Inspection on 03/02/09 for Brent Cottage

This inspection was carried out on 3rd February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Brent Cottage Brent Cottage Admirals Walk Hoddesdon Herts EN11 8AB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Yoke-Lan Jackson     Date: 0 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Brent Cottage Admirals Walk Brent Cottage Hoddesdon Herts EN11 8AB 01992467450 01992467450 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Roccs Residential Community Care Services Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The maximum number of service users who can be accomodated is: 5 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning Disability Code LD Date of last inspection Brief description of the care home Brent Cottage is a residential care home for 5 people with learning disability and autism. It has been registered with The Commission for Social Care Inspection since September 2008. The home is located in Hoddesdon and is situated off a country lane near a lake and a canal. It is within easy reach of local shops and public transport. The home has its own minibus service. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home The building is a five bedroom detached family house that has been altered to meet the needs of people with a learning disability and autism. The premises are secured with locked side and back gates and entrance is via the front door. There is a large lounge next to the spacious kitchen which overlooks the back garden. There is an additional sitting and dining area by the entrance to the kitchen and lounge. The administrative office is on the first floor. There are three bedrooms on the ground floor, one with an en suite bathroom and one with en suite toilet and washbasin. There are a shower room and toilet facilities in the corridor nearby. On the first floor there are two more bedrooms and the fifth bedroom comprises two small rooms suitable for a client who prefers a bedroom away from the sitting and activity area. The bathroom and toilet facilities are nearby. The home has a spacious and attractive back garden with a sitting area. The home charges £1200 - £1668 per week. Further information can be obtained from the homes Statement of Purpose and the Service User Guide. A copy of the CSCI inspection report is available in the home. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the first inspection for this service since registration in September 2008. This unannounced inspection was carried out on 03/02/09. The Senior Manager was present. There are currently 3 people in residence. The inspection included a tour of the premises. Time was also spent observing how the staff interacted with the residents. Staff and residents were spoken with and key documents were examined. There were no relatives present during this site visit. Information received by us included the Annual Quality Assurance Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how the outcomes are being met for the people using the service and also provides us Care Homes for Adults (18-65 years) Page 6 of 27 with statistical data. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective clients have the information they need to make an informed choice and they can be assured that a thorough pre-admission assessment will be carried out before they are admitted to ensure that the home can meet all their care needs. Evidence: The service has a Statement of Purpose and each resident is given a Service User Guide. The Senior Manager, who is currently overseeing the service, said that the Statement of Purpose and the Service User Guide will be revised once the service has in place a new home manager. The revised copy will also be in pictorial format. The pre-admission documents for two new admissions were examined and they were found to be thorough and detailed. The management team had carried out a thorough assessment of each prospective clients care needs to ensure that the home can meet their personal, healthcare and social needs before they were admitted. One other resident was a direct transfer from a sister home. The Senior Manager confirmed that each resident is given a three month trial period. All the residents seemed settled in Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: their new home. Two more new clients will shortly be admitted. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be given the opportunity to make everyday choices and their preferences and requests will be respected and that they will be encouraged to achieve independent lifestyles. People who use the service know that their written care plan reflects their care needs to enable staff to deliver their care needs and to support them to meet identified needs and goals. Evidence: Residents are consulted on all aspects of life in the home and are encouraged to make their own decisions and to get involved in the daily routine in the home. Each resident has a regular one-to-one session with their key support worker to ensure that all aspects of their care needs and preferences are discussed and recorded in their written care plan. The care plans examined were detailed and informative. In addition to the main care plan folder, there is an alternative version which is written in person-centred pictorial Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: format. Risk assessments were carried out and documented. Each care plan reflected the specific and changing needs of the resident. The care plan is generated from the care management assessment and covers all aspects of personal, social and healthcare needs. It included specialist requirements such as speech and language therapy, structured environments, rehabilitation and therapeutic programmes and one-to one communication support. All the residents have their written care plans reviewed monthly by their key support worker. There is also a six monthly whole life review. The resident and their relatives, the social worker and the relevant community psychiatric clinical team are all involved in the whole life review. Residents are encouraged to lead independent lifestyles. On the day of the site visit, we met two of the residents who appeared very happy and content. They had just returned from visiting their peer group in a sister home nearby and were looking forward to spending the afternoon with them again. Both residents had a late breakfast of their own choice with a member of staff assisting them to prepare their breakfast. They later showed us their bedrooms. Staff handled confidential information in accordance with the Data Protection Act 1998. On the day of the site visit it was noted that all the documents and care plans were kept in the administrative office on the first floor and the office door was locked when it was not in use. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can be assured that they will be given every opportunity for personal development and that they will be assisted to maintain their social, emotional and independent-living skills. People who use this service will be encouraged to maintain links with their friends and families and they will be encouraged to have a healthy diet. Evidence: Residents are actively involved in planning their social and recreational activities and the daily menus. Each resident is given the opportunity to participate in the daily living routine, including domestic chores and cookery lessons. Staff assist and encourage each resident in their chosen activities each day. Since registration with us, the provider organisation has employed a full time activity Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: co-ordinator manager to co-ordinate activities for all the homes of the organisation in the area. This encourages residents to integrate with peer groups and in the community through a range of outdoor activity programmes. Residents from Brent Cottage seemed to enjoy visiting their friends in the sister home nearby and vice versa. Residents are encouraged to get involved in activities that are stimulating, therapeutic and educational, such as swimming, football, cookery and social events. One of the residents who has musical talents is encouraged to sing and listen to music of their choice. Relatives are encouraged to visit the residents. Some residents visit their parents at the weekend. Residents are encouraged to assist with food preparation and each resident takes turns to help a member of staff to cook or assist with domestic chores. Residents carry out the weekly shopping accompanied by members of staff. On the day of the site visit, a resident was observed making their favourite pot noodles for breakfast with assistance from a member of staff who ensures that the resident is safe while in the kitchen. A member of staff said that staff make sure that the meals provided are varied, nutritious and balanced so that residents maintain a healthy diet. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be treated with respect and they will receive personal care and support in the way they prefer and require. They are safeguarded by the homes Medication Policy and Procedure although some shortfalls were noted. Evidence: During the site visit it was noted that the two residents present appeared well cared for. Members of staff interacted well with them and seemed to understand their limited verbal communications and gestures. It was noted that staff have been trained to observe residents behavioural changes and to respond appropriately with positive reinforcement and encouragement. Staff have strict instructions and guidelines to follow in the event of any challenging behavioural episodes by a resident. Staff have the support of health care professionals such as the General Practitioner and the Community Psychiatric Team. Health and behavioural concerns are referred to them for immediate assessment. The home liaised with the community psychiatric nurse, speech and language therapist and the social worker who will attend to see a Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: resident when required. One of the residents has had a six monthly review of their care needs recently. Another will shortly have their review. All medicines are stored in the drug cupboard which is also a controlled drug cupboard and this is fixed to the wall in the administrative office. Currently there are no controlled drugs in use. The Medication Administration Record (MAR) Charts were examined and no gaps were found. It was noted, however, that the handwritten notes on the MAR charts were not signed or dated by the author. In order to ensure that medicines are administered safely, and to enable case tracking of written information, it is important that all handwritten notes on the MAR charts are signed and dated. It was further noted that the MAR chart that is currently in use is folded up together with the old MAR charts in a plastic folder. This practice is unsafe as a member of staff may use the wrong MAR chart during the administration of medicines. The Senior Manager has taken note of this issue and has set up a new folder and has reissued new instructions for staff on the safe recording and use of MAR charts to ensure safety and consistency of practice. All staff who administer medication have been appropriately trained. On the day of the site visit, the Senior Manager had pointed out that the supplying pharmacist had made an error in the supply of medicines for one of the residents. The medicines have since been returned to the supplying pharmacist and the correct medicines have been issued. The Senior Manager assured us that the resident had not been affected. It was noted that the management had not retained a copy of the prescription form written by the residents own doctor before the medicines were prescribed. Since the site visit, the Senior Manager has made arrangements for the home to retain copies of all prescription forms before these forms are handed to the supplying pharmacist so that staff are able to check against the supplied medicines when they are delivered to the home to ensure safe handling and correct supply of the prescribed medicines. While the home is without a registered manager since 01/02/2009, the Senior Manager ensures that medicines are handled and administered in accordance with the homes Policy and Procedures, Guidelines from the Royal Pharmaceutical Society and current legislation. Care Homes for Adults (18-65 years) Page 18 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the service has a robust Complaints Policy and Procedure and people can be assured that their complaints will be listened to and that any concerns raised will be investigated and appropriate action will be taken. Evidence: The Senior Manager confirmed that residents and their family are aware of the Complaints Policy and Procedures and any issue raised is dealt with promptly. Since registration with us there have been no complaints or safeguarding issues reported. All members of staff have had training on the protection of the vulnerable, Abuse Awareness and Whistle-Blowing Policy. The home follows the joint agency Safeguarding Procedures of Hertfordshire County Council Adult Care Services. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they live in a homely, comfortable and safe environment. Evidence: The premises are well maintained, clean and comfortable. Residents have access to all the communal facilities. The overall appearance is fresh and attractive. The two residents present on the day of the site visit were happy to show us their bedrooms. They seemed very pleased with their bedrooms, which appeared clean and spacious. The decor and furniture were arranged to suit individual lifestyle and personal preferences. For one resident, there is a therapeutic element included in the choice of colours and the way the window is facing. One of the bedrooms is designed for a resident with autistic spectrum disorder and the bedroom furniture and equipment have been risk assessed to ensure that the occupant is safe in the event of any challenging behavioural episodes. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the home has an effective staff team who will support them and can be confident that they will be safeguarded by the homes robust recruitment policy and procedures. Evidence: The Senior Manager, who is also the Responsible Manager is currently overseeing the service following the departure of the registered manager on 30/01/2009. There are two support workers on duty each shift to assist the three residents and this will be increased to three or more when the number of residents increases to five. The members of staff present during the site visit interacted well with the residents and assisted them accordingly. The homes recruitment policy and procedures were being followed. All workers only commenced work after the Criminal Bureau Record (CRB) checks and the Protection of Vulnerable Adult (POVA) Register checks had been cleared. A number of staff files, including that of a new recruit were examined and the documents seen included training certificates, two references and the CRB certificate. The service has appointed a new home manager who will commence working soon subject to a satisfactory second reference. All the files were kept in a locked cupboard in the administrative Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: office. The management encourages staff to undertake professional development in addition to mandatory training. There is a rolling training programme for all staff, including courses on learning disability, autism, safeguarding, medication and equality and diversity. The Senior Manager is a trained assessor and she ensures that all new staff complete their period of induction. The mandatory training includes Moving and Handling, Fire Safety, First Aid and Food and Hygiene. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the standards of administration and management of the service have been maintained to meet the Statement of Purpose and support residents interests. They can be assured that their health and safety are promoted and protected. Evidence: This is a new service that was registered with us in September 2008. Since 01/02/2009 the home has been without a registered manager. However, the Senior Manager, who is also the Responsible Individual for the service is overseeing the day to day management and administration of the service which are being maintained. A few discrepancies were found in the management and administration of medication and some regulatory recommendations have been made. However it has been confirmed that these have been addressed and met since the inspection. A new home manager has been appointed and will soon commence working at Brent Cottage. The Registration Certificate was on display in the administrative office. In view of the Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: change in management a replacement certificate will be issued by our Registration Team in due course. The service has an annual development plan and the first annual quality assurance and monitoring survey report is not yet due. The Senior Manager ensures that a written questionnaire survey form will be sent to each resident, their families and other stakeholders as part of the quality assurance and quality monitoring system over the next few months. An annual audit report will then be produced. There is a monthly proprietors report in compliance with regulations. All records for the protection of the residents are kept secure and handled in accordance with the Data Protection Act 1998. The servicing records have been well maintained. The provider has updated all its policy and procedures to comply with current legislation and recognised professional standards. The Senior Manager is in the process of updating the Statement of Purpose and the Service User Guide to reflect the change in management. The Annual Quality Assurance Assessment (AQAA) forms issued by the Commission were received on time for this inspection. It provided us with some relevant information. The Senior Manager said that more detailed information will be provided in the next AQAA. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 It is recommended that all handwritten notes on the Medication Administrative Record (MAR) Charts be signed and dated by the author to ensure that medicines are administered safely, and to enable case tracking of written information. It is recommended that the home retain a copy of each prescription form before it is handed to the supplying pharmacy to ensure that the correct medicines are supplied by the pharmacist. 2 20 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!