Inspection on 22/01/08 for Brynsworthy

This inspection was carried out on 22nd January 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brynsworthy 19/10/06

Brynsworthy 07/11/05

Brynsworthy 29/06/05

Brynsworthy 22/02/05

Brynsworthy 01/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Brynsworthy Brynsworthy Higher Woodway Road Teignmouth Devon TQ14 8RB Lead Inspector Judy Hill Unannounced Inspection 22 & 23 January 2008 10:30a nd rd Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 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 Brynsworthy DS0000059603.V349334.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 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. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brynsworthy Address Brynsworthy Higher Woodway Road Teignmouth Devon TQ14 8RB 01626 779364 01626 779364 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) Atlas Healthcare South West Ltd Karen Farrelly Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 4 people who have a Learning Disability aged between 18 and 65 may be accommodated at any one time. 19th October 2006 Date of last inspection Brief Description of the Service: Brynsworthy is registered to provide accommodation and care for a maximum of four people with learning disabilities who are under 65 years of age. The home specialises in providing a service for people with complex needs and who can display challenging behaviour. Brynsworthy is located in a residential area of Teignmouth. It is approximately one mile from the town centre and sea front. A public bus service runs close to the home. Information about the service is available from the service provider in a Statement of Purpose and a Service Users’ Guides. Copies of inspection reports can be obtained from the home and are also available on the CSCI Website. The fees are calculated according to the individual needs of the service users and currently range from £1,077.60 to £3,164.18 per week. The fees cover the costs of accommodation, board and care. The fees do not cover items of a personal nature, including toiletries, clothing and meals out. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and was carried out by one inspector over two half days. The information contained in this report was gained in conversation with the people living at the home, the registered manager, the staff on duty and operations manager. Additional information was gained from an Annual Quality Assurance Assessment (AQAA) that had been completed by the registered manager, surveys completed by relatives of all four of the people who use the service, the Service Users’ Guide and the homes Statement of Purpose. Resident’s records, including needs and risk assessments, care plans and reviews and staff recruitment records were inspected during a site visit to the home. What the service does well: The individual needs and risk assessments carried out by the manager and staff are comprehensive and well documented. These are used to draw up detailed care plans and risk management strategies, which are regularly reviewed to reflect the changing needs of the people who use the service. The people who use the service are actively encouraged to express their individual needs and choices and to play an active role in planning the care and support they need. The people who live at Brynsworthy are given the help and encouragement they need to enable them to develop their life skills and autonomy. The social, recreational and occupational needs of the service users are included in their assessments and care planning. Opportunities for social activities are provided and continued family contact is supported and encouraged. The service users health care is monitored and timely referrals are made to the primary and secondary health care services as and when necessary. The principles of respect, dignity and privacy are clearly understood by the manager and staff and put into practice. The home has a written complaints procedure and this is included in the Statement of Purpose and Service Users Guides. Staff training, policies and procedures are in place to protect the service users from the threat of abuse. Each of the service users has their own bedroom with en-suite bath or shower facilities. There is a shared lounge, dining room, kitchen, laundry room and gardens. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 6 The home is kept clean, hygienic and well maintained. Safe recruitment practices are used to ensure that unsuitable staff are not employed to work with the residents. The staff receive appropriate training, supervision and support and the staff seen and spoken with during the inspection were very committed to the people who use the service and happy in their work. Although the quality of the service deteriorated following the transfer of the former manager, the new manager has successfully brought the quality of care provided back up to a high standard. She is very positive, highly motivated and committed to enabling the people who use the service to develop their potential. Regular monthly audits are carried out to ensure that the home is safely maintained and that the service is meeting the National Minimum Standards and regulations. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 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 Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. Prospective residents can be confident that their individual needs will be comprehensively assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes Statement of Purpose and Service Users’ Guide were both updated in September 2007 and copies of both documents have been sent to the Commission. The Statement of Purpose was seen to be clearly written and comprehensive. It does, however, need to be amended because the details included about the Registered Provider are incorrect. The registered service provider is Atlas Healthcare South West Ltd and not Active Care Partnerships Ltd. Copies of the Service Users’ Guides were seen in the resident’s files. This is a well-written document that provides good information about the service provided. The possibility of producing a version of the Service Users’ Guide in a format that is suitable for the people who use the service was discussed with the registered manager. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 9 No new residents had been admitted since the last inspection. At that time care management assessments had been obtained for the current residents and the physical, social, cultural and emotional well-being were included in their individual needs assessments and an inspection of the assessments for all four of the current service users demonstrated that detailed in house assessments were being carried out. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. Individuals are involved in making decisions about their lives and play an active role in planning the care and support they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Detailed care plans have been developed from the service users individual needs assessments and these were seen in their case files. The care plans seen were relevant and comprehensive and included risk assessments and risk management strategies. Regular formal reviews of the residents needs are carried out and evidence was seen of input from specialists in the fields of behaviours that challenge services, including the local Social Service/NHS support team and a private consultant on autism. This was seen to supplement informal reviews and good communication and teamwork between the manager and staff. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 11 During the inspection it was evident in conversations with the registered manager and staff and through verbal and non-verbal communication with the people who use the service that a considerable amount of work has been done to enable the people who use the service to make decisions about their lives. This has been achieved by improving the communications skills of the staff and by providing active support to enable the people who use the service to have greater control of their daily lives. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. People who use the service are able to make choices about their lifestyle and supported to develop their life skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the people who use the service have complex needs and can display behaviour that challenges. This currently limits their ability to access external social, occupational and recreational support services, but provides them with a goal that may be achievable in the future. The people who use the service are encouraged to lead active social lives and evidence was seen to show that three of the four people using the service receive the support they need from the staff to enable them to go out on a regular basis and engaging in activities that they enjoy. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 13 The Commission sent surveys to the closest relatives of each of the people who use the service and all of them responded. Three of the relatives commented on the deterioration of the service following the transfer of the former manager and the high staff turnover that followed that event, however, recognition was given to the improvements to the service following the appointment of the current manager. Family contact is recognised by the registered manager and staff as being very important to the people who use the service and every effort, including the provision of transport, is made to encourage and facilitate visits. The registered manager said that she had considered holding group meetings for relatives but had found that individual meetings were more productive. It was observed that the people who use the service have become more involved in carrying out duties around their home. During the last inspection the kitchen and laundry facilities were kept locked and out of bounds to the people who live at the home but this is no longer the case and the people are encouraged to make themselves hot drinks and snacks and to assist with meal preparation. The main meal of the day is served in the evening and one of the people who use the service said that she and another resident helped to plan the menu. Although the evening meal is a set meal alternatives will be offered if requested. The people who use the service have a choice of meals for breakfast and tea. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. The health and personal care that the people who use the service receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The personal care needs of the people who live at the home are met flexibly and according to their wishes and assessed needs. Brynsworthy does not provide nursing care but records demonstrated that the staff monitor the resident’s mental and physical health and make referrals to the professional health and social care services as and when necessary. The external support provided for the people who live at the home includes support from the Community Learning Disability Team, a private specialist in autism, local GP’s, the District Nursing Service, NHS Dentists and Opticians, Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 15 including an domiciliary optician service that provides a specialised service for people with learning disabilities. The medication is stored in a locked cupboard that is fixed to the wall in the laundry room. None of the people using the service users are on controlled medication. An inspection of the medication administration record sheets was carried out and these were seen to be clear and up to date. The staff who administer the medicines have received training to do so safely and have access to information about the medication they are administering, including what the medication is used for and possible side effects to be aware of. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. The concerns of the people who use the service will be taken seriously and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The written complaints procedure is included in the Statement of Purpose and Service Users’ Guides and displayed in the kitchen. The procedure is also available in picture format. At the last inspection the Complaints Procedure had also been available in audio form but this is no longer the case. Some of the feedback in questionnaires received from relatives of the people who use the service suggests that they were concerned about the quality of care provided following the transfer of the previously registered manager and prior to the appointment of the current manager. However, no complaints had been made since the last inspection. The Commission has received correspondence from a local counsellor about noise. This appears to relate to complaints made by neighbours over a year ago, which were dealt with appropriately at the time. Records and conversations with the staff on duty confirmed that most of them had received Safeguarding (POVA) training and that arrangements were being Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 17 made for new staff to receive this. The Annual Quality Assurance Assessment completed by the registered manager stated that policies and procedures were in place to protect the residents from the threat of abuse and the staff interviewed confirmed that they were aware of how to access the relevant policies and procedures. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. The people who use the service benefit from living in a clean, comfortable and well maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Brynsworthy is a detached house set in its own grounds on the outskirts of Teignmouth. The town centre and beach are approximately one mile away and there is a local convenience store close by. The home has a car for the residents use and one of the residents has her own car. A tour of the premises was carried out. Each of the residents has his or her own bedroom with en-suite bathroom or shower facilities. There is a shared lounge, dining room, kitchen and laundry room. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 19 On previous inspections the kitchen and laundry facilities have always been kept locked but these are now unlocked and accessible to the people who live at the home. This positive move enables the people who live at the home to play a more active role in the domestic aspects of their care, such as receiving assistance to do their own laundry and making snacks and drinks. The home is currently being redecorated throughout and new furniture has been purchased. Since the last inspection the garage has been converted into a self-contained annex and registration has been granted to enable an additional person to be accommodated. Tentative plans are being made to enable one of the current residents to move into the annex. The home was seen to be clean and hygienic throughout. Because of behavioural issues parts of the home are a little bare but the staff are aware of this and are trying, to introduce suitable ornaments and soft furnishings. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. The care staff are positive and committed to providing good quality care for the people that live at the home and to ensuring that they are given opportunities to develop their independence and life skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In addition to the registered manager, there is a deputy manager, three senior support workers and five support workers and two waking night support workers. The registered manager said that she normally had four staff on duty during the day and the rotas seen confirm this. Each of the people living at the home needs a lot of individual attention and it is the practice of the home to provide one-to-one support for each of the residents when they are at home during the day. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 21 The registered manager said that one to one support is also appropriate for each of the residents when they go out. This means that they are able to go out with an escort whenever they wish to do so without leaving the home short staffed. It was observed that the staff continue to work excessively long shifts. This was discussed with the staff on duty who confirmed that they had the option of working shorted shifts and one of the staff spoken to did so, but the rest said that the preferred to work long shifts and did not get overtired. The records of recruitment for the most recently employed staff member were inspected and safe practices were used to ensure that she was suitable to work with vulnerable people. An application form had been completed and references had been taken up. CRB and POVA First checks had been carried out. Evidence was seen that new staff are provided with induction training. The registered manager said that all of the staff had done or were doing an National Vocational Qualification in Care at Level 2. Two of the staff interviewed said that they had completed their National Vocational Qualification at Level 2 in Care and one said that she was currently working towards gaining this qualification. The provision of training was discussed with three of the staff. All three confirmed that training is given a high priority, that they have attended essential training courses in health and safety related areas, that regular updates were provided as and when necessary and that they are being given access to specialist training in the field of learning disabilities. Staff meetings are held and minutes taken. Arrangements are in place for the staff to receive regular one to one supervision and informal supervision is provided on a daily basis. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. The recently registered manager has made an excellent start and demonstrated her committed to improving the quality of life for the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is Karen Farrelly. Karen has a National Qualification in Care at Level 4, a Registered Managers Award and a Btec in Social Care and sixteen years experience in care management. Karen was a finalist in the National Care Awards 2007 Caring Times Special Needs Management and in the Southern Cross Manager of the Year Awards 2007. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 23 Karen was registered as manager since December 2007. She has an exceptionally positive approach to the management of the service and this has clearly been transferred to the staff spoken with who were all very positive about the changes that she had introduced, the impact that this had had on the people who use the service and on staff morale. Regular monthly monitoring visits are being carried out on behalf of the registered service providers and copies of reports are forwarded to the Commission. The registered manager completes a detailed monthly audit that covers all aspects of the service provided and the premises. The views of the staff, residents and relatives are sought through regular meetings, including staff handover meetings, one to one supervision with staff, one to one meetings with relatives and daily contact with the people who use the service. The premises are well maintained and evidence was seen to demonstrate that regular safety checks and services are being carried out. Policies and procedures are kept at the home and accessible to staff regarding safe working practices and this is underpinned through regular training. Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 24 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 2 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 4 X Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 25 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. 1 Standard OP1 Regulation 4(1)c Requirement The registered service providers must ensure that the name and address of the company that is the registered service provider is included in the Statement of Purpose. Timescale for action 25/03/08 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 Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Brynsworthy DS0000059603.V349334.R01.S.doc Version 5.2 Page 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!