Inspection on 06/10/05 for 2 Warwick Road

This inspection was carried out on 6th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 Warwick Road 25/02/09

2 Warwick Road 24/07/07

2 Warwick Road 08/05/06

2 Warwick Road 11/01/05

2 Warwick Road 14/09/04

2 Warwick Road 17/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Warwick Road 2 New Barnet Hertfordshire EN5 5EE Lead Inspector Anthony Lewis Unannounced Inspection 6th October 2005 09:00 Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 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 Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 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. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Warwick Road 2 Address New Barnet Hertfordshire EN5 5EE 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) 020 8449 7973 020 8441 2817 Tamarisk Trust Miss Sharon Jane Brown Care Home 22 Category(ies) of Learning disability (22), Learning disability over registration, with number 65 years of age (22) of places Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 22 service users with learning disabilities some of whom may be elderly. 26th May 2005 Date of last inspection Brief Description of the Service: Warwick Road is a care home registered for a maximum of twenty-two adult residents with learning difficulties. Tamarisk Trust, a registered charity, runs the home. The home is a four-storey corner house with an extension added to it. On the ground floor are located the kitchen, office, laundry room, two lounges and a dining room. There are also an additional kitchen and dining room facilities on the first floor and second floor. The bedrooms are located on the lower ground floor, the ground floor and on the first and second floors. All bedrooms are single. There is a unit on the second floor designated for training residents in independent living skills. There is a small garden to the front of the home with off street parking and a paved area to the side. There is also a long partially paved garden to the rear. The home is situated in a residential part of New Barnet, with shops, buses and rail links a short walk from the home. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on Thursday 6th October 2005 at 9am and was completed at 2:30pm. Neither the registered manager or deputy manager was available. However, the senior support worker was available throughout the inspection and was very helpful and understanding. The service manager was available for part of the inspection. To gather information for this inspection, one resident was spoken to formally in the office and three informally. Three staff, including the minibus driver, were spoken to. Evidence was also gathered by viewing five staff’s and four resident’s files, safety certificates, various other files and documentations. An extensive tour of the building was conducted with the senior support worker and later the kitchen and garden were toured with the service manager. What the service does well: What has improved since the last inspection? What they could do better: Twelve requirements have been made, four are restated requirements and four are immediate requirements. One recommendation is made. To ensure that meals are varied and creative a review must be undertaken, which includes the views and suggestions of the residents. Resident’s wishes in the event of them becoming terminally ill and dying must be recorded in their file. Regular resident’s meeting must occur to ensure that residents are able to air their views. To ensure that the home looks presentable at all times, the carpets in the lounge and on the stairs must be cleaned or replaced. The cooker must be immediately replaced and the kitchen must immediately have a thorough cleaning programme in place and the units repaired or replaced to ensure that residents are safe and free from cross contamination. The toilet in the independent living flat must be regularly cleaned and the “baby potty” Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 6 removed. To ensure that residents clothing is washed correctly and that dirty clothes do not accumulate, the home’s industrial washing machine must immediately be repaired or replaced. To ensure that residents can enjoy their back garden in safety it must be immediately, cleared, cleaned and made safe. To ensure that staff’s personal development is monitored and that senior staff supports them, they must receive regular supervision. Contraventions identified by the LFEPA must be complied with to ensure the safety of residents, staff and visitors to the home. The staff must ensure that all residents with challenging behaviour receives additional support from an appropriate professional. It is recommendation that staff files are sorted into a logical and consistent style. 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. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 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 Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 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): 4 and 5. Prospective residents are confident that they will be able to visit the home to make an informed choice prior to moving in and that they will be provided with sufficient information regarding their residency. EVIDENCE: A resident spoken to and who has lived in the home for more than seven years, stated that she was able to visit the home on many occasions prior to moving in. She went on to say that the home provides a good quality of care to the residents. Four resident’s files were viewed all contained a copy of their terms and conditions of residency. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 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): 8 and 10. Residents are confident that their views and suggestions will be listened to and acted upon by the staff team and that any confidential information will be treated according to the organisation’s confidentiality policy and procedures. EVIDENCE: Residents were observed assisting in setting and clearing the table at lunchtime. Some were observed putting cutlery in the dishwasher. One resident spoken to said that residents help in the home by doing the vacuuming and help with the laundry. Residents are able to have their say at resident’s meetings. At the last such meeting on 19th May 2005, residents discussed forthcoming training and recruitment. All confidential information is kept in a lockable cupboard in the main office, which is kept locked when not in use. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 10 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, 13 and 17. Residents are confident that the staff team will motivate them to become more independent and access appropriate activities of their choice in their community. However, residents are not confident that the staff will ensure that they have varied and creative meals and that they will be part of the menu planning. Residents are also not confident that they will be supported with any behavioural issues that they may exhibit. EVIDENCE: The home has provided an upstairs flat, which consists of a kitchen/diner, toilet and shower room for four residents to develop their independent living skills. Staff will support and help to motive the residents when required. A member of staff stated that one resident in particular regularly puts items such as toilet roles, kitchen cutlery and other items down the toilet and that this behaviour has been going on for some time. A requirement is made that the registered persons ensure that a behaviour therapist or other professionals are consulted with regards to management of the resident’s behaviour. The staff team have ensured that residents are a part of their community. Residents and staff spoken to said that, with staff support, residents access Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 11 their local pub, cinema, restaurants and one residents said that she has day visits to her relatives. Residents are also encouraged to participate in Tamarisk Opportunity Network (TOM). An activities support worker from TOM was spoken to about what service TOM provides to residents. She stated that TOM staff do outreach such as one to one visits to residents and support with escorting to day activities, work and walks in the community. The home’s menu was viewed and although the meals consumed by residents are now being recorded, as was a requirement at the previous inspection, the home is using an eight weekly cyclical menu and there was insufficient variety and creativity in the meals, especially the evening meals. Breakfast and lunch is recorded the same every day. A requirement is made that the registered persons ensure that a review of the menu is undertaken and that residents are involved in the menu planning process. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 12 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): 19 and 21. Residents are confident that the staff team will support them with their health care needs and ensure that they receive regular check ups by a health care professional but they are not confident that their wishes will be met in the event of their death. EVIDENCE: On looking through four resident’s files, there was evidence that residents are being seen by health care professionals on a regular basis and receive regular health care checks ups. In addition to support from staff in the home, residents are supported by Tamarisk Opportunity Trust’s support staff with their emotional needs. Four resident’s files were viewed and none contained resident’s wishes in the event of them becoming terminally ill and dying. A requirement is made that the registered persons ensure that in the event of a resident becoming terminally ill and dying, that their wishes are recorded. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 13 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. Residents are not confident that they will be able to have regular resident’s meeting so that they may discuss their views as a group. EVIDENCE: The home has a complaints policy and procedure and a file for recording complaints. Two residents spoken to said that they are able to discuss any views and concerns they may have with any member of the staff team. They are also able to air their views at the resident’s meetings. However, the last resident’s meeting was on 19th May 2005, which is not often enough. A requirement is made that the registered persons ensure that regular resident’s meeting occur to ensure that residents are able to air their views and that minutes of the meetings are recorded. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 14 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, 29 and 30. The staff are not ensuring that the residents live in a clean and safe environment internally or externally. Maintenance of various parts of the home such as the kitchen and back garden is poor and unsafe for residents, staff and visitors to use. EVIDENCE: On a tour of the home, the carpets in the lounge and on the stairs were badly stained, due to spillages. A requirement is made that the registered persons ensure that the carpets in the lounge and on the stairs are either cleaned or replaced. When viewed, the industrial washing machine was not working. Staff stated that it has broken down on numerous occasions and has been repaired but that it keeps breaking down. The residents and staff had to make do with an ordinary household washing machine, which is in the laundry room. An immediate requirement is made that the registered persons ensure that the industrial washing machine is either repaired or replaced. A tour of the back garden was found to be in a poor state of neglect. To one side were overgrown shrubs and bushes and weeds were growing through the crazy paving. There were also discarded clothes, plastic shopping bags, and a Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 15 bag with what appeared to be clothes inside and bags with other items inside. In addition, there was a large discarded wooden bed head and a large electric fan and near the laundry room door was a plant pot overflowing with discarded cigarette butts. A immediate requirements is made that the registered persons ensure that the back garden is cleared and cleaned. The kitchen was in a poor state when viewed. The cooker particularly was in a poor state. There were numerous heat stains, the sides were caked in old grease and inside was dirty and stained from years of food preparation. Most of the kitchen unit door handles were missing or broken, the potato pealing machine was dirty, the extractor was dirty and greasy and the floor to the side of the cooker and underneath units was dirty with food, grime and other bits. Two immediate requirement were made, that the registered persons replace the cooker and for a thorough kitchen cleaning programme to be implemented. All residents are physically independent and do not require any special equipment or aids, although there is an assisted bath available for resident’s use. A tour of the independent living flat was made and although generally in good condition, the toilet had faeces on the toilet seat and next to the toilet was a “baby potty”. A requirement is made that the registered persons ensure that the toilet in the flat is regularly cleaned and that the “baby potty” is removed. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 16 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, 35 and 36. Residents are confident that the staff working in the home have the necessary skills and experience to support them. The registered manager is not ensuring that staff’s personal development is being monitored and that they are being supported by receiving regular supervision. EVIDENCE: On looking though five staff files, each had a photograph of the member of staff inside, as was a requirement from the previous inspection. Files also contained a copy of the staff’s induction. Throughout the inspection, staff were observed interacting with residents in a respectful and professional manner at all times. The staff training file contained various certificates and courses that staff have undertaken. For instance, two staff’s National Vocational Qualification NVQ certificates were seen. Protection of Vulnerable Adult certificates were also seen, one staff has completed a Makaton course and most staff have completed a learning difficulties awareness course. Although staff are receiving supervision, there is no consistency as to when they receive it. Some staff have gaps where they have not received any supervision for more than six months. A requirement is made that the Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 17 registered persons ensure that all staff working in the home receive regular supervision at least six times a year and that all supervisions are recorded. Finding information in staff files was time consuming because there was no structure or logical sequence to the information contained in the files. Information was all over the place and took time to sort out. A recommendation is made that the registered providers ensure that staff files are sorted into a logical and consistent sequence. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 18 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): 41 and 43. Residents are confident that confidential information regarding them is at all times kept securely in the home. The registered manager is not ensuring that the health and safety of residents, staff and visitors are promoted and protected by ensuring that safety issues are dealt with as a matter of urgency. EVIDENCE: Resident’s confidential files, along with other files, are kept securely in the office. Resident’s files were seen to be up to date and in order and containing the relevant information. Various safety certificates were seen and most were up to date and in order. Fire safety checks are carried out regularly. However, the London Fire and Emergency Planning Authority (LFEPA) certificate was seen and four contraventions were identified on 7th July 2005 and not all have been complied with. A requirement is made that the registered persons ensure that the Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 19 identified LFEPA contraventions are complied with and confirmation of this is sent to the Commission. The home has the relevant employer’s insurance cover in place and was seen to be up to date. Staff are aware of the lines of accountability. Staff spoken to were aware of the role of the manager and deputy manager. The service manager was available for part of the inspection and residents were aware of who he is. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 3 Standard No 22 23 Score 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X X 3 2 LIFESTYLES Standard No Score 11 2 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Warwick Road 2 Score X 3 x 2 Standard No 37 38 39 40 41 42 43 Score X X X X 3 2 x DS0000010534.V251104.R01.S.doc Version 5.0 Page 21 Yes 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 YA11 Regulation 12(1b) (3)13(1) (b) Requirement Timescale for action 27/01/06 2 YA17 16(2,i) 3 YA21 12(3) 4 YA22 12(2)(3) 16(2,n) The registered persons must ensure that a behaviour therapist or other professionals are consulted with regards to management of the resident’s behaviour. The registered persons 28/10/05 must ensure that a review of the menu is undertaken and that residents are involved in the menu planning. (Timescale of 03/06/05 not met). This requirement is revised and restated. The registered persons 27/01/06 must ensure that resident’s wishes in the event of them becoming terminally ill and dying is recorded in their file. The registered persons 28/10/05 must ensure that regular resident’s meetings occur to ensure that residents can air their views and that minutes of the meetings are Version 5.0 Page 22 Warwick Road 2 DS0000010534.V251104.R01.S.doc recorded. 5 YA24 The registered persons must ensure that the carpets in the lounge and on the stairs are either cleaned or replaced. (Timescale of 03/06/05 not met). 16(2g,h,j)23(1a,2bd) The registered persons must immediately ensure that the home’s main cooker is replaced and for the kitchen units to be repaired or replaced. (Timescale of 24/06/05 not met). This requirement is revised and restated. 16(2h,j) 23(1a,2d) The registered persons must immediately ensure that a thorough kitchen cleaning programme is implemented. 16(2e,f)23 (2c,k) The registered persons must immediately ensure that the industrial washing machine is either repaired or replaced. 23(2,b,o) The registered persons must immediately ensure that the back garden is cleared, cleaned and made safe. 16(j),23(2,d) The registered persons must ensure that the toilet in the independent living flat is regularly cleaned and that the “baby potty” is removed. 18(2) The registered persons must ensure that all staff working in the home receive regular supervision at least six times a year and that it is recorded. (Timescale DS0000010534.V251104.R01.S.doc 23(d) 27/01/06 6 YA24 14/10/05 7 YA24 10/10/05 8 YA24 11/10/05 9 YA24 14/10/05 10 YA30 28/10/05 11 YA36 27/01/06 Warwick Road 2 Version 5.0 Page 23 of 03/06/05 not met). 12 YA42 23(4a,c,i,ii,iv) The registered persons must ensure that the registered persons ensure that the identified LFEPA contraventions are complied with and confirmation of this is sent to the Commission. 27/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 17 (2). Schedule 4 para 6. Good Practice Recommendations A recommendation is made that the registered providers ensure that staff files are sorted into a logical and consistent format. Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Warwick Road 2 DS0000010534.V251104.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!