Inspection on 08/02/07 for 39 Townend

This inspection was carried out on 8th February 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

39 Townend 17/01/06

39 Townend 12/07/05

39 Townend 07/10/04

39 Townend 16/06/04

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 Townend Townend 39 Townend Caterham Surrey CR3 5UJ Lead Inspector Kenneth Dunn Unannounced Inspection 8th February 2007 10:00 Townend DS0000013814.V327615.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 Townend DS0000013814.V327615.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. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Townend Address Townend 39 Townend Caterham Surrey CR3 5UJ 01883 383827 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) Surrey and Borders Partnership NHS Trust Mrs Tracy Tonczynski Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (4), Physical disability (1) of places Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1) Of the 10 (ten) residents within the category Learning Disability (LD), 1 (one) may also be in the category Physical Disability (PD). 2) The age/age range of the category LD must be between 30-65 years. 3) Of the 10 (ten) registered 4 (four) may be in the category Learning Disability over 65 years of age LD(E). Date of last inspection 17/01/06 Brief Description of the Service: Townend is registered with the CSCI (Commission for Social Care Inspection) to provide accommodation and care for nine people with learning disabilities, the majority of whom are under the age of 65 years. Townend is a large detached family styled house is in a residential street in Caterham-on-the-Hill. The service is close to shops, public amenities and transport in addition the service has its own transport to enable the service users to enjoy a flexible service. The service users are supported to live as independently as possible with the help of staff and the wider network of community health care professionals. The accommodation is arranged over two floors of the house. On the ground floor two large communal lounges, assisted bathroom, toilet and 4 bedrooms. The first floor has 5 good-sized bedrooms and a further bathroom. There is a moderately sized garden at the rear of the property, and a limited amount of off street parking for cars at the front of the house. The service does not have a lift. The service is owned and operated by Surrey and Borders NHS Partnership. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) undertook an unannounced site visit using the new ‘Inspecting for Better Lives’ (IBL) process. Regulation Inspector Mr K Dunn was assisted throughout the site visit by the manager of the establishment. The inspection started at 09.30hrs and finished at 13.30hrs. The inspection process included a tour of the premises, interviews with staff, a review of documents and records informal conversation with the service users, however due to the levels of disabilities of the service users direct observation was the main source of evidence. The inspector noted service users at the home have some communication difficulties and judgements were made about them based on their mood, behaviour and information given by staff. In addition the inspector has received several comment cards from external stakeholders, the information they have provided has also been included in this report. The inspector would like to thank the manager, staff and the service users for their contribution to the inspection. What the service does well: What has improved since the last inspection? What they could do better: It was observed that the home is operating extremely well and that all policies, procedures and practice issues are of a good standard. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Townend DS0000013814.V327615.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 Townend DS0000013814.V327615.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): Standard 2 was assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The arrangements for assessing the needs of potential service users are well designed and robust. The assessment process offer clear concise guidance to ensure that the Service users needs can be fully met by the service. The manager was able to demonstrate the homes capacity to meet the assessed needs. EVIDENCE: The service has not admitted any new service users since the previous inspection. The manager stated that all potential service users would be fully assessed prior to admission by a member of the care team who have been trained to complete the assessment process. The manager further stated that the service will only admit a new service user based on there assessment of needs, and the appropriateness of the placement. The initial assessment is used to form the basis of the care plan and a support plan, which identified the actions that carers should follow to assist an individual living at the home. The policies sampled during the inspection appeared to have been designed to ensure that the needs of any potential service users can be effectively met and enhanced by the home and to make sure that the existing service users life styles will be enhanced by a new service user. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 9 Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 10 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): Standards 6, 7 and 9 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The systems in place at Townend for the continual reassessing and the consultation of service users are well developed, with clear evidence that their views are sought and acted upon. A person centred approach was central to the home’s management and operation. EVIDENCE: The inspector was informed by the manager that because of the complex needs of the service users it would be very difficult if not impossible for them to have appropriate control over their lives. The responsibility therefore falls to the staff to ensure that all the service users receive appropriate levels of support, to promote some form of individual independence. The manager stressed that no matter how small the level of independence was, it was their role to enhance and support that person in maintaining the level and ultimately developing it. The individual needs and personal goals of the service users were clearly recorded and these have been carefully developed using the service users Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 11 previous likes and dislikes and in consultation with, their families and other stake holders/professionals. A sample of care plans indicated that they have been reviewed regularly, generally this is annually, however the manager stated that this could be more frequent if there was a need because of changes within the needs of the individual. The sample provided evidence that the needs of the service users were being well documented and highlighted all areas of care needs for each service user. In addition to the care provision for each service users the service has developed a comprehensive range of risk assessments to allow the service users to benefit from living in the community. All of the service users have had a health action plan completed for them by staff and again a sample of these documents confirmed that the service users interests were being best served by the procedures of the home. The Comments cards returned the inspector by one family member clearly indicates that the service is held in high esteem “my daughter is being cared for extremely well” “ by excellent staff” and finally they “they cope marvellously”. Feedback from other professionals also indicated a high level of satisfaction with service provision at Townend one stated that the service offers a “high standard of individual care” to the service users. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 15 16, and 17 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Activities provided were satisfactory and the home offered a good range of activities to suit the needs of the individual service users. Visitors are welcome in the home at anytime. The meals provided at the home meet service users needs. Service users are supported to exercise choice and control over their lives. EVIDENCE: A copy of the programme of activities was provided and this showed a varied range of activities were being offered to the service users on a daily bases. The manager informed the inspector that the activates programme was designed to suit the range of service users known likes dislikes in addition it had to be flexible to ensure any changes to their individual needs could be factored into to plan. On the day of inspection three service users were having an at home day the staff on duty were seen to engage with them and to assist them to have as fulfilling a day as they wanted. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 13 The manager stated service users had opportunities for social contact and activities out side the home and the home had a minibus to promote community access and participation. The inspector sampled service users daily notes and their individual activity schedules these appeared to be well developed and allowed a good degree of flexibility for changes if the individuals wished. The manager stated that families and friends of the service users are welcomed into the home at any time and no restriction is in place to limit visitors. A review of the visitor’s book indicated that the service users receive regular visitors both personal and professional. Comments received from stakeholders also indicated that they are always made very welcome when visiting the home. The manager commented that service users are helped to exercise choice over their lives and are free from any restrictions within a risk-assessed environment. Observations confirmed that staff supported service users in their preferred activities and domestic tasks to maximise personal choice. The staff were seen to be courteous, polite and demonstrated a warm relaxed approach when they were engaging with the service user. It is recommended that the manager reviews all risk assessment to ensure that all aspects of the service users individual choices are covered. This is to ensure that where restrictions have been placed on service users there is a clear audit trail to explain to the reader why actioned has been taken. The service records indicated that the service users were being offered what appeared to be well-balanced and nutritious meals. The manager informed the inspectors that specialist advice had been sought from a dietician and a speech and language therapist to ensure that the meals offered were nutritious and suitable for the service use. The guidelines were clearly available and informed the reader of measures to be taken to safeguard the service user from possible chocking or refusing food. Townend DS0000013814.V327615.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The delivery of personal care was good and was based upon known likes and dislikes of the service users. Staff appeared to respect and promote the rights of the service users to privacy and dignity. Arrangements were in place to ensure the service users physical and health care needs were met and specialist services and advice sought as necessary. The management of medication was robust. EVIDENCE: The manager informed the inspector that the service users are all individually assessed and offered the appropriate levels of support by staff for their care needs. A sample of the service users individual files clearly demonstrated to the reader the style of care to be offered and the correct level of care needed to effectively assist the individual. The service users care plans are designed to be very informative and user friendly. The care plans clearly underpin the service users preferences and attempts to guarantee their rights. Records sampled demonstrated health and social care needs were well met and risks managed. Residents were all registered with local General Practitioner, one of whom gave feedback to the CSCI indicating that the Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 15 service was effectively meeting the needs of the service users as a group and individually. The management of medication, storage and administration, is satisfactory and a review of the storage facilities indicated that the service users are being effectively safeguarded by the policies in place. Observations made by the inspectors during the site visit confirmed that the staff had a very good understanding of the needs of the residents and offered care appropriately. Townend DS0000013814.V327615.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaint procedure is accessible and well written, however in respect of the service users understanding the process it would be impossible to assess, due the levels of their learning disabilities. The service users are well protected by the home’s recruitment practices. The staff team had received training in safeguarding vulnerable adults. EVIDENCE: The complaints policy is freely available at the home and the manager informed the inspector that a copy is always displayed on the wall allowing everyone free and easy access to the process. However three of the comment cards returned to the CSCI from the next of kin of the service users stated that they were unaware of the complaints policy and would welcome more information relating to their rights and the rights of their relatives. All three did however state that they have never felt the need to use the policy, and one stated that” they have nothing but praise for the home and the staff”. There has been one complaint since the last inspection. The evidence reviewed as part of this visit indicated that the complaint had been upheld and dealt with effectively. Multi-agency safeguarding procedures were available in the home and manager and all staff had received adult protection training. Discussions with staff and management confirmed understanding of abuse and what action they should take in response to allegations or suspicions of abuse. Staff recruitment practices also safeguarded residents. Townend DS0000013814.V327615.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home provides a comfortable, good standard of accommodation suitable to the needs and lifestyles of the residents. The home was safe, clean and hygienic. EVIDENCE: The location of the home is suitable for its stated purpose; it is accessible, safe and well maintained, meeting service users’ individual and collective needs in a comfortable and homely way. Overall the home was in good condition; appropriately decorated, well maintained and furnished to an acceptable standard. The communal areas in the home are safe, accessible and of a good size to ensure that all the service users are able to access at any one time. In areas on the ground floor the lower portions of the wall have been badly marked and the paintwork damaged by wheelchairs it is recommended that the manager action some remedial works in order to remedy this. All except from one bedroom was seen during the inspection. The bedrooms were each highly personalised and individual in style. All of the bedrooms seen Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 18 had photographs and other items linked to the Service Users, their family life outside the home and items of special interest to the individual occupying the bedroom. In one of the service users bedrooms on the first floor there was signs of a recent leak through the ceiling. It is recommended that this be investigated and repaired as a matter of urgency. A further recommendation is that the manager risk assesses all of the ground floor bedroom windows that open fully and could give access via the parking area at the front of the building. The garden was well maintained and easily accessible and of a good size and was described by one member of staff as being “ a real asset to the home and a very usable space”. All areas were found to be clean, tidy and well organised. Townend DS0000013814.V327615.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff on duty demonstrated commitment to supporting residents in a way that enabled expression of individuality and recognised their rights, values and aspirations. The staff were seen to work as a team and there was a programme of staff training to equip them with the necessary skills and knowledge to fulfil their role. Staff recruitment procedures were in accordance with statutory requirements and safeguarded residents. EVIDENCE: The staff rotas reviewed during the site visit indicated that generally that staffing at the home is stable and meets the needs of the service users. The inspector viewed the recruitment policies and procedures these were found to have been designed to provide safeguards for the service users. The inspector sampled four staff recruitment files as part of the site visit they were all found to contain the relevant documents as detailed in Schedule 2 of The Care Homes Regulations 2001. All staff has had a criminal record bureau (CRB) check and Protection of Vulnerable Adult (POVA). Consultation with staff on duty confirmed they enjoyed working at the home and felt well supported by the management arrangements in place. Evidence seen during the course of the staff file indicates that all staff receives regular Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 20 supervision. On average supervision is offered to staff every 6 weeks. The inspector was able to confirm that this was accurate during the formal conversations with two members of staff and the manager. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 21 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): Standards 37, 39 and 42 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The administration of the home was efficient, well organised and the service users benefited from the ethos, leadership and management approach of the manager. Quality assurance and quality monitoring is an area where the manager is attempting to improve the current systems. Policies and procedures safeguarded residents’ rights and best interests. Overall good attention was given to health and safety practices. EVIDENCE: Observations confirmed the home to be effectively managed and administered and communication was good between the manager and her staff team. All interactions observed between the manager, staff and service users during this inspection led the inspector to believe that the home was operating in an open, positive and inclusive atmosphere. The provider ensured compliance with statutory provider visits (Regulation 26 Site Visits). Reports generated from these visits were held in the home and Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 22 copied to the CSCI. The home has a quality Audit system, which is undertaken on behalf of some of the service users at their day care facilities, however this has been limited to very few service users. It was discussed with manager that it is essential that this review must be regularly undertaken especially in view of the service users communicate problems. Record keeping was overall satisfactory, the health and welfare of the service users is a priority in the service and records observed on the day of the site visit were well documented and kept up to date. During the course of this inspection a maintance contractor was conducting routine remedial work around the home. Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 23 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 X 3 3 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 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 X 3 X Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 24 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 YA39 Regulation 24 Requirement The Registered Person must ensure that all relevant individuals complete a quality audit of the service annually. Timescale for action 08/04/07 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 Refer to Standard YA24 Good Practice Recommendations The Registered Person should ensure that the environmental damage caused by general ware and tear and wheelchairs hitting walls/doorframes be repaired regularly. The Registered Person should ensure that the general physical maintance of the building is checked regularly The Registered Person should risk assess the ground floor non restricted to ensure the overall security of the home. The Registered Person should Review all risk assessments pertaining to the activities of the service users. 2 3 4 YA24 YA24 YA16 Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Townend DS0000013814.V327615.R01.S.doc Version 5.2 Page 26 - 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!