Inspection on 19/06/07 for 5 Beacon Gardens

This inspection was carried out on 19th June 2007.

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

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

Other inspections for this house

5 Beacon Gardens 18/12/08

5 Beacon Gardens 24/02/06

5 Beacon Gardens 23/08/05

5 Beacon Gardens 23/02/05

5 Beacon Gardens 31/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 5 Beacon Gardens Beacon Street Lichfield Staffordshire WS13 7BQ Lead Inspector Ms Wendy Jones Unannounced Inspection 19th June 2007 16:00p 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 5 Beacon Gardens DS0000005074.V343518.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. 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 5 Beacon Gardens Address Beacon Street Lichfield Staffordshire WS13 7BQ 01543 264720 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) Mrs Margaret Jean Holton Mr John Edward Holton Mrs Margaret Jean Holton Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th February 2006 Brief Description of the Service: 5 Beacon Gardens is a family home registered to provide care for two people with a learning disability. The home is a semi-detached property situated in a cul-de-sac on the outskirts of Lichfield town centre. The cul-de-sac is found off a main road leading into Lichfield, and there is easy access to a large supermarket at the bottom of the road. Access to public transport is also very close by, with regular buses into Lichfield town and all of its amenities. Although registered for two people only one gentleman now lives at the home, and the proprietor has no plans to change this. The resident has been with the family from the age of two and a half years. In that time he has been treated as a family member with the proprietor acting in loco parentis with the extended family as substitute aunts and uncles. The provider receives £341.09 per week for caring for the resident. 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection visit of 5 Beacon Gardens undertaken between the hours of 4pm-8.30pm on 19/07/07. The inspection was undertaken with the provider. The service user was present throughout and was able to contribute to the inspection process. His comments are included in the report. The inspection methodology included a brief tour of the building, discussion with the provider and resident, pre inspection discussion with a social worker and analysis of feedback provided in returned questionnaires. What the service does well: What has improved since the last inspection? What they could do better: The provider has made efforts to provide the resident with opportunities to be as independent as possible, and discussed some of the things he has been supported to be involved with, this includes day-to-day decision making. However the model of service is a family setting where the provider is the 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 6 parent figure and the resident subordinate to her, in the longer term this may have an effect on his ability to live independently as an adult. It is hoped that the provider will continue to support and enable the resident to achieve further independence, which may include moving into his own accommodation with support, in the future. The provider has not adhered to the minimum requirements of the Care Homes Regulations in a number of key areas. A previous requirement asked that a complaints procedure is developed this hasn’t been produced. The service does not have any of the procedures and paperwork associated with care homes and in this respect fails to meet the minimum standards. However the resident is clearly enjoying a good quality life, he was able to discuss freely his needs and aspirations in and out of the presence of the provider during this visit and gave a positive account of his life. 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. 5 Beacon Gardens DS0000005074.V343518.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 5 Beacon Gardens DS0000005074.V343518.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): 1,2,3 and 5. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents assessed needs have been satisfactorily met and the promotion of independence has ensured that he enjoys a good quality lifestyle. Prospective residents do not have access to information about the service. EVIDENCE: Previous inspection reports have commented that the provider has not developed a Statement of Purpose or Service User Guide, both are minimum requirements of the Care Homes Regulations 2001. The provider has not marketed the service or sought to accommodate any one else for a considerable number of years and does not intend to. However the certificate of registration provides that the service is registered to care for, and accommodate 2 persons, this is historical and the provider should give consideration to changing this to 1 person. As it is unlikely that placement in this service would be considered in the future, given the changing criteria for placing and funding for residential placements by the local authorities at a national level. The resident was present throughout the inspection and commented on all aspects of his care and lifestyle. Original admission to the home was as an infant and obviously overtime his needs have changed and apparently been met. The placing authority had carried out the original assessment and has 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 9 contracted with the local authority to undertake any subsequent reviews. A social worker was contacted during the pre inspection planning for this visit, who maintained that the resident has “a good quality of life, a brilliant social life and has been supported by the provider to be as independent as possible.” The core standard to assess from this section of the National Minimum Standards for Care Homes For younger adults asks, “are prospective residents individual aspirations and needs assessed?” It was evident from observation and discussion during the inspection that the resident’s current needs are being met. The placing authority contract provides terms and conditions of the placement and the expected standards to ensure continued funding. 5 Beacon Gardens DS0000005074.V343518.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): 6,7,8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident can be assured that he will receive appropriate care and support as determined by the care plan in place. Risk assessment should be formalised to ensure that any identified risk is minimised. EVIDENCE: The provider has a copy of the local authority placing officers care plan to adhere to, but has not produced any other documentation from this. Regular (approximately) annual reviews of care are undertaken by the local authority to ensure that the care plan remains relevant and the residents’ needs are being met. The resident himself is always involved in these formal reviews of his care. He was present throughout this visit and discussed his life, lifestyle and intention to remain in the service with Mrs Holton. 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 11 Risk assessment is an informal event, where the provider considers the potential risk and acts to minimise them while encouraging the resident’s independence. She gave an example of when the resident first started to use public transport and the steps she had taken to monitor his first journeys. Making discreet observations, and increasing the time he was able to journey independently until he was successful and also providing him with a mobile phone to ensure regular contact. It is recommended that any potential risks are recorded including the action taken to reduce the identified risk. The resident receives a weekly personal allowance and a lower rate Disability Living Allowance, he has a pay as you go mobile phone, a bus pass and has his own front door key. 5 Beacon Gardens DS0000005074.V343518.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): 12,13,15,16 and 17. Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. The resident is supported and encouraged to live as independently as possible, and become active in the community, to ensure that he is seen as a valued and integral member of the local community. EVIDENCE: The resident has an active life outside of the home. He attends college once a week for a computer course, works at a local supermarket for one day a week and also works in a local service for older people. He stated that he enjoys a number of social and recreational activities with friends and neighbours and is also involved in household shopping and other chores. He has holidays with the provider, usually going to North Wales, where other members of the family live, and was also looking forward to a day trip to York the week following the visit. 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 13 The provider takes responsibility for the bulk of the household chores as you would expect in this family setting, the resident is encouraged to undertake specific jobs associated with his personal care and private accommodation. Mrs Holton also stated that they both enjoyed gardening and had planted some flowers and vegetables in the garden recently. There is no formal menu planning in this service, the resident and provider usually decide together what they would like for their main meal on a day-today basis. No fixed mealtimes exist, although routine indicates that there is some expectation to the times meals are prepared, linked to the resident’s activities in the day and the evening. The resident was keen to discuss his particular hobbies and interests throughout these included music, classical and popular styles and television. Information from pre inspection questionnaires indicated that he has a number of friends and acquaintances in the local community and does get involved in local social events. The residents’ family is that of the provider, having been placed in her care as an infant. Contact is maintained through the provider, including visits to other siblings and relatives. The resident identified that he had lost his “dad” last year and from a brief discussion it was evident that he had been supported by the provider and the family during that time. Mrs Holton discussed her wish to ensure that the resident is fully prepared for independent living and expressed a desire to be able to properly discuss intimate relationships with him. She was keen to ensure that this was done in a sensitive manner and in a form that he could easily understand. Information was provided to her about the resources available in the community and contact details provided for health care facilitators attached to Primary Care Trusts, who would be able to assist and advise her. It is recommended that the provider is more proactive in considering the residents future, as there does not appear to have been any progress made in this area. It was understood that he had considered moving into more independent accommodation in the past but this had not occurred and he stated during this visit that he no longer intends to pursue this. 5 Beacon Gardens DS0000005074.V343518.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): 18, 19 and 20. Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The resident can be assured that his personal and health needs are met. EVIDENCE: The family GP monitors specific health issues and the resident it supported to attend appointments with the chiropodist, optician and hearing aid clinic, he confirmed this. The resident does take medication for a long-standing health condition; he self-administers this medication. There isn’t a policy on medication administration in this service. Mrs Holton stated that the service user is able to take care of his own personal and hygiene needs. Mrs Holton’s role in this is therefore purely a monitoring and advisory role. 5 Beacon Gardens DS0000005074.V343518.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 provider demonstrated that she understood her responsibilities to protect the resident against the risk of abuse, but was not familiar with local procedures agreed for this purpose. The resident has access to people independent of the service to go to if he is concerned about his care. EVIDENCE: The provider has not complied with the previous requirement to provide a complaints procedure for the resident to access, this continues to be an issue of this report. It was understood that the provider has an understanding with the social worker, that if there are any concerns the social worker is to be contacted. The resident also has input from an independent advocate funded by Mencap, he has the opportunity to raise any concerns with her during their regular meetings. Mrs Holton confirmed that she had not received any complaints and also stated that she did not see the need to produce a complaints procedure, as any concerns by the resident could be addressed and resolved as soon as they arose. Mrs Holton does not have any current policies and procedures in place relating to the protection of vulnerable adults. But was able to demonstrate any understanding of resident’s rights and vulnerability, discussing potential scenarios where the resident may be at risk of abuse. Pre inspection information from neighbours and friends indicated that they felt that the resident was well cared for in this service. An advocate from Mencap 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 16 also stated that they felt the resident was well cared for in a safe and loving environment. 5 Beacon Gardens DS0000005074.V343518.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): 24, 25, 28, 30. Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. The quality of the accommodation is high providing the resident with a safe, clean and comfortable home in which to live. EVIDENCE: The service is a family home, which is located in residential area of Lichfield. It is a semi-detached property in a cul-de-sac and not distinguishable from other properties as a care home. All furnishings and fittings are of good quality and are present a homely appearance. The access to outdoor space is user friendly in that the resident does not struggle to enter or exit the garden area. From observation it was clear that the resident was comfortable and secure in his surroundings. The accommodation provides sufficient personal and communal space to meet the needs of the resident and the provider. There is a comfortable lounge/front room, a spacious kitchen of domestic style and design and a 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 18 conservatory area on the ground floor. There is an enclosed garden to the rear of the property. The resident gave the inspector a tour of his own bedroom during this visit. It was highly personalised, well maintained and pleasantly decorate. It was understood that the resident has the use of two bedrooms usually. On this occasion, the provider and he were expecting family visitors to stay for a couple of nights and therefore one of the bedrooms was being prepared for them. The resident confirmed that he was able to furnish his room as he chose, he has a range of electrical equipment including a television, DVD player, CD player and a laptop computer also all of the bedroom furniture he required. He also has full use of a conservatory to the rear of the property if he wanted to play music downstairs. He accesses all parts of the remainder of the house as a family member. Both the provider and resident take great pride in the appearance of the gardens and they were maintained to as high a standard as the interior of the property. The provider stated that the house is conveniently situated for visiting the local shops, the town via public transport and for access to the service user’s friends and attending leisure activities. 5 Beacon Gardens DS0000005074.V343518.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): 35 only as 32 and 34 do not apply in this setting. The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident has 1:1 support from the provider when he is in the home, which ensures that his needs can be easily met. EVIDENCE: The provider does not employ any staff and is the sole provider and caregiver. She has been in the care industry for a long time, previously working in older persons services and care homes for people with learning disabilities. She has provided care and accommodation for the resident since he was a small child and the arrangements mean that the service is operated as a family home with the resident as part of the family, he referred to the provider as “mum” on occasions during this visit. Mrs Holton has not undertaken any recent training and does not employ anyone else. It was of concern to the inspector that Mrs Holton did not have any obvious arrangements for support if she needed it, but from discussion there did appear to good family and neighbour contact should assistance be necessary. 5 Beacon Gardens DS0000005074.V343518.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 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The provider does not have a system for formally monitoring the quality of the service she provides, but has ensured that the residents needs can continue to be met. There are no policies and procedures in place, but the health and welfare of the resident is of paramount importance to the provider. EVIDENCE: Mrs Holton has been involved in care for a very long time and has provided care and accommodation to the resident since he was a child, initially as a foster carer and then registering as a care home when he reached adulthood, to ensure his care needs could continue to be met. She has not undertaken any of the training recommended for managers of care settings and also has not recently undertaken any training at all. She does have her care and life experience although should ensure that she is up to date with current trends. 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 21 In discussion Mrs Holton demonstrated considerable commitment to promoting an independent lifestyle for the service user and great effort in supporting him to develop and achieve a valued role in the community. It was clear from Mrs Holton’s interaction with the service user that he is included in a family lifestyle where he is cared for in a loving and safe environment, and his needs and wishes met and respected. In terms of quality monitoring Mrs Holton doesn’t have a formal system to assess the quality of the service she provides. The review of the residents care needs and his continuing placement at the home indicate that she is providing the type of service he currently requires and meets the placing authorities requirements. It was understood that there is current buildings and contents insurance. 5 Beacon Gardens DS0000005074.V343518.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 1 2 3 3 3 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 X 28 4 29 X 30 4 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 x 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 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 X 2 X X 2 X 5 Beacon Gardens DS0000005074.V343518.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5 6. 7. 8. Refer to Standard YA1 YA2 YA1 YA23 YA9 YA22 YA11 YA42 Good Practice Recommendations The provider should produce a Statement of Purpose and Resident Guide. The provider should give further consideration to reducing the registration of the service to accommodate one person only. The provider should inform the Commission for Social Care Inspection of any changes that affect the registration of the service. It is recommended that the registered manager obtain a copy of the Local Authoritys policy and guidance on The Vulnerable Adult Procedure. The provider should make a record of any identified risks to the resident and the steps taken to reduce the risk. The provider should produce a complaints procedure. The provider should be proactive in developing future plans for the resident in consultation with him. Mrs Holton should consider recording when she checks that the fire alarm is operating properly. DS0000005074.V343518.R01.S.doc Version 5.2 Page 24 5 Beacon Gardens Commission for Social Care Inspection Birmingham Local Office Commission for Social Care Inspection 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 - 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!