Inspection on 10/01/06 for Broadstreet House

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 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

Broadstreet House 16/02/09

Broadstreet House 21/02/07

Broadstreet House 30/08/05

Broadstreet House 18/01/05

Broadstreet House 22/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Broadstreet House Broadstreet House Broad Street Lyminge Folkestone Kent CT18 8DZ Lead Inspector Lisbeth Scoones Unannounced Inspection 10th January 2006 09:40 Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 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 Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 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 Adults 18-65. 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. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Broadstreet House Address 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) Broadstreet House Broad Street Lyminge Folkestone Kent CT18 8DZ 01303 862448 Family Investment (Three) Limited Ms Michelle Ann Christie Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th August 2005 Brief Description of the Service: Broadstreet House, a part Georgian, part Victorian building, is an attractive family home, which provides supervision and support for 16 residents, over the age of 19, with learning disabilities. It is a large detached property set in extensive well-maintained gardens on the perimeters of the village of Lyminge, near Folkestone. In the main house, accommodation is provided on two floors. The stable block provides ground floor accommodation. All rooms are single, six of which have en-suite facilities. The home is owned by the Family Investment (Three) Limited and each residents family has a share interest in the property of the home. Prior to admission, the family purchases this share. Families play an active role in the conduct of and care provided in the home. The residents are encouraged to lead as independent a life as possible and take part in a range of meaningful activities; these include assisting in the garden and in the house. Garden activities comprise maintaining the lawn, growing plants, flowers and vegetables for own use as well as for sale, chopping and packing up logs. A road sign says, logs for sale. Work in the Day (Fifth Trust Work) Centre, Elham Valley Vineyards, the teashop and pottery provides a focus to and forms an integral and significant part of the lives of the residents. More than 50 adults attend Family Investment Day Care Services, some live in Family Investment Homes, others in the community. The home provides attractive, homely, family accommodation. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3 hours and comprised conversations with the four residents at home that day, the manager and two other members of staff. Records were examined, a partial tour of the house undertaken and a residents’ room visited. A coffee break was shared with the residents and staff in the kitchen. The inspector did not meet with any of the directors on this occasion. What the service does well: What has improved since the last inspection? The existing hot and cold water system has been renewed resulting in a reliable supply of hot water for the residents. Thermostatically controlled valves to the hot water taps have been supplied as well as radiator covers. This has been a major and expensive project. It was noted that adult protection training is included for all staff on the stafftraining plan for 2006. (This was outstanding at the previous inspection) The manager and administrator are making progress with in the auditing of staff and training files. (This was outstanding at the previous inspection) Supervision notes seen indicate that the process of formal supervision has been re-commenced. (This was identified at the previous inspection) Following a recent visit by the fire officer, a freestanding fire extinguisher, identified at the previous inspection as possibly posing a risk, has been removed. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 6 The requirement/recommendation made by the EHO in respect of hazard analysis and recording of temperatures have been acted upon and additional staff training identified on the training programme. 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. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 The Service User Guide, when completed, will provide existing and future residents and their families with comprehensive information about the services provided. New residents would only be admitted following a full assessment and trial stay at the home. EVIDENCE: There has not been an opportunity for the inspector to meet with the director and the manager to discuss the draft Service User Guide presented to the inspector for comment at the previous inspection. The guide provides comprehensive information but could expand on staff training. It was recommended that the Service User Guide be made available in a format user friendly for the residents. This was discussed with the manager and a pictorial version suggested. The manager agreed with the suggestion but also said that an effective way of ensuring that residents are aware of the content of the guide would be from staff’s regular verbal reminders. No new residents have been admitted since the previous inspection but the admission process, discussed at previous inspections, is comprehensive and robust. A resident said she had a trial stay before she decided to become a permanent resident. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Residents’ needs and progress of care needs are reflected in their individual plan, which is regularly reviewed. Records of achievements are maintained but further attention is needed in respect of “goal setting”. Residents are assisted and supported to make decisions about their lives within a risk assessment framework. EVIDENCE: Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 10 The inspector viewed a sample of care records, which include an assessment of need and plan of care based on the activities of daily living. It covers risk assessment, achievements and a medication profile. It includes a page for significant events, which might trigger a care plan review and day services assessments and progress reports relating to their participation in activities such as pottery, craft, design, media (reading and writing skills) and art. Noted in care records were attainment/goal sheets, which identify tasks residents are striving to achieve. At this inspection it was noted that some of these are blank or incomplete. See also standard 11. This issue was discussed with the manager who said that this would receive her attention as part of care plan review. Care records are regularly reviewed and updated. Records for monthly care plan reviews are maintained. Regular formal reviews are also undertaken with the home and the care manager, residents and their next of kin. Both day and night staff maintain a detailed daily log. It was observed that staff encourage the residents in making decisions and enable them to take responsible risks. Contributions from each individual resident are valued. All are encouraged to take an active role in the running of the household and the sharing of domestic chores. Two young people were cleaning their room; one resident was helping in the kitchen. At regular meetings and at meal times, residents’ views about life in the home are discussed and plans made. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 15, 17 Residents have opportunities for personal development and take part in a range of activities. Residents are supported to maintain family contact and develop appropriate friendships inside and outside the home 15 Residents are offered a healthy, varied diet and enjoy their meals. EVIDENCE: Residents are given many opportunities to maintain and develop social and emotional communication. Independent living skills are encouraged with discreet and sensitive staff support. Birthdays are celebrated and parties organised. The residents have a structured working week, which includes participation during four days a week in a variety of activities either at the vineyard at Elham Valley or the day centre at Barham. Individual programmes are designed for them, which take into account personal preferences and abilities. The programme offers woodwork, art and craft, Media studies and IT, working Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 12 in the grounds and with animals, horticulture and growing plants, creative design, music and drama, pottery, assistance with wine production, working in the teashop and cooking for fun. At the previous inspection it was reported that three residents have achieved NVQ 1 in catering and are working towards NVQ 2. Staff assist residents in developing individual interests and maintaining social contacts as well as the planning of holidays, social activities for the evenings and weekends. Residents spoke enthusiastically about a forthcoming holiday to a holiday camp in Somerset and visit to the Edinburgh Tattoo. In consultation with the residents, interesting holidays are organised. At the time of the inspection, the planning for 2006 was underway. The home has a minibus and a people carrier. There is an impressive programme of activities. In addition to shopping and visits to the local library service, trips to the cinema, meals out, bowling alley, table tennis and swimming sessions, Kent County Show, pubs and leisure centres are organised. Residents attend concerts, pubs, and events organised in the local community. Service uses may attend local churches or meet with the local reverend. The Friends of Broadstreet House organise fund raising events and contribute to the cost of holidays. Residents’ families play an important and regular part in all aspects of residents’ lives. Although not discussed at this inspection, the home has a policy on sexuality, which provides guidance when residents develop intimate personal relationships. Residents and staff have coffee and tea breaks and eat together in the pleasantly furnished, colourful dining room or outside when the weather is good. The inspector was invited to join the residents and staff for a coffee break. As on previous occasions, this was pleasant and unhurried with lots of talking and laughing. A member of the care staff has taken over the kitchen duties with considerable assistance from the residents. One resident said she works in the kitchen every other Tuesday. An initiative to start a residents’ folder for achievements in the kitchen was discussed. Nutritious, varied and balanced meals are provided. Lunch was homemade pizza and salad. A choice is provided both for main meals and desserts. Four meals a day are provided including a supper at 20.30. Many vegetables used are home grown and in the summer the gardens produce asparagus, runner beans, marrows, strawberries and other soft fruits. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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, 19, 20 Residents receive personal support and their physical and emotional health care needs are met. The medication at the home is well managed promoting good health. EVIDENCE: It is evident that staff know the residents very well and give flexible support based on individual’s preferences. Residents wear clothes of their choice and their appearance reflects their personality. Residents’ dignity and privacy are respected and independence and control over their lives promoted. All residents are registered with a local GP. They all completed an inoculation programme re Tetanus, Hepatitis B and flu vaccination. They have regular appointments with a dentist, chiropodist and optician. On the day of the inspection, 2 residents had medical appointments. One resident was anxious about the appointment and was skilfully reassured by the manager. The advice of a dietician is available when necessary. Opportunities are given to attend well-woman and well-man clinics. Monthly weight records were seen. Medication charts were examined and well maintained. Residents’ care plans contain a medication profile. Some medication requires regular blood tests and these are organised. Staff are provided with medication training. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Residents feel confident that their views are listened to and acted upon. Residents are protected from abuse by adult protection training should be provided more frequently. EVIDENCE: The home’s complaint procedure makes reference to the CSCI. No complaints have been received since the last inspection. Staff are very sensitive to any issue of discontent and these are dealt with immediately. There is an adult protection procedure and whistle blowing policy. At the previous inspection, it was recommended that regular update adult protection training sessions be provided. It was noted on the 2006 training plan that POVA issues are included for all staff. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28, 30 Residents live in a homely, comfortable, well-maintained, clean and hygienic environment. Communal spaces are pleasantly furnished, homely and spacious EVIDENCE: The home provides comfortable, homely, colourful accommodation, which is safe and well maintained. Broadstreet House is a listed building and some of the repairs and maintenance work needed may therefore be costly and upgrading plans may be difficult to action. A new boiler has recently been installed in the stable block resulting in a now constant supply with hot water. A resident said how much he enjoyed hot showers. A resident’s room has new flooring. A member of staff has the responsibility to undertake regular health and safety audits which would identify necessary repairs and need for decoration. Regulation 26 reports provide a monthly update of maintenance work planned and undertaken. The recent report identifies the need for redecoration of the lounge and some of the residents’ bedrooms. Some of this work has already been undertaken. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 16 There are two comfortably furnished lounges and a cosy dining area attached to the kitchen where residents and staff all eat together. The large garden is well maintained and provide with tables, benches and a new shed. The home provides bedroom furniture and fittings but many service users have brought in their own according the individual taste. A resident showed the inspector her room, which was light, warm, well furnished and decorated. One side of the “stable block” has been provided with a nurse call system. The standard of cleanliness is good. Residents are encouraged, with support, to maintain their own rooms and shared living spaces and do their own washing and ironing. The home has a policy on infection control and staff training is provided. There is a suitable laundry facility. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35, 36 Residents are cared for by qualified, competent people who are well trained. Staff are supervised and, despite of staff shortages, a formal supervision programme has been commenced. EVIDENCE: In addition to the manager, there is a part-time administrator, gardening and maintenance staff. Two members of staff cover the morning and two the afternoon shift. Staff accompany residents on outings and placements in the vineyards, shops and day centre. At night there is a waking and sleeping member of staff. On the day of the inspection, the cook and deputy manager were ill. A senior carer took over the catering duties and the manager was “hands on”. Residents praised the manager and the staff. There is a stable workforce but the home has had difficulty in recruiting staff to fill the current vacancy. The recruitment drive continues and permanent staff have been flexible and taken on additional duties. The manager praised the existing staff for providing cover by doing extra shifts. See also standard 37. Following the departure of the cook, a carer with an affinity for cooking has taken over this role. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 18 Staff have delegated responsibilities as e.g. care records review, medication, financial records, fire alarm and fire fighting equipment checks, fire drills, first aid and health and safety. The manager and all staff organise, plan and take part in social and leisure activities and events. No member of staff is currently undertaking induction training. The new induction standards launched by “Skills for Care” were discussed. The manager said she would review the induction training. The home is committed to NVQ training. Three members of staff have NVQ level 3 and four have just completed NVQ 2. The manager is the designated training organiser for Family Investment Limited. She has administrative assistance to ensure that the training matrix is up to date. In addition to statutory training, see standard 42, staff are provide with opportunities for specialist training. A copy of the programme for 2006 was seen. A recently audited staff file was examined and contained all required documentation. The manager said that, following a previous recommendation, all files are audited to ensure completion of all records and up to date evidence of training. Despite pressures on her time, the manager has re-introduced formal staff supervision starting with an appraisal. This would include a training profile and programme for the current year. The manager said that she is always available for practical help and a listening ear. Due to the current staff shortage, the manager regularly works as a member of the care team and in that capacity supervises her staff informally. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Residents live in a well-run and well-managed home. Good monitoring systems ensure that care is reviewed and residents’ views are sought. Residents’ health and safety is promoted and protected. EVIDENCE: Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 20 Residents and staff said they like the manager who is approachable and has an open, positive and inclusive style of management. One resident said, “ because of Shelley the place is so nice”. Another, “ you can’t have another Shelley.” The manager has been running the home since it opened in 1995. She has a wide range of experience in caring for people with learing difficulties and has a management qualification. She is supported by the area manager and two senior support workers who act as deputies. In 2002, the home achieved the Investors in People Award status, which demonstrates the commitment of the staff and high standards of services and facilities. The inspector receives monthly reports written by one of the Directors of Family Investment Limited. These provide comprehensive information about staffing and residents’ issues, the buildings, maintenance work and health and safety. The manager and staff know the residents and their families extremely well. Regular meetings take place, chaired by the residents. There are monthly management meetings. Handovers are another opportunity to share information between staff. The home provides a safe environment and undertakes risk assessments in respect of safe working practices. The Environmental Health officer’s requirement and recommendation in respect of hazard analysis and record keeping have been acted upon. All statutory training is provided including health and safety, moving and handling, food hygiene and fire safety. All staff have a first aid qualification. The manager is the home’s moving and handling trainer. Accident records are maintained and these were examined. Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 3 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 x 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 3 12 4 13 x 14 x 15 3 16 x 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 4 3 x x 3 x Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 22 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Broadstreet House DS0000023348.V276790.R01.S.doc Version 5.1 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!