Inspection on 30/11/05 for Abbottswood Lodge

This inspection was carried out on 30th November 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 but made no statutory requirements on the home.

Other inspections for this house

Abbottswood Lodge 14/05/08

Abbottswood Lodge 03/07/07

Abbottswood Lodge 11/07/05

Abbottswood Lodge 03/02/05

Abbottswood Lodge 06/09/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Abbottswood Lodge 226 Southchurch Road Southend On Sea Essex SS1 2LS Lead Inspector Mrs Bernadette Little Unannounced Inspection 21st November 2005 10:00 X10015.doc Version 1.40 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 Abbottswood Lodge DS0000015491.V263952.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 Older People. 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. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Abbottswood Lodge Address 226 Southchurch Road Southend On Sea Essex SS1 2LS 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) 01702 462541 01702 462541 Mr Eversley Peters Mrs Kamini Peters Mrs Kamini Peters Care Home 12 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12) Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2005 Brief Description of the Service: Abbottswood Lodge provided accommodation and personal care for up to twelve elderly people who may suffer from a mental disorder or dementia. All bedrooms were single and fitted with a call bell system, and a television and telephone point. Residents’ bedrooms were on two floors, which were accessed by a passenger lift. Residents had a lounge and dining room on the ground floor. The home is owned by Mr & Mrs Peters and managed on a day-to-day basis by Mrs Peters. It is situated in the Southchurch area of Southend on Sea and is therefore in close proximity to the town centre, as well as local community facilities and amenities. The home had forecourt parking facilities and a pleasant garden with a patio area to the rear of the property. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second routine unannounced inspection of Abbotswood Lodge this year. The registered manager assisted with the inspection throughout. There were 12 residents living in the home and all of them were seen, and some chatted with during the day. A visiting relative and four staff were also spoken with. All core standards have been assessed over the two inspections, along with most other National Minimum Standards. Appreciation is expressed to the residents, visitor, staff and manager for their assistance during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Abbottswood Lodge must keep the records about staff that the law requires them to, and show that they have done all the checks that they are supposed to. The home needs to have a bath with the right equipment so that it can be used by all residents. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 Information was available about the home. It could provide better detail for interested parties. EVIDENCE: The service user guide had been improved and advice was provided to the registered manager on checking its contents against the national minimum standard and regulation. A visitor confirmed the manager’s advice that relatives normally visit Abbotswood Lodge for the resident prior to their admission. A contract was available on the resident file sampled. This did not contain all the information required, for example the breakdown of who was responsible for paying the fees or the resident’s room number. It was not signed either by the resident or their representative. Staff clearly knew the residents well. There needed to be additional staff training on the specific conditions associated with older people and those with dementia, for example diabetes, Parkinsons disease or continence management. The service user guide needs to be more accurate in identifying that the home does not currently provide an assisted bathing facility. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Care plans provided good instruction for staff in the areas that were addressed. Improvements to the medication system reassured of better protection for residents. Observed care practice respected residents’ dignity. EVIDENCE: A care plan was available on all resident’s file sampled. There was a good standard of detail in the areas of need included. As advised at the last inspection, the care plan needed to identify all areas of resident care needs, for example, in relation to management of aggression, continence etc. Risk assessments remained unavailable on issues such as tissue viability and nutrition. This was the only aspect of Standard 8 considered on this occasion. The deputy manager and another senior carer had undertaking medication training recently which is positive, and the registered manager and another member of staff are booked to undertake this in the very near future. A protocol was in place for PRN (as required) medication. Some omissions continued to be noted in the medication administration recording (MAR) sheets. The manager agreed that, instead of handwriting their own, the pharmacist should have been contacted where pre-printed MAR sheets had not been provided. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 15 Abbottswood Lodge supported residents to maintain relationships with family and friends. Residents were provided with a variety of well presented foods. EVIDENCE: The relative spoken with confirmed that they are always made welcome at the home and visit regularly. Records inspected confirmed that some residents also go home on regular basis to maintain relationships with family and friends. The relative spoken with said they had observed the food to always look good and this was seen on the day of the inspection. Liquidised foods were well presented. Staff sat down with the residents to assist with feeding, chatting and giving eye contact, which was positive. The recommendation of the last inspection to vary the teatime news had been positively taken up by the home. They could now consider extending this to changes at breakfast time on occasion. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Clear procedures were in place for recording complaints. Additional training and review of policies, practices and procedures were required to ensure the best protection of residents and staff. EVIDENCE: The registered manager was able to demonstrate that an appropriate recording system for complaints was available. The registered manager confirmed that she had made opportunity for postal voting known to relatives, but that the residents at the home do not have the capacity to clearly state their wishes in this matter. She confirmed that all residents have an appropriate person to support them in decision-making. Evidence was available that some staff had recently attended training or protection of vulnerable adults and training for additional staff was planned in the very near future. The homes own policy on the protection of vulnerable adults must be reviewed and brought in line with current practice and the local multidisciplinary adult protection procedures. While it is an issue in the home, staff had not been provided with any training on positive responses or management of aggression. This is contrary to the homes own stated policy. Additionally the homes policy on restraint needed to provide clearer guidelines for staff and refer to working with the care plan. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 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, 21, 26 Abbottswood Lodge generally presented as safe and comfortable environment for residents but again needed to improve in terms of equipment and attention to detail. EVIDENCE: The premises was warm and clean. Observation and discussion with the visitor demonstrated that there were no unpleasant odours in the home. The registered manager stated that new towels had been purchased and that window restrictors were fitted to all appropriate windows. The registered manager confirmed that works had been undertaken to the exterior of the premises but there had been no changes to the interior since the last inspection. Areas noted then included torn wallpaper. Advice was given on producing a maintenance plan for the home. The home continued not to have bathing facilities adequate to meet the needs of its residents and this must be addressed without further delay. The shower facility had been reinstalled and was usable. Many residents used a downstairs hip bath. The hydraulic bath chair had been out of order since prior to the last Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 13 inspection, when one resident had to be given bed baths because of the lack of facilities. There were outstanding issues in relation to the laundry and infection control noted in the last report. These continue to need to be addressed and will be considered again at the next inspection. It was noted positively that the home now had a contract and appropriate systems for disposing of clinical waste. Eight staff were currently undertaking infection control distance learning training and all remaining staff will undertake a one-day infection control training course with Southend Borough Council. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staffing levels were adequate to meet residents’ need. Staff recruitment procedures were poor and put residents at risk. Staff needed to be provided with additional training to protect both themselves and residents. EVIDENCE: The roster demonstrated that the agreed minimum staffing level of three staff all day and two awake staff at night were maintained. The roster did not indicate that one of the registered persons was covering the cleaning hours. The manager advised of the hope that arrangements can be made to restart the NVQ training programme in the very near future. Access was made available on this inspection to the staff recruitment files and two files were sampled. One showed that the registered person had not taken up references from recent residential care home employers and gaps in employment had not been evidenced as explored. The other had a P60 that showed an employer not recorded on the application form. Neither had a declaration of mental and physical health, or a photograph and one did not have evidence of identity. One file had no evidence of training certificates and the registered manager confirmed that there had been no induction programme. Neither file had evidence of a current Criminal Record Bureau check. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 15 The registered manager confirmed that Criminal Record Bureau checks had not been undertaken for any member of staff working at the home. Advice was provided an undertaking this immediately and on how to undertake a Povafirst check. The registered manager was made aware of the concern this lack of action caused in relation to the protection of the residents. An Immediate Action Requirement notice was issued requiring the registered manager/provider to undertake appropriate checks on all staff immediately. It was noted positively that there has been an increase in the training provided for staff since the last inspection this included the protection of vulnerable adults, infection control, and medication. Evidence needed to be available on all staff files of all basic mandatory training including fire, first aid and health and safety. The registered manager/provider confirmed they she is a qualified moving and handling trainer. It was most disappointing to note again that staff had not yet been provided with moving and handling training. This needs to addressed without delay. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 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, 33, 34, 36, 37, 38 The home presented as reasonably organised and managed. Some aspects of systems, policy and record keeping need to be improved to best safeguard residents. EVIDENCE: The registered manager said that she is progressing well on the NVQ level 4 in Care and Management course. She had also recently attended training on protection of vulnerable people, infection control and has planned training on medication. Questionnaires on the service were available that had been undertaken at the beginning of the year, completed by relatives on behalf of residents and also one from a social worker. The registered manager was recommended to share the outcomes and actions taken from this. Advice was also provided on implementing a practical approach to quality assurance in the home including issues such as premises, health and safety, training or policies and procedures. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 17 One of the two staff files sampled recorded four supervision sessions in the past year. Advice was provided to the manager on raising this to six sessions per year. Advice was provided to the manager on updating several policies and procedures, including the missing person procedure. Photographs must be available of all residents. A current certificate of employers liability insurance was displayed. There was nothing to suggest that the home is not financially viable. Certificates were again not available in relation to the emergency lights, but the registered manager said this was awaited. A gas safety inspection certificate was not available. A risk assessment was again not available in relation to legionella. Checks of water temperatures did not include all outlets and were not done regularly. The manager was again advised that information can be obtained in the booklets “ Essential Information for Providers of Residential Accommodation” and” A Guide for Employers” on 01787 881165 or at www.hsebooks.co.uk Evidence of fire training for staff was seen to be available on many, but not all, files sampled. This must be the available for all staff. Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 X 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 2 X 1 X X X X 2 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 3 X 2 2 2 Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 5 Requirement Timescale for action 01/03/06 2. OP2 5&Sch4 (8) 3. OP4 16(1) & 18(1)c(i) 4. OP7 15 The registered person must ensure that the service user guide contains all the elements required by regulation and be accurate, and must supply a copy of this to the Commission for Social Care Inspection. (Previous timescales from 12/03/03 and 01/09/05 not met). The person registered must 01/02/06 supply each resident with a written contract or the statement of terms and conditions to be provided and any fees and who is responsible for them (previous timescale of 01/09/05 not met). 01/02/06 The person registered must demonstrate the homes capacity to meet the assessed needs of residents. This includes training for staff on the specific conditions associated with their client group and the facilities of the premises. A care plan must be in place for 01/02/06 each resident at the home. This must include details of how all aspects of the residents needs in DS0000015491.V263952.R01.S.doc Version 5.0 Page 20 Abbottswood Lodge 5. OP8 13(4)(c) 6. OP9 13(2) 7. OP12 16(2)(m) &(n) 8. OP18 18(7) 9. OP19 23(2)(d) 10. OP21 23(2)(c),( j),(n) relation to the health and welfare are to be met (previous timescale of 01/08/05 not met). The person registered must ensure that any unnecessary risks to the health of service uses are identified and as far as possible eliminated. This refers to risk assessments for such issues as nutrition, tissue viability and moving and handling (previous timescale of 01/08/05 not met). The registered person shall make arrangements for safe recording of administration of medication in the care home. This refers to the omissions on, and the use of handwritten, medication administration records. The person registered must consult with residents about their social interests and the programme of activities arranged by or on behalf of the care home. These must then be reflected in the residents care plan.(This standard was not inspected on this occasion and will be carried forward to the next inspection). The person registered must ensure the safety of staff and residents by the provision of training in management of challenging behaviours and positive responses (previous timescale of 01/09/05 not met). The person registered must ensure that all parts of the premises are kept reasonably decorated (previous timescale of 01/09/05 not met). The person registered must ensure that are adequate and appropriate bathing facilities to meet residents need and that any equipment is kept in good DS0000015491.V263952.R01.S.doc 01/02/06 01/01/06 01/01/06 01/03/06 01/04/06 01/02/06 Abbottswood Lodge Version 5.0 Page 21 11. OP26 13(3) 12. OP29 17(2) & 17(3) 13. OP29 7,9,19 14. OP30 18(1) (a) & (c) 15. OP33 24(1) & (3) working order (previous timescale of 01/08/05 not met.) A written response is required from the persons registered by 01/02/06 that identifies their planned actions to meet this requirement with specific timescales. The person registered must ensure that appropriate arrangements are in place at the home to prevent the spread of infection. This refers to the siting and use of the sluice and hand washing facilities within the home’s laundry (previous timescale of 01/08/05 not met). The person registered must maintain in the care home records relating to staff as identified in Schedule 4. These records must be kept up-to-date and must be available at all time for inspection( previous timescale all for the 11/07/05 not met). The person registered must demonstrate robust recruitment procedures, to include criminal record bureau checks for all staff, and have available records relating to staff recruitment as required by regulation and scheduled 2 as amended. The person registered must ensure that all the staff are suitably qualified and trained for the work that they are to perform. This includes formal induction training and regular and updated basic mandatory training for all staff, for example in moving and handling (previous timescale on 01/09/05 not met). The person registered must continue to develop the home’s quality monitoring system to DS0000015491.V263952.R01.S.doc 01/02/06 01/12/05 01/12/05 01/02/06 01/04/06 Abbottswood Lodge Version 5.0 Page 22 16 OP37 24 17. OP38 23(4)d 18. OP38 13(3) 19. OP38 23 20. OP38 23 include all relevant aspects. The person registered must review and update policies and procedures including those identified in this report to include protection of vulnerable adults, restraint and missing persons. The person registered must ensure that all staff working at the care home receive suitable training in fire prevention (previous timescale of 01/08/05 not met). The person registered must ensure the safety of the water storage system and undertake appropriate risk assessment and actions (previous timescale of 01/08/05 not met). The person registered must ensure regular maintenance of fire equipment. A copy of the certificates pertaining to emergency lighting safety to be sent to the Commission by 01/02/06 ( previous timescale of 01/08/05 not met). The person registered must ensure regular maintenance of the gas supply. A copy of the certificate pertaining to the gas safety inspection must be sent to the commission by 01/02/06. 01/03/06 01/02/06 01/02/06 01/02/06 01/02/06 Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 23 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. Refer to Standard OP18 OP19 OP28 OP31 OP36 Good Practice Recommendations The person registered must continue with the plan to provide training on the protection of vulnerable adults to all staff. The home should have a formal written plan for maintenance and redecoration available for inspection A minimum of 50 of all staff should obtain NVQ level 2. The registered manager should achieve NVQ level 4, in Care and Management. Staff should be provided with formal supervision at least six times annually Abbottswood Lodge DS0000015491.V263952.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Abbottswood Lodge DS0000015491.V263952.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!