Inspection on 17/11/08 for Ash Lea House

This inspection was carried out on 17th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ash Lea House 19/11/07

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ash Lea House Chesterfield Road Alfreton Derbyshire DE55 7DT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nancy Bradley     Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Ash Lea House Chesterfield Road Alfreton Derbyshire DE55 7DT 01773521763 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Dawn Elizabeth Maris Type of registration: Number of places registered: Clearwater Care (Hackney) Ltd care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The Provider may provide the following category of service only: Care home - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 14 Date of last inspection Brief description of the care home Ash Lea House is a large detached period house set in its own substantial grounds. The home is situated on the edge of Alfreton, which offers easy access to a large range of shopping facilities and amenities. The Home offers accommodation for 14 people with Learning Difficulties, aged between 18 to 65 years of age. The Home has three lounge areas, one of which includes the dining area. The bedrooms are all single bedrooms, except for one double bedroom, and all are of a good size. The kitchen area is accessible by the Residents, dependent on the Residents ability and the activity being addressed there at the time.The Home offers twenty- four staffing, three meals per day, personal laundry, lighting, heating, and a range of social activities.Details of Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 14 Brief description of the care home previous inspection reports can be found on the Commission for Social Care Inspection’s website: www.csci.org.uk. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection and took place over a total of five hours. We spoke with the manager, care staff and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the last key inspection. This included the following, the annual quality assurance assessment (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the home. Care Homes for Adults (18-65 years) Page 6 of 27 Two people living at the home were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at support plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. Additionally, time was spent in preparation for the visit, looking at the service history and the previous inspection report. Records were examined relating to the people living there and the general running of the home. There were nine people living at the home on the day of the visit, the home currently has one vacancy. We gave out ten Have Your Say questionnaires and we received nine completed questionnaires, from people living there who confirmed they were very happy at the home and were looked after by the staff and could not wish to live anywhere else. Three people indicated they would like to speak with us. People had received assistance with completing the questionnaires. We received five completed questionnaires from staff all were very positive about the home, were happy and enjoyed working there. We received a warm, friendly and enthusiastic welcome from the people living at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. .Arrangements are in place to ensure that peoples needs are fully assessed and met prior to admission. This ensures that peoples holistic needs are appropriately met. Evidence: The Statement of Purpose has been updated and amended following the last site visit. However documentation is not in an easy to read format. People living at the home have been there for a long time and there has been one new admission since the last site visit. The home provides care for fourteen people and at the time of the site visit they had no vacancies. The majority of the people who are admitted to the home have their needs assessed by social workers or through the care management system. There was evidence on file to show that the care needs assessments of the people living at the home were being reviewed by the referring agency. Information in the AQAA details the homes new admission and assessment procedure the manager confirmed she had been able to use Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: this for the new admission. Also the home undertakes their own individual comprehensive needs assessments. People are given an opportunity to spend time at the home and are allocated a member of staff to make them feel welcome. The majority of the people spoken with confirmed they had been to look at the home before moving in this was also evident from the questionnaires completed. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a care planning and review system in place, which ensures that peoples individual needs are met. However this need to be more robust in its approach. Evidence: During the visit care plans of two people who live at the home were seen. People living at the home who were case tracked had a care plan, which was in accordance with their assessed need and formulated within a risk assessment. All care plans reflected peoples individual lifestyle preferences and choices. Daily records are also maintained on each person who lives at the home. Care plans are reviewed and up dated by the registered manager and currently this is on a monthly basis. The home has yet to establish a formal annual reviewing system with the referring agency. The detail and information in the care plans has improved since the last site visit and the home now has a good direction on how they are delivery care to people living at the home. We discussed with the manager how the home could develop and further implement Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: changes to care. The registered manager is looking to develop a person centered planning approach. People living at the home knew who their key worker was and told us how they help them on a daily basis. The manager is looking to develop this role further. Care plans have been explained to the people living at the home and they have signed where possible that they agree and understand. In cases where they are not able to sign, a family member has done this. All of the staff have signed the care plans showing their commitment to people living at the home. Risk assessments were in place covering such issues as, peoples health and safety, physical health, nutrition, mobility. However behaviour management and risks associated with social activities is not fully covered. As with the care plans the there is no formal system in place to review these. We discussed with the home about people who live there having access to the local Advocacy Services. The managers stated that the relatives are actively involved in their care act on their behalf and were this is not possible then Advocacy is being involved. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were arrangements in place to enable people to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. Evidence: The care records of two people from the home seen provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and outside in the community. Discussions with people from the home during the visit confirmed they were very happy living at the home and they liked the activities offered. Various photographs, which were around the home showed, people having a good time and enjoying themselves. The relationships observed between care staff and people who live at the home appeared open and good-humoured. People at the home told us they Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: have a close relationship with the staff who play an important part in their lives. The staff encourage the people living at the home to take pride in their appearance and their dress sense is respected. The daily routines are flexible with every one being able to make their own decisions about how they spend the day. People told us they were able to go out to shops, library and cinema as they chose. They were also able to visit the pub leisure centres and places of worship. To enable them to do this the home provides transport. The home regularly takes people out in the evenings to such places as bingo, cinema, social clubs and to late night shopping. People can watch TV in their rooms or many lounge areas in the home. The registered manager has taken people from the home on holiday or short breaks. The people living at the home are encouraged to be as independent as possible taking responsibility for some of the household tasks, like tidying their rooms and keeping the communal living area tidy. Information on peoples records indicated that contact with family and friends were appropriate. Any restrictions on contact are recorded in care plans. People at the home can speak with family and friends by telephone or they can visit whenever they wish. Information from the registered manager showed that the home has also arranged social occasions for family and friends. People living at the confirmed care staff respect their privacy and knock before entering their bedroom. Several of the people have keys to their rooms The home has a smoking area, which is for both staff and people living at the home. People can also have a drink in the home, this is usually under staff guidance and supervision. From examination of the menus the home is providing a healthy well-balanced and nutritious diet. People at the home made positive comments about the meals and said their likes and dislikes are taken into account. During lunchtime everyone was given a choice of menu. We had lunch with everyone at the home. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and wishes. Evidence: Records seen and discussions with staff indicated that peoples health and personal needs were being met People living at the home were generally healthy and records showed that staff promptly contacted the appropriate medical services. People living at the home are registered and attended services within the community including doctors optician, podiatry, dentist, and audiologist. The home maintains a record of peoples weight as part of maintaining a healthy lifestyle. The medication administration practices of the service were assessed. Peoples photographs were in place on medication administration records confirming their identity. The home currently is not administering any controlled drugs. The storage of medication was looked at and was found to be satisfactory. The medication is supplied from the local pharmacy. As discussed with the registered manager PRN medication requires two signatures. Records seen confirmed that all people living at the home Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: have an end of life plan. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure people are listened and their concerns are acted upon. However in the absence of a safeguarding policy and guidance peoples rights are being fully protected or safeguarded. Evidence: The home has a complaints procedure this is detailed in the Service Users Guide and is displayed in the home. The policy shows the complaint would be responded to within 28 days and can contact the Commission for Social Care Inspection at any stage. The complaints policy did not show the current contact details for the Commission for Social Care Inspection. The complaints procedure is not available in an easy to read format. People spoken to stated they would speak with Dawn or their families if they were not happy at the home. There was no safeguarding vulnerable adults policy available at this site visit. There have been several safeguarding issues involving staff. These have been fully investigated to a satisfactory level by the local social services department and by the provider under their complaints and safeguarding procedures. Records seen indicated all staff have received training on safeguarding vulnerable adults. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well equipped and maintained, which prompts peoples independence. Evidence: We carried out a full tour of the home, accompanied by the registered manager. All communal areas were seen. Peoples bedrooms were inspected with their agreement and all rooms had been furnished to their personal choice and were being personalised. The home was clean, well maintained, well furnished, equipped and well lit and heated. Where personal items, furniture and fittings have been removed for a health and safety reason has been risked assessed and included in peoples care plans. People living at the home stated they were happy with their bedrooms and the home. All maintenance issues are dealt with quickly. The home was free of any unpleasant odours or smells on the day of the visit. The home has effective infection control procedures in place. Records indicated all staff had received training on infection control Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has recruitment and selection procedures in place to ensure that the appropriate staff are employed to care for vulnerable people. Evidence: The home has a good percentage of staff who hold a NVQ level 2 or above. At the time of this site visit staffing levels were appropriate to the care needs of the people who live there. Issues raised concerning staffing levels have now been addressed. The home has a recruitment procedure in place, which ensures that staff appointed are suitable to work with vulnerable people. Several staff personnel records were examined which confirmed that thorough employment checks were carried out. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a probationary period. From recent staff recruitment records examined, applicants were not providing a full employment history. This area of shortfall were discussed with the registered manager The home has an induction training programme for all new staff, and this is followed up with the foundation training. The registered manager stated the home has a number of training days throughout the year and that the Learning Disability Award Framework accredited training, was also provided for all staff. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: The registered manager maintains training record ensuing staff receive training update as and when necessary All staff spoken with confirmed they have regular supervision and records seen supported this. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well managed with staff seeking the views of the people ensuring the home is run in the best interest of the people who live there. Evidence: The registered manager has been in post since July 2007 and is registered with the Commission for Social Care Inspection. The registered manager stated she has a relevant job description setting out her roles and responsibilities. The registered manager has a number of years experience in care and has a qualification to work in the care sector. Completed staff questionnaires stated the manager was approachable and supportive and open to discussion. The manager has completed a recognised managers award. The registered manager has stated that a process for monitoring care and services provided by the home is in line with the policy operated within Clearwater Ltd. The AQAA indicates there is regular feedback obtained from house meetings and regulation 26 visits. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: A senior manager in the organisation undertakes the monthly provider visits. Copies of these documents were made available at this site visit. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to us by way of the AQAA. Systems were in place for the monitoring and maintaining the hot water temperatures. These were examined and found to be within a safe range. The registered manager had completed the AQAA to a satisfactory standard. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Care plans must be formally 31/01/2009 reviewed at regular intervals and be clearly shown as such. This is to ensure peoples care needs are fully met. 2 9 12 Detailed risk assessments must be complied on all outside activities. This is to ensure people are supported to take risk as part of an independent lifestyle. 31/01/2009 3 9 12 Risk assessments must be regularly reviewed to reflect changes in peoples care. This is to ensure people are fully supported to take risk as as part of an independent lifestyle. 31/01/2009 4 20 13 Any change or addition to medication must always be signed by two staff, dated and state the name of the 31/12/2008 Care Homes for Adults (18-65 years) Page 25 of 27 Doctor authorising the medication. This is to ensure people receive the correct medication. 5 22 22 The complaints policy must include the current contact details for the Commission for Social Care Inspection This is to ensure people know who they can contact. 6 23 13 The home must have a current and up to date safeguarding policy This is to fully protect people who live at the home. 7 34 18 All applicant must provide a full employment history. This is to fully protect vulnerable people. 31/01/2009 31/01/2009 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 5 1 22 34 39 39 The home should develop a Statement of Purpose and Service Guide in an easy to read format. The home should develop a easy to read complaints procedure for people who live there. All applicants should provide the days date month year when providing a full employment history. Outcomes from quality assurance procedures should be made public. Feedback on the home should be sought from family, friends and stakeholders. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!