Inspection on 16/01/06 for Beechcroft Care Home

This inspection was carried out on 16th January 2006.

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

Beechcroft Care Home 20/08/08

Beechcroft Care Home 30/10/07

Beechcroft Care Home 20/09/06

Beechcroft Care Home 21/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Beechcroft Care Home Nursery Avenue West Hallam Derbyshire DE7 6JB Lead Inspector Anthony Barker Unannounced Inspection 16th January 2006 09:20 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 Beechcroft Care Home DS0000035748.V273793.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. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beechcroft Care Home Address Nursery Avenue West Hallam Derbyshire DE7 6JB 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) 01629 580000 Derbyshire County Council Mr Paul Miller Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th August 2005 Brief Description of the Service: Beechcroft is situated within a residential area of West Hallam, near Ilkeston. The Home is owned by Derbyshire County Council and is registered to provide residential care for 40 older people, all within single rooms on the ground floor. It has a small car park at the front of the property. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The time spent on this inspection was 5.25 hours and was a routine unannounced inspection. The last inspection took place in August 2005 and was an unannounced inspection. The Manager and Deputy Manager were spoken to, records were inspected and there was a brief tour of the premises. Four residents were spoken to and the records of two residents were examined as part of the case tracking method. The focus of this inspection was on progress made on the requirements and recommendations made, and those standards not assessed, at the last two inspections. What the service does well: What has improved since the last inspection? What they could do better: The Home must improve the amount of information obtained regarding residents’ needs. There must be a written plan of care, in respect of each resident, available at all times. These plans must set out in detail the action which needs to be taken by care staff and must be regularly reviewed. All residents’ records must be signed at all times and all potential risks to which residents are exposed must be recorded on a risk assessment and monitored. Staff must ensure that they administer all residents’ medicines and take care, while doing this, that they maintain the security of all medicines. Entries in Medication Administration Record must be unambiguous and consistent and any hand-written entries must be signed, dated and countersigned and dated. Residents must be provided with a choice of meal from a varied tea-time menu. The paths around the Home must be repaired or replaced and the wooden facia boards on the building must be redecorated. Domestic hours must be raised to at least 100 per week and a record of all persons employed Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 6 at the Home must be kept within the Home at all times. Staff must be provided with all mandatory training. 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. Beechcroft Care Home DS0000035748.V273793.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 Beechcroft Care Home DS0000035748.V273793.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): 3 Prospective residents’ needs were being assessed prior to admission. However, there was need for improvement on the recording of necessary information held on residents. EVIDENCE: The Manager reported that the Home’s Service Users’ Guide now included the service users’ views of the Home but still did not make it clear that a complaint about the service can be made at any stage. However, the Guide was being printed and there was no draft version available at the time of this inspection. Other aspects of standard 1 were not assessed on this occasion. Residents’ files were examined and showed that there had been a recorded assessment of need prior to admissions. The file of a self-funded resident was also examined and included a form entitled Care Assessment for Admission to Beechcroft completed by the Manager. This did not include all the items detailed in Standard 3.3 – for example, history of falls and medication usage. As at previous inspections, it was noted that information on residents, required by Schedule 3 of the Regulations, was being inconsistently recorded in a number of places. Based on the current headings within document templates Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 9 there appeared to be the potential for some Schedule 3 information not to be recorded, especially for self-funded residents. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 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 the following standard(s): 7&9 Residents’ needs were not being consistently set out and monitored in personal care plans due to a number of poor recording practices. Also, poor recording and other practices meant that residents were not being protected by the Home’s procedures for dealing with medicines. EVIDENCE: Two residents’ records were case-tracked. Record 1 had an information ‘front sheet’ where little information had been recorded – there was no name of the social worker/care manager, no date of admission, no date the sheet was recorded and no signature. Some of this information was found elsewhere. Although the resident’s preferred name had been recorded there was no actual heading for this information. There was some recorded evidence on record 1 of regular management monitoring. The Personal Service Plan (PSP) had very few care plan objectives – the importance of these was discussed with the Manager. This resident’s PSP Monthly Review Sheet completed by night staff was seen but there was none by day staff. It was therefore not possible to cross-reference these reviews with the PSP. Record 2 contained no PSP, only a care manager’s care plan. However, there was a PSP Monthly Review Sheet although there were no signatures beside any of the entries. This resident’s ‘GP Visits’ form had no signatures beside any of the entries. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 11 There was no recorded risk assessment or appropriate care plan objective, on one resident’s record, to reflect certain mental health risks, as discussed with the Manager. There was still no written policy/procedure on managing tissue viability. One resident reported that the district nurse had just visited. Other aspects of standard 9 were not assessed on this occasion. One large vitamin tablet, in a pill pot, was found on the WC cistern in the staff toilet. This was drawn to the Manager’s attention. The Medication Administration Record (MAR) sheets still showed evidence of several handwritten entries not being signed, date or countersigned and dated. There were also gaps in the MAR sheet entries relating to several residents. With regard to one resident an entry of ‘S’ had been used to indicate that the resident had been ‘sleeping’. However, there was no code ‘S’ at the bottom of the sheet. Several MAR sheets contained a line of ‘F’ entries – indicating at the bottom of the sheet that this referred to the resident being asleep. It was suggested to the Manager that medical advice should be sought about changing the time of administration of the medicine to one when the resident was more likely to be awake. One resident said he disliked other residents accidentally wandering into his bedroom. There was a discussion with him about the possible use of a picture/image on the outside of his door depicting something personal to him. This may deter any confused resident bothering him. Other aspects of standard 10 were not assessed on this occasion. Letters of thanks and appreciation were displayed on a notice board in the main entrance area. These indicated that relatives have felt that staff show dignity and sensitivity when residents are dying and in their dealings with relatives at that time. There was evidence, in these letters, of relatives being enabled to stay by the bedside in the final days of the resident’s life. Other aspects of standard 11 were not assessed on this occasion. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 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 the following standard(s): 15 Residents were receiving a wholesome, appealing and balanced diet in surroundings of their choice. Only the teatime meal, temporarily, offered a more limited choice. EVIDENCE: One case-tracked resident said, ”I can do what I like here”. This resident went on to add that other residents also exercised choice and control over their lives. Other aspects of standard 14 were not assessed on this occasion. Residents spoken to in the dining room stated that they had had a good breakfast. At that time each day they were asked about their choices for lunch. It was noted that there were no menus displayed, to enable residents to independently assess the choice of meals available. Residents spoke about there being less choice of menu recently at teatime – mostly only sandwiches being available now. The Deputy Manager said this was due to a current catering staff shortage – the teatime menu would return to normal in February. Also, she said, menus would again be displayed at that time – taking the form of a laminated menu displayed on dining tables. The recently reviewed menu was examined and found to be varied and nutritious – including the tea-time meals although, as stated, these would not restart until February. At lunchtime it was noted that residents’ dining tables were provided with cloths, drinks and condiment sets. Staff described how some residents use the Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 13 Home’s three kitchenettes to wash glasses and fold serviettes so as to feel they are making a contribution. One case-tracked resident spoke of being provided, by choice, with all meals in the bedroom. Only occasionally was the dining room used by this resident. The larder was found to be well stocked with food. Fresh fruit and vegetables were seen. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 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 the following standard(s): Residents were not benefiting from a staff group that had sufficient information concerning Adult Protection matters. EVIDENCE: The Manager stated that the Authority had still not formulated written policies and procedures on aspects of adult protection that were recommended at the inspection in October 2004. These would ensure that staff understand the possible reasons for, and appropriately deal with, physical and/or verbal aggression by residents; that physical intervention is used only as a last resort; and that address all the forms that abuse and restraint can take. The Adult Protection Policy & Procedures document, dated January 2004, was seen not to address these issues. Other aspects of standard 18 were not assessed on this occasion. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 15 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): 26 Residents’ safety was not being promoted with regards to outside areas immediately adjacent to the Home. The Home was clean and hygienic. EVIDENCE: The Manager reported that the garden areas had been tidied up – using volunteers on Community Service Orders - some of the external wooden fascias had been redecorated and additional outside lighting provided. However, the cracked and sinking concrete slabs around the perimeter of the premises still presented a serious hazard to residents. This matter had appeared in every recent inspection report. An Immediate Requirement Notice was left with the Manager. Other aspects of standard 19 were not assessed on this occasion. The Home had two large washing machines and two large dryers in the goodsized and well-laid out laundry room. The former had a sluicing facility and there was also a sluicing sink. The laundry room door was lockable. There was one dedicated member of laundry staff. The Manager drew attention to the vinyl flooring laid in a bedroom, since the last inspection, to address an Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 16 issue of offensive odours. This was seen to be of an attractive wood laminate design chosen by the resident. The Home was clean and odour free. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 17 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): 29 & 30 Residents were not being fully protected because of less than fully adequate staff recruitment procedures and a staff group that was inadequately trained. EVIDENCE: The Manager reported that domestic staffing levels were back up to the 87.5 hours per week following staff appointment. He also said that the Authority has stated these hours will not be raised any further. The Manager stated that, as recommended at the last inspection, he had re-assessed the dependency levels of residents and concluded that all were of low dependency except for one resident of a medium dependency level. Other aspects of standard 27 were not assessed on this occasion. The file of one recently appointed member of staff was examined. Three of the items of recruitment information required by Schedule 2 of the Regulations were absent. These were… • proof of identity, including a recent photograph, • details of any criminal offences, including cautions, and • a CRB disclosure or documented confirmation of one being received. A large-format training matrix was displayed on the office wall. It showed evidence of… • no staff having undertaken Basic Food Hygiene training within the past 3 years – a session was booked for February 2006, the Manager stated, Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 18 • half the staff group had not undertaken Moving and Handling, Fire Precaution and First Aid training within the past 3 years – half had received training in December, September and November 2005, respectively. The requirement timescale, made at the last inspection, to address this mandatory staff training shortfall had not expired at the time of this inspection. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 19 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): 35 & 38 Residents’ financial interests were being safeguarded. The health and safety of residents were being protected. EVIDENCE: There was some evidence of management monitoring on the case-tracked files. However, there were several examples of poor recording practices, as noted previously in Standards 7 & 9, thus indicating the need for more management monitoring and more staff training on recording practices. A recommendation was made at the last inspection for extending the managers’ monitoring of records to include Personal Service Plans. The Manager stated that this had taken place but accepted that there was no recorded evidence, apart from managers’ signatures beside daily logs, and the monitoring had not been consistent. Other aspects of standard 33 were not assessed on this occasion. Residents’ money balance checks were being undertaken monthly and recorded evidence of this was seen. Money was securely kept in a locked safe Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 20 in individual money bags. One case-tracked resident’s cash balance was found to match the recorded balance. Double signatures were being recorded on most money transactions. The security of the building and of residents had been improved through linking the main entrance door to the wireless pagers held by staff thus alerting them to when the door was opened by a visitor to the Home or someone leaving. Food hygiene practices were found to be satisfactory. Product data sheets, as required by the Control Of Substances Hazardous to Health (COSHH) Regulations, were in place and kept near to cleaning materials at all times. No Health and Safety problems were found at this inspection. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7OP3 Regulation 17(1)(a) Sch 3.3 Requirement The manager must ensure that the Home has all information detailed within Schedule 3. (Previous timescale was 31/5/05) There must be a written plan of care, in respect of each resident, available at all times. Written care plans must set out in detail the action which needs to be taken by care staff – through the use of written and reviewed objectives. Personal Service Plans must be regularly reviewed by the staff involved with residents care. (Previous timescale was 01/10/05) All residents’ records must be signed at all times. All potential risks to which residents are exposed must be recorded on a risk assessment and duly monitored with associated recording. Staff must ensure that they administer all residents’ medicines and take care, while doing this, that they maintain DS0000035748.V273793.R01.S.doc Timescale for action 01/04/06 2 3 OP7 OP7 15(1) 17(1a) Sch3.1(b) 15(1) 01/03/06 01/05/06 4 OP7 15(2)(b) 01/03/06 5 6 OP7 OP8 17(1)(a) 13(4)(c) 01/03/06 01/03/06 7 OP9 13(2) 01/03/06 Beechcroft Care Home Version 5.0 Page 23 8 OP9 13(2) 9 10 OP15 OP19 16(2)(i) 13(4)(a) 23(2)(b) 11 12 OP19 OP29 23(2)(b) 19 Sch 2 13 OP30 18(1)(c) 13(4)(c) the security of all medicines. The registered persons must ensure that entries in Medication Administration Record are unambiguous and consistent. Any hand-written entries must be signed, dated and countersigned and dated. (Previous timescale was 01/10/05) Residents must be provided with a choice of meal from a varied tea-time menu. The registered person must ensure that the paths around the Home are repaired or replaced in order to remove potential trip hazards. (Previous timescale was 1/5/04) The wooden facia boards on the building must be redecorated. (Previous timescale was 1/5/04) A record of all persons employed at the Home, including all documents specified in Schedule 2, must be kept within the Home at all times. (Previous timescale was 1/12/05) Staff must be provided with the mandatory training referred to in the body of this report, including Moving and Handling training. (Previous timescale was 1/4/06) 01/03/06 01/03/06 16/02/06 01/05/06 01/03/06 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations The Service Users Guide should include service users views of the Home.(This was a recommendation from 11 October 2004) DS0000035748.V273793.R01.S.doc Version 5.0 Page 24 Beechcroft Care Home 2 3 4 5 6 7 8 9 OP1 OP3 OP3 OP8 OP9 OP10 OP15 OP18 10 OP33 The Service Users Guide should make it clear that a complaint about the service can be made at any stage. (This was a recommendation from 26 August 2005) The recorded needs assessment of prospective residents who are to be self-funding should include all the items detailed in Standard 3.3. The current system for recording residents’ details should be reviewed in order that information required by Schedule 3 of the Regulations can be easily identified. A written policy/procedure on managing tissue viability should be developed. (This was a recommendation from 26 August 2005) Medical advice should be sought about changing the time of administration of medicine to one resident. Consideration should be given to the possible use of a picture/image on the outside of one resident’s door, depicting something personal to him. Menus should be displayed. The registered persons should provide written policies and procedures that ensure that physical and/or verbal aggression by residents is understood and dealt with appropriately, and that physical intervention is used only as a last resort, should be available to staff. Such policies also need to address all the forms that abuse and restraint can take.(This recommendation was from 11/10/04) Managers monitoring of records should be extended to all residents records. Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Beechcroft Care Home DS0000035748.V273793.R01.S.doc Version 5.0 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. 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