Inspection on 28/11/05 for 66 St Edmunds Road

This inspection was carried out on 28th November 2005.

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 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

66 St Edmunds Road 07/11/07

66 St Edmunds Road 27/03/07

66 St Edmunds Road 20/06/05

66 St Edmunds Road 01/03/05

66 St Edmunds Road 25/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 66 St Edmunds Road Stowmarket Suffolk IP14 1NU Lead Inspector Jane Higham Unannounced Inspection 28th November 2005 14:10 66 St Edmunds Road DS0000037220.V264938.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 66 St Edmunds Road DS0000037220.V264938.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. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 66 St Edmunds Road Address Stowmarket Suffolk IP14 1NU 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) 01449 626210 Suffolk County Council Post Vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 Brief Description of the Service: 66 St. Edmunds Road is a registered care home for five adults with learning disabilities, owned and administered by Suffolk County Council and situated in a residential area of Stowmarket within easy reach of local amenities and resources. The home was originally opened as a children’s residential resource but was changed to provide care for adults when the original residents progressed into the appropriate age group. The accommodation is single storey and comprises of five single bedrooms, communal lounge and dining facilities, two communal bathrooms and one shower room. There is limited parking to the front of the building. 66 St Edmunds Road DS0000037220.V264938.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 of 66 St Edmunds Rd., a five bedded residential resource for adults with learning disabilities owned and administered by Suffolk County Council and sited in a residential area of Stowmarket. This was the second scheduled inspection in the inspection year 2005/2006. The Inspection took place on 28 November 2005 over a period of four hours. All core standards have been assessed over the two inspections and this document should be read in conjunction with the report of the Announced Inspection dated 20 June 2005. The home was inspected against the National Minimum Standards: Care Homes for Adults and the Care Standards Act 2000. The National Minimum Standards and Care Homes Regulations 2001 are referred to throughout this report and any non compliance identified. On this occasion, core standards not assessed as part of the previous inspection were examined and requirements made at that time were reassessed. Required procedures and records were examined as were a selection of resident care plans. An environmental tour was undertaken and the range of activities provided to residents was discussed. Due to the limited communication abilities of residents it was difficult to gain detailed feedback on the quality of services provided, although all residents appeared very satisfied and were happy and relaxed in the homely environment. What the service does well: What has improved since the last inspection? Over the past nine months and under the guidance of the acting manager, significant progress has been made in the work practices and administration of the home. Out of the twelve requirements made during the previous inspection, eleven have now been addressed and the one outstanding 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 6 requirement is to be discussed between the Commission and the Responsible Individual for the service. It has been particularly positive to note that staff have worked hard to ensure that all service users have been provided with a detailed plan of care which places a strong emphasis on the way in which they wish their care to be delivered. Staff should be commended on their efforts and for ensuring that all residents now have a risk assessment. The home has ensured that procedures in relation to residents’ finances, complaints and intrusive medication have been introduced and that detailed training plans for each member of staff are maintained. Additionally the home now has a comprehensive Statement of Purpose and Service User Guide which sets out the services that the home seeks to provide. Several environmental improvements have been made which have further enhanced the provision of comfortable and homely accommodation. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 66 St Edmunds Road DS0000037220.V264938.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 66 St Edmunds Road DS0000037220.V264938.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): 1, 2 and 5 Prospective residents can expect to receive a detailed assessment of their individual care needs and to receive relevant information about the services available on which to base a decision about whether they wish to live there. EVIDENCE: Since the previous inspection, the acting manager has ensured that a Statement of Purpose and Service User Guide has been produced. Both these documents are very detailed, well presented and set out the services that the home seeks to provide. Both documents contained all the information as required by Regulations 4 and 5 of the Care Homes Regulations 2001 and a copy of each has been submitted to the Commission. Additionally, in response to a requirement made in the previous inspection, the home has also produced a detailed admissions procedure which details the process for referrals and includes the terms and conditions of placement. An admission assessment template has also been produced which will be used when assessing the individual needs of prospective residents. This document is detailed and when completed should provide a clear outline as to whether a prospective resident’s needs could be met at the home. 66 St Edmunds Road DS0000037220.V264938.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): 6 and 9 Service users residing at the home can expect to be provided with and involved in the production of a detailed plan of care which reflects their individual care needs, goals and aspirations. Service Users can also expect to be supported to take informed risks as part of their daily life. EVIDENCE: At the previous inspection, resident care plans were in various stages of redevelopment and did not in all cases determine the assessed needs of each resident and the interventions required to meet those needs. It was very positive to note that at this inspection all care plans had been redeveloped and gave a clear picture of the assessed needs of individuals and also highlighted preferred routines and likes and dislikes. These documents are now presented in a very organised and user friendly format and also include detailed risk assessments and moving and handling assessments. Care plans seen addressed spiritual and cultural needs and set individual goals for service users in relation to daily life skills. The home was able to evidence that resident care plans were reviewed on a regular basis in addition to the annual external review where other agencies such as day services and social services would be required to have an input. A new review template is being produced to 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 10 evidence the monthly review of care plans and this process will be implemented by the end of February 2006. The home should be commended on the progress it has made in compiling such detailed and resident centred documents. In response to a requirement made in the previous inspection, the home has produced a detailed risk assessment in relation to any service user who wishes to manage their own finances. As in the previous inspection detailed general risk assessments were in place for all residents in addition to challenging behaviour management plans. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16 and 17 Residents living at the home can expect to be provided with a range of leisure activities and occupational/educational opportunities. Residents can also expect to be provided with a planned menu of meals which are varied and nutritious and to have their rights and freedom of choice and movement recognised. EVIDENCE: Four of the five residents living at the home are provided with a range of activities via community resource day centres. Activities provided range from leisure activities such as cooking or relaxation to work based activities such as recycling or in the case of one resident assisting at a local museum for one day a week. One resident receives direct payments and uses these to fund individual support to follow chosen activities such as going for walks. All five residents have an “at home” day once a week where they are supported to attend to more domestic matters such as cleaning their rooms or laundering their clothes and perhaps going shopping for products they may wish to buy. Staff at the home also provide residents with activities in the evening and at weekends on both a group “in-house” basis and individually. On the day of the inspection, an additional member of staff was on duty to support one service 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 12 user in their individual chosen activities. The home produces a monthly report of activities undertaken and also provides details on the individual development of service users in relation to daily living skills. This report is shared with both service users and their families as part of the homes emphasis on “pro-active communication”. Since the previous inspection, staff at the home have produced a planned 4week menu of meals for residents. These menus evidenced that residents are provided with a varied and nutritious diet. In general, the main meal of the day is served in the evenings, although some residents are provided with a full lunch at day services. Menus seen showed that in addition to a dessert, residents are always offered a yoghurt and fresh fruit as an alternative. One staff member commented that it was much better to have a planned menu of meals as staff could now inform residents in the morning what they would be served for the evening meal. The home is working towards providing a maximum provision of fresh vegetables in the main meal of the day. Observations during the inspection evidenced that residents have unrestricted access throughout the building and are well integrated into the daily routines. On return from day services, residents spent their leisure time where and how they wished. Staff were noted to interact well with residents in conversation about how they had spent their day. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Residents can expect to receive personal support in the way they prefer and to have their physical and emotional care needs monitored and met. Residents can also expect to be protected by the home’s procedures in relation to the safe keeping and administration of medication. EVIDENCE: Resident care plans seen at the time of the inspection, evidenced that each service user is provided with an Essential Life Plan which sets out a “pen picture” of levels of support required, including those around personal care. This plan highlights how individual service users would like to have their personal care support provided and also details likes, dislikes and preferred routines. It was identified during the previous inspection that the home was unable to provide an audit trail of which members of staff had received training in intrusive medication, when this training and been undertaken and who had provided the training. Since the previous inspection a written procedure has been produced for the one service user who requires this medical intervention, a copy of which is to be included in their care plan. The procedure provides clear guidance on when, where and how intrusive medications should be used. Training records seen at the time of the inspection clearly evidenced that all staff had received training in the use of intrusive medication from a named 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 14 community nurse. This training is renewable on a two yearly basis. The home was also able to evidence through training records that all staff undertake a two day training course on Epilepsy. The home was able to evidence that the physical and emotional needs of service users are monitored and they are enabled to access community health facilities where required. One section of the service user care plan is devoted to the health care needs of the individual and details how and via which services these needs will be met. A log of all hospital, GP or dental visits is maintained. The home is able to access learning disability assessment and treatment services for each resident via GP referral. Clinical guidance is accessed via agencies such as community nursing services and the Intensive Support Team which provides additional support from a multi-disciplinary team where required. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Residents and their families can expect to be provided with sufficient information to enable them to make a complaint about the service where they feel this is necessary. Residents can also expect that the home’s policies and procedures protect them from abuse, neglect and self-harm EVIDENCE: At the previous inspection, the home was unable to evidence that it had a clear and robust complaints procedure which was available to all residents and their families. However since that inspection, the management of the home had ensured that a complaints procedure had been included as part of the information contained within the newly produced Service User Guide. A copy of this document is provided to all residents and their families and an additional copy is displayed on the home’s notice-board making it accessible to any visitors to the premises. In addition to the home’s complaints procedure a copy of the local authority complaints procedure for learning disability services entitled “Speak Up” is displayed. Since the previous inspection, no complaints have been received by the Commission in relation to this service. At the time of the inspection, the home was able to evidence that five of the existing seven staff members had completed the local authority training programme on the Protection of Vulnerable Adults. The home was also able to evidence that it had a copy of and adhered to the local Protection of Vulnerable Adults Procedure which is produced jointly by health and social services. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24- 30 Residents can expect to be provided with accommodation which is both comfortable, homely and clean. Residents can also expect to be provided with both private and communal accommodation which meets their needs and lifestyle. Whilst service users are provided with appropriate bathroom facilities, they can not at the present time expect to be provided with bedroom accommodation which is equipped with basic fixtures such as wash hand basins. EVIDENCE: 66 St Edmunds Road, comprises of a single storey dwelling which is sited in a residential area of Stowmarket and blends well with the surrounding domestic dwellings. The home has five bedrooms, all for single occupancy and a good provision of communal accommodation which includes a spacious and comfortable lounge and a well equipped kitchen and dining room. There is also a garden room, provided with wicker furniture which leads out onto the pleasant rear garden. There are two offices within the home which dual as “sleeping-in” rooms for the two members of staff on night duty. Although none of the resident 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 17 bedrooms have the benefit of ensuite accommodation, the home has two communal bathrooms and a shower room. As in previous inspections, resident bedrooms seen were found to be comfortably furnished, attractively decorated and contained personal belongings and equipment purchased by service users. Bedrooms seen reflected the personal tastes and interests of the occupant. Several improvements had been made to the environment since the previous inspection. These included the redecoration of the kitchen, dining room and lounge and the provision of new lounge furniture. Two new fridges had been purchased for the kitchen as had a “dual cook” microwave which was being used for cooking sessions with service users. Artwork had recently been purchased and was in the process of being mounted on walls. The acting manager and deputy acting manager had recently spent some time tidying garden areas. The acting manager advised that a new carpet had been selected for the home’s lounge but funding had yet to be secured. Residents who were able made positive comments in relation to the accommodation provided and appeared happy and relaxed in their surroundings. As highlighted in previous inspections, resident rooms are not provided with wash handbasins, although these are available in all three of the communal bathrooms. The home needs to ensure that when current residents have vacated each room, a wash handbasin is provided for any new resident. In general the home provides a good standard of accommodation for service users, both communal and private. All areas of the building were maintained to a good standard of decorative order and repair and were furnished appropriately. All areas were maintained to an acceptable standard of cleanliness and there were no unpleasant odours. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 33 Residents can expect to be supported by a level and skill mix of staff which is sufficient to meet their individual needs. Residents can also expect that staff receive the training and gain the knowledge and expertise necessary for them to carry out their roles. EVIDENCE: On the day of the inspection, service users were being supported by two members of staff. The inspection took place during a shift handover period, when four members of staff were on duty at the same time. One to one support is provided by staffing over and above the minimum level of two to allow residents to pursue chosen activities etc. During the night period the home is staffed by two support workers on a “sleeping in” basis. Staffing rotas seen at the time of the inspection correctly reflected the number of staff on duty. During the inspection, staff undertook their roles in a confident and professional manner and were clear about their responsibilities. Staff were observed to interact with service users in a professional but warm manner and it was evident that good working relationships existed. Since the previous inspection detailed and organised training records for each staff member have been produced. These records evidenced that all staff 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 19 members have received training in all mandatory areas. An additional record of individual training achieved over and above the mandatory areas was also available for inspection. Records also showed that since the previous inspection all staff have undertaken training in moving and handling. Three out of the existing seven staff members have achieved an NVQ Level 3 in care. Another staff member has just completed this level and is awaiting verification of achievement and another is about to commence study for this qualification. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 Residents can expect the home to be managed effectively and in their best interests. EVIDENCE: The home is currently being managed by Mr. David Gilbert, who is also the registered manager for another residential learning disability resource within the same area. Whilst the Commission agreed that Mr. Gilbert could manage the home on a temporary basis without registration, this situation has existed since March 2005 and the need for his registration with the Commission is now under consideration. Since Mr. Gilbert has taken over the management of the home, there has been significant improvement in many areas of the service, such as the provision of clear and detailed care plans for each service user and the provision of a Statement of Purpose and Service User Guide as requested by regulation. 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 21 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 3 3 x x 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 66 St Edmunds Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x DS0000037220.V264938.R01.S.doc Version 5.0 Page 22 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 YA26 Regulation 23(2)(j) Requirement The Registered Persons must ensure that all newly admitted residents are provided with a wash handbasin in their bedroom. Timescale for action 28/11/05 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 NA Good Practice Recommendations None 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 66 St Edmunds Road DS0000037220.V264938.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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