Inspection on 15/11/05 for Bessmount House

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bessmount House 29/07/09

Bessmount House 10/05/08

Bessmount House 12/12/07

Bessmount House 20/07/07

Bessmount House 05/07/06

Bessmount House 24/08/05

Bessmount House 07/04/05

Bessmount House 01/09/04

Bessmount House 13/04/04

Bessmount House 23/03/04

Bessmount House 06/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bessmount House 1 Rose Hill Kingskerswell Newton Abbot Devon TQ12 3PP Lead Inspector Megan Walker Announced Inspection 15th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bessmount House DS0000003652.V251774.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. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bessmount House Address 1 Rose Hill Kingskerswell Newton Abbot Devon TQ12 3PP 01803 872188 NONE 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) Mr David George Simpson Mrs Jacqueline Sheila Simpson Mr David George Simpson Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2005 Brief Description of the Service: Bessmount House is a detached care home that is registered to provide accommodation and care for an maximum of eleven people who need residential care for reasons of old age. It is situated in the village of Kingskerswell and is close to the Health Centre, local shops, church and other amenities. The home has been extensively renovated and refurbished over the past six years by the current Registered Providers, David and Mrs Simpson and there are plans to extend the property to overcome some of the current cramped areas of the home. Mr Simpson is also the Registered Manager. Both David and Mrs Simpson work full-time at the home, including sharing the waking night duty and they live on the premises. There are seven single bedrooms and two double bedrooms, all except one have en-suite toilet facilities. All the bedrooms are connected to a callbell system and have telephone and television points. There is a quiet sitting room and a loungedining room. There is a bathroom/toilet on each floor. A stairlift provides access to the first floor. At the back of the house is an enclosed patio garden. There is a terrace to the front of the house where the home’s pet guinea pigs and rabbit have their hutches and below is a large garden providing home to a variety of domestic fowl. The home also has three dogs. Bessmount House has a no smoking policy . It is not registered to provide nursing care. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place on Tuesday 15th November 2005 between 10h20 and 17h40. It was the third inspection in this inspection year prompted by the unavailability of records and other documents at the last inspection. This inspection therefore was concerned about those standards identified in the last report that had not been met. For more details about Bessmount House the reader is advised to read this report in conjunction with the previous two inspection reports. The inspector toured the premises. All the residents were introduced to the inspector and four residents offered comments and views about living at Bessmount House and the care services they receive. Time was spent talking with the Registered Providers Mrs Jackie and Mr David Simpson, and Ms Heybourn whom they have employed as a Management Consultant. Care records, staff files, and other records and documents were inspected. The Commission has received four Relatives/Visitors Comment Cards and three Service Users Comments Cards. There were fifteen requirements and three “Good Practice” recommendations from the last inspection. With the exception of two requirements and one recommendation, these had all been met by the time of this inspection. There are no additional requirements and one more “Good Practice” recommendation to be met following this inspection. What the service does well: Mr and Mrs Simpson and their staff provide a high standard of care and respect to each of their residents. Mrs Simpson takes time to get to know every resident, their likes, dislikes and personal preferences. She has very high standards and expectations of any staff in her employ. The atmosphere in the home encourages residents to feel at home and to enjoy an easygoing lifestyle with very few restrictions other than those designed to protect residents and ensure their safety. The home is tastefully decorated and provides a comfortable, homely environment. Residents can bring in their own personal belongings if they so wish, and each bedroom is arranged to suit individual choice and preference. Dogs, guinea pigs, a rabbit and domestic fowl are kept at the home, and are clearly appreciated by the residents. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bessmount House DS0000003652.V251774.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 Bessmount House DS0000003652.V251774.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): 2,3,4,5 Improved information is now available for prospective service users to help them in making their decision to live at Bessmount House. Service users and their families are made to feel welcome before and after they move in. A dedicated team of care staff provide the service users with a high standard of care. EVIDENCE: Each resident has now been given a personalised Service User’s Guide that includes the terms and conditions of residence in the home. Inspection of all the individual Service User Files showed that assessments, including assessments by relevant professionals, are done prior to a new resident moving into the home. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 9 One individual Service User’s File inspected contained documentation from a third party confirming that the Registered Providers had spoken to the prospective resident prior to her moving into the home. Conversation with the same resident confirmed that she had been reassured by the telephone conversation, and that the staff were able to meet her needs since she moved into the home. The Registered Providers confirmed that anyone considering moving into the home and/or their families and representatives could visit to see the quality, facilities and suitability of the home. The home does not provide intermediate care. Bessmount House DS0000003652.V251774.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): 7,8 The residents can feel sure that their health, personal and social care needs will be met in a way that maintains their privacy and dignity. EVIDENCE: All the residents now have an individual Care Plan detailing their individual needs and how these are to be met. Each care plan also has information about individual likes and dislikes, for example, personal preference about assistance with bathing. There is also a “Daily Log”. Mrs Simpson stated that it is her intention to consolidate the residents’ Care Plans so that they are concise and easily readable for all staff, and that the “Daily Log” will be used to record anything that is different from the norm. At the time of this inspection no Care Plan reviews had been done with residents. Discussion about this with the Registered Provider showed how the information in the “Daily Log” could be used to inform the detail of the monthly reviews for each resident. It was agreed with Mrs Simpson that the reviews would be started this month. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 11 Ms Heybourn stated that she would work with Mrs Simpson to ensure that the Care Plan reviews are started this month. She also stated that she would devise a Review format that is “user friendly”. The Registered Providers explained about a recent resident who had had to be admitted to hospital and then her subsequent return to the home. It was evident from this information that the Registered Providers had taken action to ensure that health care staff properly and appropriately treated the resident. All the residents spoken to stated that they were well cared for and that the Registered Providers know their individual preferences. One Service User Comment card states “A wonderful family atmosphere. I couldn’t wish for better care anywhere.” All the Relatives/Visitors Comments Cards include comments about the care as “loving”, “friendly”, “consistent quality [of care]”, “exceptional”, and “fantastic”. Bessmount House DS0000003652.V251774.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): 0 None of the above standards were inspected on this occasion as they were all assessed as met in the report of the inspection done on 7th April 2005. EVIDENCE: Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 13 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): 18 Residents are protected from abuse, neglect and self-harm. EVIDENCE: All the staff and the Registered Providers have attended a “Vulnerable Adult” training course. They have all signed to confirm that they have read and understood the home’s policy and guidance on Protection of Vulnerable Adults. Ms Heybourn stated that the home’s guidance on abuse was written in conjunction with the Local Authority’s procedures for the protection of vulnerable adults and the “Alerter’s Guide”. As the home’s version of this is overwhelming in structure, Ms Heybourn stated that she would devise a flow chart so that staff have an “at a glance” procedure should any of them have to deal with any issues of adult protection. This will also include a “Whistleblower’s” policy. Conversation with each of the Registered Providers confirmed that they are very alert and aware of how the home’s residents should be treated and how they are treated. Each Registered Provider independently recounted separate incidents where they had taken action in prevention of “institutional” abuse. One incident resulted in the dismissal of a member of staff for failing to respect the dignity of a resident, and the other concluded with a complaint to the local health authority. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 14 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): 21, 24, 26 Residents live in a safe environment that suits them. EVIDENCE: All the bedrooms except one have en-suite toilets and wash hand basins. One en-suite is accessible using a wheelchair. There is a large communal bathroom on the first floor with a power-assisted bath chair to enable easy access in and out of the bath. The toilet flush mechanism is a pushbutton on the side of the cistern, and on the day of the inspection this was damaged. The Registered Providers stated that they would call back the plumber to replace this mechanism with something more traditional so that residents and visitors could easily flush the toilet. There is another bathroom on the ground floor. This is directly opposite the front door and next door to the kitchen. It has a Continental –style “half-bath” with an electric shower over it. Access to this bath is by means of a bath Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 15 board to assist sliding onto the seat in the bath. The Registered Providers confirmed that this bathroom is serviceable, however, because this room hasn’t been upgraded yet, the residents prefer to only use the toilet, and the home’s hairdresser uses the wash hand basin for hair washing. The residents spoken to stated that they could have a bath when they choose, although one resident stated that she hadn’t asked for a bath because she didn’t think that she should. Further conversation showed that she had previously lived in a home where bathing was restricted so had assumed it was the same at Bessmount House. The Registered Providers stated that they have plans to convert the downstairs bathroom into a shower room with possibly a separate toilet. They are restricted in carrying out any works at present because this is the only communal downstairs toilet and all the residents with bedrooms upstairs are dependent on it during the day. The Registered Providers and Ms Heybourn stated that lockable metal cash boxes have been bought for each of the residents to be fitted in each bedroom. This has not yet been done because each resident has signed an agreement stating that they do not want one. The Registered Providers stated that locks have been bought to fit on each bedroom, however all the current residents have signed an agreement stating that they do not want a lock fitted on their bedroom door. The Registered Providers confirmed that a lock would be fitted to each room when there was a change of resident, or if the current occupant should change their mind. They also confirmed that this would be subject to regular review with each resident, and/or if there was any change in circumstances such as a resident wandering into bedrooms. This practice must also be applied to provision of suitable lockable facilities. The laundry room is only accessible via the kitchen. Staff demonstrated how all soiled laundry is “bagged up” in scented plastic bags before being taken through the kitchen into the laundry room. Mrs Simpson stated that most laundry is done in the evenings or overnight, and never when food was being prepared. Mrs Simpson confirmed that there have not been any outbreaks of infection within the home. Further conversation with both the Registered Providers showed that they are planning to extend the property to include a new laundry room. Inspection of the premises showed that there is no alternative to the current situation. It is not possible to create a separate entrance to the laundry because the most easily accessible wall has a gas cylinder and the boiler blocking it; the other exterior wall would open out on to the street, and the third wall is the dividing wall between Bessmount House and the next-door neighbour’s garage. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 16 Bessmount House DS0000003652.V251774.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): 27,29,30 There are good recruitment procedures - necessary checks and references are performed to safeguard service users. Staff are competent in doing their jobs. EVIDENCE: Ms Heybourn stated that since the last inspection she has undertaken”Training Needs Identification” plans with each member of staff. Inspection of staff files showed that each staff plan identifies all statutory training individuals have taken with dates, and need to take with timescales. The plans also show a record of other relevant training that individual staff have done/would like to do for their own personal development. Inspection of the home’s training programme showed that this year all staff have completed courses on Health and Safety, Infection Control, Fire Safety Awareness (twice), and Vulnerable Adult/Abuse Awareness. Two staff updated their First Aid certificates in October 2005. All staff need to update their Moving and Handling certificates and there was a letter from the local Health Authority trainer confirming they are booked for January 2006, the earliest available course. All staff have been booked on a Food Hygiene course being run over two days at the end of November 2005, and Ms Heybourn stated that she has received confirmation that all staff are booked for Medication Administration training in December 2005. Other recent staff training included Dementia Care. One Senior Carer spoken to confirmed that she is hoping to start an NVQ Level 2 course in January 2006. Ms Heybourn stated that she is currently sourcing funding for this training. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 18 All the staff files were inspected. With the exception of one part-time member of staff, each staff file had a copy of a birth certificate and, where possible, a passport, a CRB check, a photograph of the staff member, and two references. Ms Heybourn stated that she would ensure that the incomplete file met the requirements of the previous inspection report. The home employs four staff that work with the Registered Providers in caring for the residents. All staff work the same hours each week, however, inspection of the staff rota and discussion with Mrs Simpson showed that the staff are all flexible and willing to work different hours as required. Since the last inspection there has been an active recruitment programme and consequently Mrs Simpson was able to confirm that she has received applications from people potentially suitable to be employed at Bessmount House. Interviews are to be held in the week following this inspection. Mrs Simpson stated that she has already received written and telephone references in advance of the interviews. This recruitment programme will continue to run until there is the staff complement required to meet the needs of the residents. The Registered Providers separately stated that when they are in a position to move into their own home, then they will be seeking to recruit a manager for Bessmount House, and they will reduce their current hours. Bessmount House DS0000003652.V251774.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): 36,37,38 Policies, procedures and record keeping in the home have greatly improved since the last inspection. Action has been taken to improve staffing levels. EVIDENCE: Mrs Simpson and Ms Heybourn both confirmed that each member of staff has had their first formal supervision in October 2005 and that future dates have been recorded in the home’s diary. No supervision records were available for inspection. All the staff files were inspected and with the exception of one, they all meet the requirements of the last inspection. All residents individual Care Plans and files were inspected and they all met the requirements of the last inspection. Some files need to be updated, e.g. with an inventory of individual residents personal belongings in their bedrooms. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 20 Discussion with Mrs Simpson and Ms Heybourn showed that previously Marlborough House policies had been used by the home, however, Mrs Simpson and Ms Heybourn have now customised all the policies and procedures required by the Care Standards Act to make them specific to Bessmount House. They confirmed that this process is 90 complete, and only Advocacy, and, Managing Violence and Aggression, policies are still outstanding. Ms Heybourn stated that she is introducing one or two policies and procedures each week to ensure that staff do read them and are not overwhelmed by them. A record of staff signatures confirming that they have read a number of policies and procedures was seen. Each resident and their relatives have received a personalised copy of the home’s Service User’s Guide with a statement of terms and conditions and contract for the home. Copies were seen on individual residents files. The home has a record of weekly menu plans. Inspection of this record alongside the daily records showed all meals actually served to individual residents, including entries stating when a resident has either been out for the day so eaten elsewhere, or if a resident was unwell. Discussion with Mrs Simpson and in the presence of two staff showed that residents’ preferences are respected. Currently a private “Meals-On-Wheels” company supplies the midday meal to the home. This is under review because it is increasingly not meeting the needs and preferences of the residents. There is a Visitor’s Book although the Registered Providers and staff need to be more vigilant in ensuring that all visitors to the home sign this book. Since the last inspection Mrs Simpson has been pro-active in seeking to recruit more staff. Interviews are to be held in the week following this inspection, and advertising for more staff will continue until there is sufficient staff to meet the needs of the residents. Bessmount House DS0000003652.V251774.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 xCHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X 3 X X 3 X X STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 3 3 Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement A locked facility for medicines kept in the ‘fridge’ must be provided Previous timescale 07/06/05 and 01/10/05 – not met. Sufficient staff must be employed to ensure that no one works excessively long hours. Previous timescale 07/10/05 not met. Timescale for action 30/11/05 1 OP27 18 31/03/06 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 2 Refer to Standard OP21 OP26 Good Practice Recommendations The communal toilet in the first floor bathroom should be fitted with a more conventional flush mechanism. Food should be stored in an alternative location to the laundry room. Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Bessmount House DS0000003652.V251774.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!