Inspection on 02/11/06 for 24 Northcroft Road

This inspection was carried out on 2nd November 2006.

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

24 Northcroft Road 29/11/05

24 Northcroft Road 07/04/05

24 Northcroft Road 08/09/04

24 Northcroft Road 21/04/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Northcroft Road (24) 24 Northcroft Road Ewell Surrey KT19 9TA Lead Inspector Suzanne Magnier Unannounced Inspection 2 November 2006 16:00 nd Northcroft Road (24) DS0000013468.V297290.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 Northcroft Road (24) DS0000013468.V297290.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. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Northcroft Road (24) Address 24 Northcroft Road Ewell Surrey KT19 9TA 020 8394 2119 01999 999999 abiddurri@hotmail.com Telephone number Fax number Email address 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) Mr A H Akbarally Mrs D Akbarally Mr A H Akbarally Mrs D Akbarally Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be 30 - 65 YEARS 29th November 2005 Date of last inspection Brief Description of the Service: 24,Norhcroft Road is a Care Home providing accommodation to 4 residents. The semi-detached house is situated in a residential area near local amenities. All residents have their own bedrooms on the first floor. There are two lounge areas on the ground floor one of which has a dining area with comfortable furnishings. The kitchen is also situated on the ground floor with free access to residents. The area to the front of the home has an attractive paved area for visitors or the homes vehicle. The range of fees are £585-£810 per week. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted in an evening and lasted four and a half hours. During the visit the inspector looked at the homes complaints procedure, residents care plans, risk assessments and daily records. Records also included menus and some medication records and storage of medicines within the home, policies and procedures, the staffing rosta, staff training and recruitment records. The resident’s gave the inspector a tour of the premises. The home is currently supporting three residents and for the purpose of the report the inspector was advised that the people who live in the home are referred to as residents .The home currently has one resident vacancy. Resident’s views about their home included ‘it’s a nice house, I like living with my friends, there are nice staff and we go on holidays and outings’. ‘I like having parties, going out to the pictures, meals outings, visiting friends, going out for drives, and having my privacy and space’. ‘ I like everything about the home’. ‘I like having my own bedroom, going on holidays, seaside outings, trips to the farm, visiting friends for tea, and friends visiting me. Relatives comments included ‘ I can only reiterate what I have said in previous years that my relative’s care is exemplary. The home is very happy and safe environment. I have no worries whatsoever. It is managed impeccably’. ‘We are completely satisfied with our relative’ s care. She is happy and well looked after, always smartly dressed and well groomed’. Other comments included ‘Three very lucky people, cant think of a better environment for them. They enjoy life, and that is obvious.’ Comments from a General Practitioner to the home included ‘Very satisfactory home for my patients with Learning difficulties’. The inspector wishes to thank the resident’s staff for their cooperation during the inspection. What the service does well: The home has robust care plans, based on a person centred approach and supports resident’s to maintain active, stimulating and meaningful activities in the community. Encouragement is given to residents to maintain links with family and friends and make promote new friendships. Risk assessments are well managed. The home is clean and hygienic throughout. The environment and private rooms of the residents are well maintained and personalised. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 6 Staff recruitment, induction and training files are well recorded and staff spoke favourably of the day-to-day management of the home. 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. Northcroft Road (24) DS0000013468.V297290.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 Northcroft Road (24) DS0000013468.V297290.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have sufficient information to make an informed choice if they would like to live in the home. EVIDENCE: The home have an updated statement of purpose and service users guide which assist residents to make a choice if they want to live in the home. One person had been admitted to the home since that last inspection yet their stay was only for a short while following a further review of their needs. The care plan sampled by the inspector evidenced a licence agreement regarding the residents terms and conditions of residency in the home. Northcroft Road (24) DS0000013468.V297290.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has maintained robust care planning and risk assessments. The documents were current and well recorded to ensure the residents wellbeing and health needs were evidenced as being met. Residents make decisions regarding their lives and participate in the running of their home. EVIDENCE: The care plan sampled by the inspector evidenced that the person’s daily living skills and goals were well recorded. The goals included safely crossing the road, washing clothes, safe bathing, ironing clothes and room cleaning. Each of the goals had been reviewed and evidenced a meaningful activity for the resident. Risk assessments had been developed for all areas in the resident’s life that posed a potential hazard. The assessments had been updated and also signed by the new staff member. The risk assessments included concerns regarding choking, bathing, verbal distress, road crossing and rushing down stairs. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 10 All the residents take part in the running of the home and it was observed that they each undertook various tasks in either preparing the supper or helping to clear away the dishes after their afternoon tea and supper. One resident told the inspector that they trusted the managers to act on their behalf and knew that their records were kept safely in the office and only certain people could look at them. Northcroft Road (24) DS0000013468.V297290.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes and maintains residents involvement in their community, to develop and maintain friendships and be involved in the running of the home and improving daily living skills. The available choice of food provided was of a high standard. EVIDENCE: The inspector met with all the residents at the home. During the day there had been a meeting regarding the care needs and arrangements for one resident to go to India with her family. The meeting had taken place with the resident, their family and care manager and the manager of the home. The atmosphere in the home during the evening was busy with the residents eagerly wanting to tell the inspector what they had been doing since we last met. The residents told the inspector that they enjoyed their holiday in Spain and explained what their accommodation was like, how they enjoyed the Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 12 seaside and showed the inspector some of the mementos brought back which included a handbag and a toy parrot. During the inspection the inspector noted that the residents chatted between themselves and were happy to be home after being out all day. The home was warm and comfortable for residents to return to and on return the residents made themselves comfortable by putting on their slippers and taking off their coats. The residents told the inspector what they had been doing which included going to a bonfire night party at Newdigate and the party included hot dogs, drinks and meeting friends. There had also been a visit to the golf club and there had been music and drinks available. The residents said they had been to the Bentley Day Centre where they went on the trampoline and had a boat trip. They also attended a Tuesday club in the evenings and went to the cinema in Epsom. Other activities had included visiting family relatives at weekends. Meeting friends at the local working farm and going to an arranged cowboys and indian themed party in the summer. One resident told the inspector that they had made a new friend and another told the inspector that the staff support him to church each Sunday where he has lots of friends and that he had also been to Lourdes with the local church and the Lake District. One resident had a birthday party and all her family came and that they were going to have a magic party at the home which friends will be invited. Residents were free to move around the kitchen safely and were observed to wipe the table and wash their mugs up after their tea and supper. The residents told the inspector that they do some of the housework, which includes hovering, dusting, cleaning their bedrooms and polishing. The washing machine is in the kitchen area and all residents with staff support participate in loading their washing into the machine, or fold their washing with staff support if needed. The inspector sampled the homes recording of meals taken by the residents. The records indicated a varied diet, which included vegetarian dishes as well as meat dishes. Food serving temperatures were also recorded. The staff member on duty was observed to ask the residents what they wanted for their supper and there was a selection of meals available. The inspector shared the evening meal with the residents and observed that each resident was offered choice, which was steak and kidney pie, mashed pots and cabbage with gravy or chicken. One resident had a chicken curry with rice, nam bread and a dahl dish made by the manager. Salad was also available and a trifle was served as a desert. The residents told the inspector that they can chose what they want to eat and also that they enjoy their take away meals and going out to restaurants. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 13 The homes fridges and freezers contained had a variety of foodstuffs, which included salad cold meats, pizzas, pies, sausages, yoghurts, fresh and frozen vegetables, and a variety of diary products. Fresh fruit and vegetables were also available. The inspector noted that in the homes refrigerator several opened packages for example cooked meat and cheese had not been labelled at the time of opening. This was brought to the manager attention and rectified immediately at the time of the inspection by the staff member on duty. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 14 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 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 home has consistent recording and documentation to evidence that service users attend health care appointments. The homes medication procedures are robust to ensure the safety and wellbeing of the service users and staff. EVIDENCE: The inspector sampled one residents care plan, which included a health care checklist, their body weight chart, clear records of health care appointments attended, Community Care Assessments and records to indicate that a care plan review had taken place in May 2006. The manager explained that some additional needs have been identified that need to be addressed and have been discussed with the local Bentley Day Centre and the residents care manager. As a result a further meeting has been arranged to review the resident’s daytime activities due to the resident returning home anxious and disorientated at times. The manager explained that one resident due to choking concerns had been recently referred to the speech and language therapist. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 15 The home has a comprehensive medication policy and procedure regarding administration of medication. The home has a Monitored Dosage System (MDS) system, which is overseen by the managers. The home have a robust recording system of medication brought into the home and returned to the dispensing pharmacy. The inspector noted that handwritten ‘give only as required’ (PRN) medication had been authorised by the manager and there were clear documented instructions that the medication was only to be administered by the managers of the home. The inspector evidenced a clear audit of the verbal direction of changes in resident’s medication given by a health care specialist. The home has medication stored and locked in a non-metal cabinet. Following advised from the CSCI Pharmacist it is recommended that the home undertake a documented risk assessment to ensure that all medications stored in the home are as far as reasonably practicable free from avoidable risks to residents and staff. The home works closely with the local pharmacist and a recent audit has been conducted. The manager explained that all staff except one new staff member had had medication training, which they share with another local care home. The new staff member will be undertaking medication training on the 8th November 2006. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 16 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 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 home has a robust complaints procedure to demonstrate that complaints will be acted upon and a Safeguarding Adults (Adult Protection) policy and procedure in order that residents are adequately protected by the same policy and procedure. EVIDENCE: During the inspection one resident told the inspector that they had not been happy with something that had occurred at the day centre they were attending. The resident said that they had talked to the homes manager and together they had raised the concern with the day centre manager who acted promptly and reassured the resident. It was evident on questioning the residents at the home that if they had concerns they would feel confident to talk with the managers and staff. The home has a complaints procedure and no complaints have been received by CSCI. The manager explained that all staff, except one staff member recently employed had received training in safeguarding vulnerable adults. Arrangements are in place for the member of staff to undertake training in safeguarding adults with the manager. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 24,25,26,27,28,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was viewed as clean and bright throughout. Resident’s rooms reflected individuality. Communal areas, including bathrooms in the home were spacious and met the current needs of the residents. EVIDENCE: The home continues to offer a homely and comfortable environment. Two residents showed the inspector their bedrooms, which had been recently decorated and they had chosen the colours. In each of the bedrooms there were personal possessions, furniture and leisure items which included televisions, music and photos. It was noted that whilst sampling the care plans each resident had an inventory of his or her belongings documented and repairs and maintenance records related to each bedroom. The home has two bathrooms with toilets and one shower is available in one bathroom. Both bathrooms are well decorated and meet the current needs of the residents with regard to safe bathing. Water outlet temperatures are Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 18 recorded as part of a safe bathing policy within the home. Residents were observed for move around their home freely. The two lounge areas have comfortable sofas and adequate seating for the residents and their visitors to the home. One lounge has a dining area, which is adequate to meet the needs of the residents to enjoy their meals. The general state of decoration, maintenance, cleanliness and hygiene in the home is of a high standard. Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a robust system for the induction, training development and recruitment of staff. EVIDENCE: The home operates a flexible rosta, which reflects the lifestyle and needs of the residents. Three of the four staff work part time. All staff have received mandatory training. The inspector sampled one staff member’s file, which indicated they had commenced employment in April 06. All records were in place yet the home had not received a current CRB clearance or POVA first check for the staff member. The manager explained that the disclosure had been requested yet had not been returned. The inspector has required that the staff member must be supervised in their work with residents until such time as the CRB or POVA first documentation is received. Following the inspection the manager informed the inspector that they had contacted the CRB to chase up the application. Records indicated that the staff member had undertaken a face-to-face interview and a full induction to the home. Northcroft Road (24) DS0000013468.V297290.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall management of the home is robust, service users and their representative’s views and opinions are considered and service users safety and welfare is well managed. EVIDENCE: The home continues to be well managed and runs efficiently. The philosophy and values of the home are evident and resident’s views about their home included ‘it’s a nice house, I like living with my friends, there are nice staff and we go on holidays and outings’. ‘I like having parties, going out to the pictures, meals outings, visiting friends, going out for drives, and having my privacy and space’. ‘ I like everything about the home’. ‘I like having my own bedroom, going on holidays, seaside outings, trips to the farm, visiting friends for tea, and friends visiting me. The inspector sampled a variety of health and safety records, which included fridge and freezer temperatures, food serving temperatures, water temperature records, accident and incident records, fire drills, practices and Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 21 fire risk assessment which had been updated and general maintenance records. Hazardous substances were secured in the home and a risk assessment had been completed and updated regarding the non-fixture of radiator covers throughout the home. The inspector sampled the home policy and procedure regarding safekeeping of resident’s funds and all records; receipts were accurate and well documented to protect residents from financial abuse. Northcroft Road (24) DS0000013468.V297290.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 X 2 3 3 X 4 X 5 X 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 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 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 2 X 3 X 3 X X 3 X Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 23 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. 1 Standard YA34 Regulation 7,9,19 & Schedule 2 (2)(a)(b) Requirement The registered person must ensure that all persons employed to work in the care home have adequate pre employment checks for example CRB disclosures or POVA first checks in order to protect residents from harm. Timescale for action 30/11/06 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 Northcroft Road (24) DS0000013468.V297290.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Northcroft Road (24) DS0000013468.V297290.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. 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