled to participate in, and make decisions about, all aspects of their life. EVIDENCE: Reviews of care are held every three months and involve health professionals and the person that lives at 13 Longmeadow Rd. Written assessments come from these meetings. The plan of care identifies appropriate responses to various situations and behaviours. These behaviour management plans are agreed between the professional advisors, the organisations staff, and the person that uses the service. The person that uses the service’ care plan, daily diary, evaluation, and communication records were inspected. His care planning is adequate. It was advised that a copy of his needs assessment should be kept at Longmeadow Rd as well as at the organisations head office. There are some action plans on 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 10 his file but these are generally basic and do not give a detailed picture of the support that he is receiving from the service. When additional information has been passed into the home from the organisation’s head office, and the action planning has been expanded, the information in the home will then be comprehensive and detailed. This will help the support team provide consistent support. As the person that lives at the home was not present during the inspection interactions between him and staff could not be observed. The manager said that the person that uses the service does not want to be involved in house meetings. However he is encouraged to take part in daily living activity in his house. Elements of this are described in his care planning. His care plan also describes his ability to participate in the local community. Risk assessments that have been developed to protect the person that uses the service have been renewed. They are thorough and detailed. They identify escorted and non-escorted activity and some restrictions of the person’s choice. The person that uses the service is aware of these restrictions and has agreed to them. He has the freedom to make decisions and choices, though the staff are always available to support his decision making. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home encourages the man that uses the service to participate in the community. The staff work to provide him with consistent positive advice with which to make decisions. He is actively involved in the day–to-day decision making of his home. EVIDENCE: Discussion with the home manager demonstrated that the person that uses the service is enabled to live as full a life as possible and had opportunities for personal development. The service is individually designed for the person that uses Longmeadow Rd. He was away during the inspection. However records and discussion show that he has as active a lifestyle as he wants. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 12 The person that uses the service has many skills and abilities including managing and holding his own money and holding a front door key. There is an appropriate key operated lock on his upstairs bedroom door. The person that uses the service is encouraged to participate in domestic activities and to takes part in leisure activities of their choice. He enjoys active mechanised sports, and going out for meals and other activities locally. The home does at times provide transport to enable him to be properly supported. He decides the amount of contact he has with relatives and friends and he is supported by the service. There are no limitations on visitors to Longmeadow Rd. The manager confirmed that with support he plans his own menu and shopping list, and goes out to buy his food as he wishes. He also helps to prepare his own meals as well as enjoying take away meals. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The person that uses the service receives support in the way, and at the time, that they want and need. His health care needs are supported appropriately. EVIDENCE: Personal support is provided on a 24-hour basis for the one person that uses the service. The service aims to support and maintain this persons independence and help him to maximise control over his own life. He uses a local GP and has access to a dentist and optician. His care needs and progress are reviewed at 3-monthly case reviews. Health professionals attend these reviews. The home maintains a record of his attendance at medical appointments. The service user orders repeat medication prescriptions from a local chemist with staff support. There is secure and properly maintained storage for his medicines. A corporate medication administration policy and a procedure for medication administration, that is specific to 13 Longmeadow Rd, were seen. The listing (profile) of this person’s medication, with potential side effects 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 14 noted, was up to date and accurate. The Medication Administration Record (MAR) was signed appropriately and comprehensively. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The person that uses the service is protected from abuse, neglect and selfharm. He can be confident that the Registered Provider always takes complaints seriously and any concerns are listened to and acted upon immediately. EVIDENCE: Neither the organisation nor the Commission for Social Care Inspection have received any complaints regarding the service since the last inspection. The staff and home manager are in continuous contact with the person that uses the service. Should he have any issues of concern they would be dealt with immediately. It was clear from discussion that he can raise any issue at any time. The man that uses the service has been given a new simplified complaints procedure to use should he wish to raise an issue. This has also been given to the professional responsible for his care and to his family. There was a simplified ‘Alerters’ Guide available in the house to enable contact with Cornwall County Council in the event of an allegation of abuse. Staff have received training in the protection of vulnerable adults and are aware of their responsibilities should they suspect a vulnerable person is at risk. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is satisfactory providing the person that lives there with a homely place to live. EVIDENCE: The home is a normal domestic house in a location that suits the needs of the man that lives there. He has some responsibility for domestic duties and these are linked to his goals towards further independence and as noted in his care plan. The home was clean at the time of the inspection. A bathroom and separate toilet are provided on the first floor. The person that uses the service has the use of two of the three bedrooms on the first floor. There are two lounges on the ground floor one of which is for his private use. In the last 12 months one lounge has been redecorated and the rear garden has been tidied. A new combi boiler has been installed and some parts of the house’s guttering have been replaced. One bedroom carpet, the kitchen/diner 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 17 carpet, the hallway carpet / stairs carpet were in poor condition and should be planned for replacement. The standard of the décor in the home is generally adequate but there were some areas that could be improved. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment processes are robust and the person that uses the service benefits from well supported staff that have a good understanding of his needs. EVIDENCE: The Foundation has a department that ensures recruitment practices are safe. A sample of staff files were examined and showed a robust recruitment procedure. All the required information was available, including Criminal Record Bureau checks and 2 written references, ensuring as far as possible only suitable staff are employed. Documentation showed records of staff meetings. Individual supervision sessions were taking place but not as frequently as stated by the organisations supervision policy. Staff are supervised informally while supporting the person that uses the service. The manager was advised to ensure that regular formal supervision sessions are carried out with each staff member. The supervision meetings addressed the principles and values of the Foundation, staff performance and training and development needs, as well as day-to-day support issues. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 19 The Foundation has a designated staff member to coordinate and arrange training, to maintain an overview of what the organisation requires, as well as ensuring that individual staff members receive the training they need. The foundation is now providing training to other organisations in the nationally recognised Learning Disability Qualification (LDQ), which has replaced the Learning Disability Award Framework (LDAF) levels 1 2. All new employees are being trained in this qualification and it is being backdated to any existing members of staff who do not hold LDAF1 2. The LDQ covers basic training on topics such as social role valorisation, person centred planning, human development, adult protection, emergency first aid, and health and safety ensuring staff members have the skills and confidence to support the people that use the service on a day-to-day basis and also at times of crisis. The majority of staff are either enrolled on or have completed the LDQ or have completed LDAF levels 1 2. Both courses are nationally recognised qualifications. 75 of the team of four that provide support at 13 Longmeadow Rd are qualified to LDAF level 2 / LDQ or above. The manager confirmed that the person that uses the service has an appropriate level of support. The organisation operates and on call’ system whereby members of the management team are available to provide support both in and out of office hours. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach is open, inclusive and positive, providing clear leadership and guidance. The person’s rights, health, safety and welfare are protected and promoted. EVIDENCE: The home manager, Paula Bryant, is competent and experienced to run the home and confirmed that she is nearing completion of an NVQ 4 in Care having already obtained an NVQ3. She has also completed the “Humanistic Approach to Support” Course, a LDAF course that follows a person-centred philosophy of care and support. The management of the service has been successful in supporting the person that uses the service to establish and maintain a fulfilled lifestyle. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 21 The organisation uses a system of management cover where, in the first instance, another manager oversees the planned absence of this service’s manager. Further support can also be gained from the organisations duty system. The organisation supplies monthly reports about the service to the CSCI in line with Regulation 26 of the Care Homes Regulations. Tests and checks of fire safety equipment had been carried out as required and a fire evacuation procedure was displayed. Original records of accidents are kept at the home and copies are kept at the organisations head office. Staff have completed training in fire safety, first aid, food hygiene and health and safety ensuring they have the skills to deal with emergencies. Risk assessments for the environment of the building were not in place. These must include management of hot water, hot surfaces and the prevention of falls from windows. A copy of the electrical safety certificate for the wiring of the building was seen. Though a visual check of domestic electrical appliances is carried out annually a test of their electrical wiring is not. The Foundation has a Quality Assurance Auditor who is responsible for assessing whether the services provided meet peoples needs to their satisfaction as well as ensuring their safety and that of the support staff. These assessments are detailed and include all aspects of a person’s personal, health, emotional and social support needs. The organisation ensures that people that use the services are approached for information on their service in a manner appropriate to their communication abilities. There is a draft Quality Assurance policy and procedure. As part of the Quality Assurance process relatives of the people that use the service, and professionals involved with each persons support, are approached to give their opinions on the service provided. The results of the quality assurance process are shared with the people that use the service and their relatives or representatives. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 2 X 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 23 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 YA42 Regulation 13 Requirement Individual risk assessments must be carried out for all window openings above ground floor, all unprotected hot surfaces, and all hot water outlets. (This requirement was verified as complete, by the date required, before publication of this report). Timescale for action 01/01/08 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 Refer to Standard YA5 YA6 YA24 YA42 Good Practice Recommendations The registered provider should provide the person that uses the service with a Statement of Terms and Conditions. Care planning should be comprehensive to reflect all aspects of the person’s life. The hallway, stairs, and one bedroom carpet should be planned for replacement. Electrical wiring tests should be carried out regularly on all domestic appliances in the home. 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 13 Longmeadow Road DS0000008977.V349868.R01.S.doc Version 5.2 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!