Inspection on 16/10/07 for Brooklyn

This inspection was carried out on 16th October 2007.

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 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

Brooklyn 02/09/09

Brooklyn 07/11/06

Brooklyn 21/02/06

Brooklyn 13/06/05

Brooklyn 02/12/04

Brooklyn 20/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Brooklyn 22-24 Nelson Road Clacton on Sea Essex CO15 1LU Lead Inspector Sara Naylor-Wild Key Unannounced Inspection 16th October 2007 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 Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brooklyn Address 22-24 Nelson Road Clacton on Sea Essex CO15 1LU 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) 01255 430324 01255 688370 Mrs Eileen Theresa Morley Mrs Eileen Theresa Morley Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 16 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 16 persons) The total number of service users accommodated in the home must not exceed 16 persons The registered person shall ensure that a continuing programme of development is provided for managers and staff in relation to dementia care and good practice equivalent to the recommendations of the Alzheimer’s Society The registered person shall keep under review the environmental provision to meet the assessed needs of service users with dementia in relation to good practice guidance 7th November 2006 5. Date of last inspection Brief Description of the Service: Brooklyn is a converted premises, which is in walking distance of Clacton seafront, and local amenities. Mrs Morley is the registered owner and Manager of the home. The home provides accommodation for 16 residents on two levels. Communal space is made up of two lounges and a dining room. Twelve of the fourteen bedrooms are single and all but one room have en suite facilities. Residents have access to a passenger lift. The home is well maintained throughout and there is a small garden area to the back of the premises. Parking can be found to the front of the home. The range of fees charged by the service are between £367.15 and £450.03 per week. There are additional charges for hairdressing, chiropody and staff and some activities. The provider provided this information to the Commission in September 2006. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key inspection was carried out on 16th October 2007. The evidence contained in this report was gathered from discussions with managers and staff, a visit to the home, observation of residents’ interaction and information contained in the Annual Quality Assurance Assessment (AQAA) provided to the Commission for Social Care Inspection (CSCI). The inspector was assisted through out the inspection by the deputy manager. Feedback on the findings was given to them during the visit with opportunity for discussion or clarification. The inspector would like to thank the staff and residents for their help throughout the inspection process. What the service does well: What has improved since the last inspection? The ongoing development of the service includes updated assessment and care planning documents, development f staff skills through specialist training in dementia care mapping, development of the senior staff roles to support leadership in areas such as care planning, activities and supervision. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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 Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that the service understands their strengths, needs and aspirations before the move into the home. EVIDENCE: The AQAA provided to the CSCI by the proprietor, gave details of the services admission process. This stated “prospective residents are visited in their own environment by members of the management team prior to their moving into the home in order to carry out an assessment of their needs. It also stated that initial visits by the prospective resident and their family prior to any decisions made regarding admission is encouraged. The service explained to the resident and their families the contract or terms and conditions and a signed copy is given to the resident. Families are included in the admission Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 9 procedure and supported. A key worker is appointed and care plans are drawn up with consultation from resident and family.” The files of residents who had been recently admitted to the home provided evidence that supported the proprietor’s statements. They contained an initial assessment tick list as well as a more detailed assessment book. The book contained a full assessment, information in respect of the individual’s life history and preferences as well as personal information, assessments for falls, nutrition, and mobility. The document provided a very detailed collection of information about each resident and it was obvious that in completing this work staff were being directed to consider the individual in a person centred way from the outset. There was evidence of both resident and their supporters’ involvement in the process and they are asked to sign off the document when it is completed if they are happy with the information. At the front section of the assessments was a statement in respect of the use of cot sides. This stated that the individual signed to give permission to use cot sides in advance of any requirement for the equipment. It is unclear as to why this is necessary in advance of any identified need and a risk assessment in respect of falls from bed. The proprietors stated that information about the service is provided to prospective residents in the form of our Service User Guide. This documents sets out how the service operates and items such as the complaints policy and a copy of the resident’s contracts or terms and conditions. The service does not provide intermediate care. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they will be consulted on how their abilities, needs and aspirations are supported, and this will be documented. EVIDENCE: The care planning document had been updated from the previous inspection visit with greater detail in relation to individual residents abilities. This is evident in the descriptions of the support required by each resident with one example stating under the heading of personal care that the resident “can wash their own face and hands with support” rather than a blanket statement of “needs help with personal care”. In another example a resident’s dental care was set out in detail rather than “maintain oral health care”. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 11 The deputy manager and two staff have attended a dementia care-mapping course and they felt this had opened up their thinking to the way information is gathered and provided in care plans. They want to review the plans with more information about the behaviour and emotional needs residents have in each area of their life. The care plans seen and the developments proposed will provide an excellent level of care planning, and give a greater dimension to the staffs understanding of the residents in their care. The daily records completed by staff report on the numbered sections of the care plan only if there has been something that is significant in the day. Therefore not all aspects of the plan are included on a daily basis. The entries seen at the inspection were in the main a short statement of an event and in most cases they do not identify the individual and so state “1. Good diet and fluid, 2. Continent bowels open x 2 and 3. Chatty with staff”. This appears to undermine the person centred approach the service is aiming to achieve in other parts of the care planning documentation and was discussed with the deputy manager at the inspection. During the inspection the senior staff handover took place. This was held in the front lounge of the home with two residents present throughout the discussion of all the residents’ health and wellbeing from the morning shift. The content of the handover was of the physical wellbeing tasks with no highlight of any activities residents may have participated in during the day. When asked the Senior Carer who had been on duty in the morning recalled that two residents had taken part in an art activity, but acknowledged that this was not highlighted in the records handover. The staff were also asked if they normally conducted handover in front of residents. The inspector was told that sometimes they find somewhere quiet but not always. The failure to maintain the confidentiality of residents was discussed with those staff present. Care Plans contained risk assessment sheets that identified areas in which there may be risk and equipment provided. However the form did not provide a full detailed risk assessment that states how the service decided that for example crash mats were the most suitable equipment for prevention of falls from bed. The service’s medication management was good with well-maintained records that provided good detail of medication administered from dosset box and loose packets. A log of all medication received and returned to the pharmacist is held. At the time of the inspection only three members of staff were responsible for administration of medication and all had received training to do so. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The majority of residents can be assured that they will be provided with a range of activities to suit their preferences. Further development is required to ensure all staff understands how to provide opportunities for residents to participate in activity. EVIDENCE: At the previous inspection an activities coordinator had been appointed and had begun to develop the activities on offer and how this met individual residents abilities and preferences. An audit of staff time was maintained and a suggested list of individual preferences was being collated. However at this inspection this work had been terminated and the Care plans sampled during the inspection did not identify activities in any detail. In one instance the care plan for a resident stated to encourage and support them to take part in activities. However their initial assessment only identifies that they like reading and watching TV. Although the resident may be limited in their Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 13 preferences the lack of information about what kind of books they read or their preferred TV programme does not encourage staff to engage in this aspect of their care and provide the level of support that would benefit the resident. The Deputy Manager reports that staff do use activities such as drawing, washing up and folding washing, with residents but there are only a few residents who participate in these and others choose to do nothing. The deputy also stated that the activities coordinator was attending a course run by the Alzheimer’s Society aimed at activities and working with residents with dementia. Further discussions were held with the Deputy manager in respect of how staff involve residents in when caring out their daily routine and the need to highlight this in records. The visitors policy remains unchanged from previous inspections and visitors were seen to come and go throughout the inspection visit. The care plans included details of the resident’s family and friends and what their preferred visiting arrangements. The meals are provided to a menu based on residents known preferences. The observation of mealtime indicated that residents were not asked if they were happy with the meal on offer and a choice was not offered by staff although the deputy manager reports that choices are offered at teatime as there is a wider choice of sandwiches cakes and biscuits. The deputy manager identified an initiative to use photographs of meals and use these to offer choice to residents. This and other ways of supporting choice were discussed with the deputy manager. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they will be listened to and that their concerns will be actioned. Residents can be assured that they are protected from abuse by the staffs understanding of safeguarding adults. EVIDENCE: The service’s complaints policy is unchanged from previous visits and fulfils the requirement of the National Minimum Standard (NMS) in that it contains reference to the processes, timescales and the opportunity to alert the CSCI to concerns. The managers stated that plans to implement a dementia care mapping survey to provide opportunities for staff to understand how residents with dementia respond to the service had not been implemented at the time of the inspection. However three further staff had just undertaken the training and this would support this in the near future. The POVA policy and procedure is unchanged and meets the expectations of the NMS and the local guidance. Staff have received regularly updated POVA training as part of their annual training plan. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from an environment that meets their needs and provides a homely and welcoming place to live. EVIDENCE: The premises are maintained in a general state of good repair, following decoration of the communal areas last year, replacement flooring is planned as part of a large scale building works that are planned to give additional communal space. The issues noted in the previous inspection in respect of the layout of rooms had been addressed in the intervening period and the furnishings have been rearranged to provide a safer environment. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 16 The home has a large dog living at the premises that residents enjoy petting and talking to. At this inspection a second dog of the same breed was also at the home and observations of the residents and the dogs moving around the home indicated some possible issues with risk that should be considered in a risk assessment. Observations included the dogs inadvertently obstructing residents who would not be able to instruct them to move, and a member of staff who was supporting a resident being pawed and unable to move the resident. Overall there were no noticeable odours in the home, although an area near the upstairs manager’s office did have a musty smell. There are adequate hygiene precautions practiced by staff and infection control training is provided. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be cared for by a group of staff who are supported and trained to meet their needs. EVIDENCE: On the day of the inspection the staffing numbers were made up of three care staff in the morning in and afternoon shift with a cook and housekeeper supporting them. These numbers included the person in control of the shift. Discussions with the staff on duty indicated that at the time of the inspection staff time was under pressure from the demands of settling a newly admitted resident into the home. This was not reflected in a change of staffing arrangements in the rota and the deputy was not aware if the calculations of staff time had been made. However the AQAA submitted prior to the inspection states that staffing numbers are calculated using the residential forum calculation, which is based on the assessed needs of residents living at the home. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 18 The service’s standards in staff recruitment were assessed through the review of a sample of staff files. This demonstrated a thorough and robust recruitment procedure was followed that supported the protection of residents from abuse. New staff are all taken through an induction programme that is based on the standards set by Skills for Care. This charts staffs progress through a competency based test of learnt skills and development of individuals’ abilities to work independently. The manager reports through the AQAA that the staff turnover the service has experienced in recent months has affected the numbers of staff holding an NVQ qualification with a drop from 90 of staff to 75 . However the training programme for the coming year includes plans to address this. The training matrix used by the service to understand what training staff have undertaken and when they may need reviewing is updated and was looked at as part of the inspection. Training undertaken included nutrition, moving and handling, fire safety and health and safety. These elements of core training were not present in some of the newest staff’s profile. A number of training initiatives in understanding dementia care are provided in the service with three staff gaining the dementia care mapping qualification. The Activities coordinator is attending an activities course with Alzheimer’s society in London and the newest staff are booked to undertake the Certificate in Dementia Care at Otley College. Staff spoken with said that they are impressed by the fact that the service invests so much in training for them and is interested in increasing their skills. They felt that this was far and above the opportunities provided by other employers. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and stakeholders can be assured that a competent manager who listens to their views. They can be confident that they will be consulted, but cannot be assured that their views are progressed. EVIDENCE: The service is owned and managed by Mrs Eileen Morley, a qualified nurse who has many years experience in care settings. Mrs Morley takes her responsibilities as a provider of a care service very seriously and continues to demonstrate a high level of commitment to both the residents and the staff Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 20 team in improving the service and enhancing the standards service users experience. There continues to be a happy and friendly atmosphere in the home, which both residents and staff enjoy. The quality assurance programme had not been developed since the last inspection and the proposed dementia care mapping exercise expected to add to the information gathered from residents had not been fully audited at the time of the visit, although when carried out it would provide insight into residents assessment of wellbeing. The Deputy Manager confirmed that the home does not manage any finances on behalf of residents. Evidence of staff supervision was seen in samples of staff files and a consistent approach was being undertaken to this. Either the manager or deputy manager supervises staff and those spoken with felt this was a useful support to their practice and development. The service has carried out a quality assurance audit with questionnaires being sent to stakeholders such as resident’s relatives. Although the results of these had been collated into a final percentage for each question and answer choice, there was not a report to accompany the survey outcomes. This would ensure stakeholders understand how the service plans to implement the changes required to improve the quality of service that stakeholders have identified. The plans for a dementia care mapping exercise would support the quality assurance system, and ensure that the views of residents with cognitive disabilities are heard and included in the service’s development. Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X N/A 3 X 3 Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 1. 2. 3. Refer to Standard OP10 OP12 OP14 OP19 Good Practice Recommendations Information about residents should be handled in a confidential manner that protects their dignity. Staff skills in engaging residents in occupation should be developed to encourage their confidence in supporting residents to participate in their daily lives. Residents enjoyment of pets owned by the home should be supported by risk assessments that assist the service to understand if risks are presented and how they will support the residents to engage with animals in a safe manner. Stakeholders should know that their comments provided through the quality assurance process have been heard and be able through a published report be able to understand what the service plans to do to address these. 4. OP33 Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 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 © 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 Brooklyn DS0000017784.V353857.R01.S.doc Version 5.2 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!