Inspection on 10/05/05 for Beech Haven

This inspection was carried out on 10th May 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

Beech Haven 09/05/07

Beech Haven 17/01/07

Beech Haven 29/08/06

Beech Haven 15/11/05

Beech Haven 17/08/04

Beech Haven 26/04/04

Beech Haven 08/09/03

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Beech Haven 15-19 Gordon Road Ealing London W5 2AD Lead Inspector Sarah Middleton Unannounced 10 May 2005, 9.20AM 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 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. Beech Haven Version 1.10 Page 3 SERVICE INFORMATION Name of service Beech Haven Address 15-19 Gordon Road, Ealing, London W5 2AD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 991 0658 0208 997 3146 j.scarman@btconnect.com Mrs Phaik Choo Scarman Mrs Phaik Choo Scarman Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical Disability - over 65 years of age (0) of places Beech Haven Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: NO Date of last inspection 17/8/04 Brief Description of the Service: Beech Haven is a private care home for thirty older people. It was first registered in 1986 under the Registered Homes Act 1984. The Registered Providers are Mr and Mrs Scarman and Mrs Scarman is the Registered Manager. Currently the home is registered for Older People only, although there are service users living in the home who have symptoms of Dementia and confusion. The home is three large attached houses in a residential area near Ealing Broadway. The home is accessible to shopping facilities and local amenities. Public transport is easily accessible, either by rail, tube or road. The accommodation consists of thirty single bedrooms, which are on three floors. There is a large lounge/dining room which is equipped to comfortably accommodate all the service users for their meals. The lounge overlooks an attractive well-maintained enclosed garden to the rear of the home. The main kitchen is off the dining room. There is a second lounge situated at the entrance of the home. The service users use this as a quiet area to see visitors and for review meetings. There are adequate bathroom facilities on each floor. There is a passenger lift which goes to the second floor and ramps to access the home and garden. To the front of the home there is parking spaces for several cars. Beech Haven Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of just under eight hours, 9.20AM- 5.05PM, was spent on the inspection process. The Inspector carried out a tour of each floor of the home and inspected service user plans, staff files and maintenance records. Four service users, three visitors, three staff and a volunteer were spoken with as part of the inspection process. The home currently has six service user vacancies and no staff vacancies. Four requirements had not been met from the previous inspection and seven new requirements were made during this inspection. What the service does well: What has improved since the last inspection? The home has identified, although not necessarily acted on, areas still needing attention. They have addressed some previous requirements such as devising a supervision format and confirming in writing to prospective service users that the home can meet their needs. Beech Haven Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beech Haven Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Beech Haven Version 1.10 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 standard(s) 1, 3, 4 & 5 Service users are provided with information about the home. Service users are assessed prior to admission to ensure the home can meet their needs. Attention needs to be paid to the information either given by professionals or identified during an assessment to ensure a prospective service user does not have additional needs outside of the home’s registration. Prospective service users and their representatives are encouraged to visit the home in order to make an informed choice. EVIDENCE: The home has a detailed Statement of Purpose that offers information on the home for service users and their representatives. A new pre-admission assessment document has been introduced and some completed documents were viewed. The document can provide a clear picture of the service users needs, which would include any mental health/dementia needs. Currently the home is not registered to admit any new service users with these additional needs. The home seeks detailed current information from external professionals who refer prospective service users to the home in order to determine if the home can meet their needs. Beech Haven Version 1.10 Page 9 The Registered Person did accept a service user several months ago who had dementia, however due to this person being outside of their category of registration and other difficulties, this service user was moved to an alternative place. The Registered Person has addressed the need to carry out a through assessment in order to gain a full picture of the service user. Where possible the home encourages prospective service users to visit the home on several occasions to ensure they like the home that is offered to them. Beech Haven Version 1.10 Page 10 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 standard(s) 7, 8, 9, 10 & 11 The health and personal care needs of service users had been identified and were being met. Although there was limited evidence that care plans had been devised with the service user or their representatives. Consultation should take place to ensure the service users opinions are noted and addressed. The medications systems were in place and being followed. Attention must be paid in future if a service user is taking a controlled drug, to ensure the home is following appropriate pharmaceutical guidelines. Service users were treated with respect and their privacy was upheld in the home. EVIDENCE: Individual service user plans were available and samples were viewed. Overall these were comprehensive, although there was little evidence of consultations taking place with the service user or their representative. In addition there were no photos of the service user on each care plan. Service user plans were up to date and had been reviewed. One senior worker completes all the care plans and reviews them. Keyworkers are involved as part of devising the plans. Daily records were available and varied in detail. Beech Haven Version 1.10 Page 11 There were some risk assessments present, however, risk assessments were not carried out if a service user had an accident or if an incident had taken place. Assessments for moving and handling were present on each care plan viewed. It was noted when a person had received a bath, although all the samples viewed noted only bed baths had taken place. The records also indicated input from GP, optician, hairdresser plus other healthcare professionals. Samples of the medication administration records were checked. All records were completed correctly. All medications were appropriately stored, apart from a controlled drug, which had not been stored in a separate container. This was rectified, as during the inspection the home purchased a small metal lockable box, where the medication would be stored. In addition the home, on the advice of the Pharmacy Inspector, who was consulted during this inspection, would purchase a controlled drug register to clearly record the receipt and discharge of this particular drug. Several staff were attending a long distance course, through a London college, which would lead to the Certificate in safe handling of medicines. Staff were seen to address service users in a courteous manner. Service users and visitors spoken with were satisfied with the care given and attitude of staff. Where able, service users receive their own mail and some have a private telephone in their bedrooms. Staff were seen to knock before entering bedrooms. On the home’s admission list there is an option to discuss a service user’s preferences for care following death. However the Registered Person stated this was a difficult area to address for some service users and their families. Beech Haven Version 1.10 Page 12 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 standard(s) 12, 13, 14 & 15 Social activities are in place and the home encourages service users to engage in local community activities. Visiting is encouraged for service users to maintain contact with family and friends. Service users choices in their care and routines are respected within the homes capabilities. The meal provision is satisfactory with a variety of choice offered to service users. EVIDENCE: The home has several external people who visit the home to offer activities. During the inspection keep fit was taking place and many service users were taking part in this in the lounge. The activities programme was on a small notice board in one of the corridors, this could be made more available to all service users in a larger format to highlight what activities were taking place each day. Several service users spoken with said they enjoyed some of the activities and others said they could choose if they did not wish to take participate in activities. Some service users were taken to the church of their choice, in addition the local church visited the home and a service was held in the home on a regular basis. Beech Haven Version 1.10 Page 13 Contact with family/friends and the local community is encouraged. Visitors were seen in both the lounge and in service users bedrooms. One service user spoken with maintains contact with several local community groups on a weekly basis. The home does not manage service users finances; either the service user or their family does this. Several service users said they were able to bring personal possessions into the home. The home did not use any advocate services, this support could benefit those service users without friends or family members to ensure their rights and wishes were being upheld. The lunch was sampled and seemed well presented; fresh produce is used throughout all meals. Menus were available and reflected choices. There are set mealtimes but if a service user is absent alternative arrangements can be made. Service users spoken with said they were happy with the food offered at the home, although one did comment that they often had to ask for extra as it was not always enough for them. Another service user had a special diet and this was noted on their care plan and was catered for by the home. Beech Haven Version 1.10 Page 14 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 standard(s) 16, 17 & 18 The home has a clear complaints procedure and service users and visitors were aware of whom to complain to if they were unhappy. Although the home had documentation in place for the protection of vulnerable adults, there was no ongoing up to date training in place for all staff on this issue. In addition, Criminal Reference Bureau checks must be carried out as part of the recruitment of staff prior to their working in the home. This is to ensure the home has followed all the appropriate procedures to protect the service users. EVIDENCE: The home has a detailed complaints procedure. There had been two recent complaints from the same family member, this had been noted and was now resolved. The CSCI has not directly received any complaints since the last inspection. Service users and visitors spoken with said that if they had any concerns these would be taken to the Registered Person. The Registered Person was not aware of any local advocate services, but that he would look into contacting one in order to provide additional support for service users. The home has a procedure for the protection of vulnerable adults (POVA). Staff had received some training on POVA issues on the NVQ courses many were attending; however there was no ongoing external training offered to staff, in particular new staff. Staff spoken with were aware of the procedure should they suspect a POVA incident, but up to date knowledge and refresher courses would enable all staff at all times to be vigilant. Beech Haven Version 1.10 Page 15 In addition, all staff must have a Criminal Reference Bureau (CRB) check prior to starting work at the home. This had not been carried out for one new member of staff, who had a CRB, which was not a year old. The home must ensure it protects the service users at all times. Beech Haven Version 1.10 Page 16 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 standard(s) 19, 20, 21, 22, 23 & 24 The home offers a pleasant homely environment with communal spaces offering time to be with others and time alone, if needed. Privacy and choice is acknowledged and service users have lockable storage and keys to their bedrooms. Service users are able to choose their bedrooms, if there are any vacant and personalise these as much as possible. This offers the opportunity for service users to feel they are in a homely and welcoming environment. EVIDENCE: A tour of each floor was carried out and a sample of rooms viewed. These were being satisfactorily maintained. The home does not accept service users who smoke to avoid any possible risk to the home. The home has a caretaker who manages the maintenance of the building. Beech Haven Version 1.10 Page 17 There is a large communal lounge offering views out to the rear garden. The garden is used in warmer weather. There is also a separate television lounge. The assisted bathrooms and communal toilets viewed were satisfactory. All the bedrooms are single with nine having en-suite facilities. The home has a passenger lift that accesses all floors. The home has a hoist and staff are trained in how to use it appropriately. There are call bells in each bedroom for service users needing assistance. Service users bedrooms all have lockable facilities within their rooms and where requested service users can have a key to their own bedrooms, although two service users stated they had never been asked if they would like a key. This was brought to the attention of the Registered Providers, who stated all service users are offered a key. However they agreed to look into this matter to ensure all service users able to have a key could do so. It was noted on care plans if service users had wanted a key to their rooms; in most cases it had stated they did not want one. Bedrooms had many personal possessions, including items of furniture for those wanting to bring personal things from their previous home. The home was comfortably warm with satisfactory lighting at the time of the inspection, although there were two bare bulbs in the hallway, with no lampshade. The Registered Person stated they would rectify this. The maintenance person on a regular basis checks hot water temperatures. All radiators are covered. Beech Haven Version 1.10 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The staff team is stable, with many having worked in the home for several years. This has brought continuity of care for the service users and provides good teamwork. The shortfalls in the recruitment of staff must be addressed to ensure the home protects service users. All procedures must be followed prior to a new member of staff being inducted. The home is aware of the need to continuously provide opportunities for up to date learning for staff. There should also be clear evidence of training staff have attended and a clear induction programme for new staff members, to ensure all staff have the knowledge and skills to work within the home. EVIDENCE: Currently the Registered Person said the home has no staff vacancies. There is always a senior member of staff working on each shift and sufficient numbers of staff to provide the level of care service users need. Additional staff are provided if there are external appointments for service users. There are seven staff completing the NVQ level 2 and one that has already completed this level. One staff member is currently undertaking NVQ level 3. The Registered Person said there were a few staff that had worked in the home for many years and did not feel capable to undertake a qualification. Staff should be encouraged and supported to keep up to date with current practice through a variety of learning opportunities. Beech Haven Version 1.10 Page 19 The staff employment files viewed contained completed application forms; Criminal Reference Bureau checks (CRB) but one only had one reference on the file. The Registered Person would address this matter. It was identified that the Registered Person had employed a new staff member without obtaining a current CRB check. This person did have a CRB that was not a year old. The Registered Person must in all cases of recruitment apply for a CRB, along with all other necessary documentation noted in the Care Homes Regulations Act 2001. This staff member will not work unsupervised whilst the home applies for a current CRB check. Staff spoken with confirmed they had received mandatory training and were able to attend NVQ courses. They were able to describe action they would take in certain scenarios given to them, for example if a service user had a fall. Much of the training is held internally, through the Registered Person attending courses and qualifying in certain relevant areas, then cascading this information to all staff within the home. The home should pay attention to areas such as dementia training in order to meet some of the service users particular needs. In addition the home should consider its induction programme, one member of staff confirmed they had an induction and shadowed other staff members. However there was no documentation to confirm this. Beech Haven Version 1.10 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 & 38 The management style is open and meeting the needs of the service users is a priority. There has been little progress in devising a system to review the care offered in the home. Quality assurance is important to consider standards within the home and examine areas that require attention, which could improve service users quality of life. Action to ensure that fire doors are maintained closed or an appropriate door closure device is in place has not been taken, which is a risk to the safety of service users in the event of a fire. All servicing records must be monitored and kept up to date to ensure the health and welfare of service users is maintained. Beech Haven Version 1.10 Page 21 EVIDENCE: The Registered Manager has applied to complete the Registered Managers Award and is waiting to hear from the local university. They have been in the post for over eighteen years. Service users, staff and visitors spoke highly of the management team, and said the management were regularly present throughout the home. The home had not carried a full quality assurance review of the home that could improve the quality of care offered to the service users. The Registered Person acknowledged this needed attention and would be addressed. The home has a business and financial plan that is monitored. The home does not manage service users personal finances, although the Registered Person is currently taking care of one service users money. The home supports service users or their representatives to take care of their own finances. A previous requirement had been for the home to offer regular and formal one to one staff supervision. This has not been carried out. The home does now have in place a new supervision format to use when supervising staff but this has not yet been used. This area will be addressed in order to offer staff the support they require to perform well in their jobs. The care records are stored securely and were up to date. Servicing records were viewed at random. The hoist, fire alarm system and call system had al been recently serviced. The Gas safety record had run out the previous month, this would be addressed. In addition those service users wanting their bedroom doors kept open did not have appropriate fire door closure devices fitted to their door and one main fire door was propped open as it had not been connected to the magnetic system. The Registered Person would address this matter immediately. Beech Haven Version 1.10 Page 22 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 x STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 1 3 3 2 3 3 2 3 2 Beech Haven Version 1.10 Page 23 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. 2. 3. Standard 4 7 7 Regulation 14 17 (a) 15 Requirement The Registered Person shall not admit a service user outside of their registration category. The Registered Person shall ensure they have a photograph of each service user. The Registered Person shall consult with the service user or their representative when devising or updating the individuals care plan. The risk assessments for service users must be completed or assessed following accidents and other occurrences. (Previous timescale 31/12/05 not met) Suitable arrangements, including staff training, must be considered to ensure all staff are fully aware of adult protection issues. (Previous timescale 31/12/04 not met) The Registered Person shall not employ a staff member without a Criminal Reference Bureau check being carried out to prevent service users being at risk of harm or abuse.. The Registered Person will Version 1.10 Timescale for action 10/5/05 31/5/05 1/7/05 4. 8 13 (4) 1/6/05 5. 18 13 (6) 1/8/05 6. 29 13 (6) 10/5/05 7. 29 Schedule 10/5/05 Page 24 Beech Haven 2 8. 33 24 9. 36 18 (1) (a) (2) 10. 38 13 (4) (a) (c ) 11. 38 13 (4) ensure they have obtained two written references prior to the start of a new member of staff working in the home. A review of the quality of care must be carried out. (Previous timescale 31/1/05 not met) Formal staff supervisions must be introduced and recorded at all times. (Previous timescale 30/6/04 not met) The Registered Person shall ensure that all servicing records are up to date to maintain the health and safety of service users at all times. All fire doors must be maintained closed, doors needing to kept opened are fitted with appropriate door closing devices that respond in the event of the fire system being set off. 1/8/05 1/6/05 1/6/05 1/6/05 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. 2. 3. 4. Refer to Standard 9 12 14 & 17 31 Good Practice Recommendations The Registered Person should purchase a Controlled Drugs Register in order to safely record separately the receipt and discharge of any controlled drugs within the home. The Registered Person should consider how the home promotes the activities offered, so that it is clear and easy to understand for all service users. The Registered Person should consider identifying an advocate organisation that can offer additional objective support for service users. The Registered Manager should ensure they undertake the Registered Managers Award in 2005. Beech Haven Version 1.10 Page 25 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 Beech Haven Version 1.10 Page 26 - 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!