Inspection on 25/10/05 for Cedar Gardens

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cedar Gardens 30/01/09

Cedar Gardens 16/01/08

Cedar Gardens 05/02/07

Cedar Gardens 15/03/06

Cedar Gardens 11/02/05

Cedar Gardens 04/10/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Cedar Gardens 122a Bromyard Road St John`s Worcester Worcestershire WR2 5DJ Lead Inspector P Wells Unannounced Inspection 25th October & 23rd November 2005 03:30 Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 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 Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cedar Gardens Address 122a Bromyard Road St John`s Worcester Worcestershire WR2 5DJ 01905 421358 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Nigel Hooper Mrs Carole Ann Green Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th February 2005 Brief Description of the Service: The home is a large detached house on the west side of Worcester. Locally there are shops, a pub and a bus route into Worcester city. There are four single bedrooms and one double bedroom with suitable communal rooms. The service users have mild to moderate learning disabilities, who require advice and support rather than assistance with personal care. Mr Nigel Hooper is the registered provider. The registered manager is Mrs Carole Green. The main purpose of the home is to provide a permanent, homely environment encouraging service users to be involved in household tasks. Mr Hooper also operates a second care home next door and supported living accommodation in the area. The staffing for the supported living houses are on the Cedar Gardens roster. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was planning to carry out a routine, unannounced inspection on the afternoon of Wednesday, 25th October 2005 but there was no one in at the house. Hence she visited the sister home next door and later the manager of Cedar Gardens joined the meeting. As the paperwork was similar in both homes, the managers explained it to the inspector together. Also for this inspection, time was spent preparing - reading the previous report and pre inspection questionnaire. An inspection was carried out at Cedar Gardens on the early evening of 23rd November 2005. As this was the inspector’s first visit to this home, the focus was to get to know the service. Two hours were spent at the home meeting with the service users, the staff on duty, observing the evening routine and reading documentation. The inspector appreciated the co-operation and time of the service users, staff and manager. What the service does well: The service provides a permanent, secure, safe home for up to six adults. It is homely with a relaxed, friendly atmosphere. The service users are supported by a staff group that know their individual needs. Many of the staff have worked at the home for some years. The service users have the opportunity to attend regular activities out of the home, either as a group or individually. The service users all spoke positively about living at the home, the activities, the support from staff and the holiday. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 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 Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 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): EVIDENCE: These standard were not assessed on this occasion because there had been no new admissions for the last two years. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 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): 6,9 Service user plans and risk assessments were in place but needed reviewing and updating. The service users were encouraged and supported to lead independent lifestyles. EVIDENCE: Service user files with life plans were in place for the six service users. The inspector was shown a sample of two plans. The plans viewed gave useful information about each service user. There was a separate record indicating reviews had taken place. However reviews were not always up to date and the plans had not been updated to reflect the changes in an individual’s situation. Brief daily logs were kept of activities that the service users attended out of the home. Risk assessments had been completed for the majority of service users, room by room, and for activities taking place in that room – for example using the kettle in the kitchen. The assessments varied in content and often gave a description of the situation or the room rather than just focusing on the identified risks. One risk assessment viewed was to the point and appropriate. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 10 There was a risk assessment in place for a service user that has been assessed as able to be left in the house alone. However this risk assessment, and others had not been regularly reviewed. The majority of service users are fairly able and staff advised that none suffered with epilepsy or challenging behaviour. The managers considered that advice given by inspectors on risk assessing differed, although this was not apparent to the new inspector. The senior staff would benefit from training in risk assessing and how this relates to service user’s care/support plans. The service users’ files retained by the staff were full and need reviewing so that it easy to access current information. Consideration should be given to the service user retaining their own plans or at least having a copy. Health matters were referred to in the plans and have been commented upon on pages 14 & 15. It was apparent through observations and discussions with the staff and service users that the service users’ individual needs, abilities and choices were well known and met. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 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): 12,13,15,16,17 The individual lifestyles of the service users were respected and independence encouraged for some service users. A variety of activities took place out of the home on a regular basis. The service users were provided with a varied diet and prepared drinks and snacks for themselves. EVIDENCE: It was evident from speaking with service users, staff, the manager, reading service user files that these standards were met. Individual lifestyles and personal development of the service users was respected and promoted by the manager and staff. For example the service users spoke enthusiastically about their day placements and regular leisure activities. On the evening of the visit the service users were having a night in watching television, pursuing their own interests and chatting. Service users spoke of the summer holiday at Butlins and one service user showed the inspector a collection of photos of previous holidays and outings. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 12 Service users indicated that they keep in contact with friends and families who can visit them. Three went home regularly to their family homes at week-ends. The home has a vehicle for taking service users out and to day placements. Also some of the service users walked to local places and used buses. The home had a set routine yet respected the individual lifestyles. There were bedroom door locks fitted but service users did not have keys to their rooms nor the front door. The main meal was prepared by staff and served soon after the service users returned from day placements. On the evening of the visit, home-made lasagne and garlic bread had been served. The member of staff on duty led on the catering arrangements – arranged the shopping, planned the menus, with healthy eating in mind, and arranged cooking sessions with some of the service users. The likes and dislikes of the service users were known to her so the main meal was planned accordingly and the menus available. She explained that the meal for the next evening is prepared by staff the night before so that when they come on duty at 4.00 pm the meal can quickly be cooked. Deserts in the week were fresh fruit or a tinned desert from the stock cupboard. The vegetables for the next day had already been prepared. Hence, with this routine, the service users were not involved in planning, preparing and cooking their meals. The service users did prepare their own packed lunches and made drinks whenever they wished. There was a large bowl of fresh fruit in the lounge for the service users to help themselves, also a biscuit barrel in the kitchen. The service users spoke positively about the food and some took pride in making drinks for themselves and visitors. The service users also enjoyed eating out. Consideration could be given to involving the service users more in the shopping, planning and preparation of meals; particularly on the days when individuals are at home. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 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 The service users receive appropriate support with their individual personal and healthcare needs. EVIDENCE: The personal and health care needs of service users were monitored and documented for the service users in their plans. At this visit the service users were well, physically and emotionally. The service users were able to mange their own personal care with prompts from staff. There were two male staff to support the male service users. It was evident that service users were supported with any health problems that arose and medical advice sought. A record of health care appointments was kept for the service users. Service users were weighed from time to time and a record kept of this but the purpose was unclear and not referred to in service users’ plans. A review should take place to confirm which service users (for health reasons) need to be weighed on a regular basis and how this will be recorded in their plans and monitored. Senior staff were about to attend a training session on introducing health care action plans with the service users. This proposal is welcomed. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 14 The medication system was not fully inspected on this occasion and will be viewed by the pharmacist inspector soon. However the following was noted: A monitored dosage system was in use. The managers had arranged medication training themselves in-house for staff which was commendable. However all staff who administer medication need to be trained by a qualified person such as a pharmacist or attend a recognized course. The community pharmacist could be asked to run in-house sessions. There should be a list with sample signatures for the staff who are designated to administer medicines to service users (previous recommendation). Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 15 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): EVIDENCE: These standards were not assessed on this occasion except to follow up on the previous recommendations relating to training for the staff in abuse awareness and the arrangements for the service users’ monies. The manager advised that these matters still needed addressing. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 16 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 The premises are suitable for their purpose. The location of the house is convenient to local services and facilities. The house is homely, clean and appropriately furnished. There is adequate communal space for the number of service users. The home needs a programme for decorating and refurbishment with the kitchen as a priority. Some of the fire doors need attention and two aspects relating to hygiene should be improved. EVIDENCE: This care home is situated on a main road on the west side of Worcester. There are shops nearby as well as a pub and bus route. The large, two storey, detached house is suitable for the number of service users. On the ground floor there is a lounge, kitchen/diner, laundry. Also bathing, toilet facilities and one single bedroom. On the second floor there are three single and one double bedrooms, staff sleep-in room, bathing and toilet facilities. The house was homely and safe. However some areas of the home needed attention with regard repairs, decoration and refurbishment. The inspector was advised that the kitchen was due to be redecorated and this needed to be done. The dining chairs were stained and needed replacing, the stair carpet Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 17 was fraying on one of the steps and some parts of the home would benefit from redecorating. Also the cooker needed cleaning. The home has its own front and rear gardens. Some of the service users showed the inspector around the home and their bedrooms, which were suitably furnished and personalized. Since the last inspection the fire doors have been fitted with intumescent strips and fire brushes (previous requirement). A few of the doors were now not closing properly and needed adjusting. Hand towel dispensers had not been fitted in the toilets and bathrooms, as previously recommended. A used, wet towel was observed on a washbasin in a toilet and indicated that this recommendation should be implemented. It was noted that the kitchen did have a dishwasher, but it was not routinely used which would be more hygienic. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 18 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): 33,35 There is an experienced staff team at the home, with skills and experience relative to the work they are doing, which ensures that the needs of service users living at the home are effectively met. The staffing arrangements for the home during the weekdays needs to be reviewed. EVIDENCE: The home has rotas, which indicated the home is staffed early morning, overnight and from 4.00pm. At weekends it is staffed throughout Saturday and Sunday. The support workers covered catering, laundry, cleaning and maintenance as well as looking after the service users. Also on the home’s rota was staff cover for the three supported living houses in the St John’s area. The rota indicated that there were two staff on duty when service users were at home. On the evening of this visit there was one member of staff on duty with all the service users at home. The second member of staff was finishing off a task in one of the supported living houses and then returned to Cedar Gardens. The member of staff at Cedar Gardens was experienced and competent and felt able to look after the service users. The staffing levels were lower than previously reported. There had been no changes in the staff group since the last inspection in February 2005. During weekdays the house is closed and when service users are not attending day placements, they are expected to stay at the sister home, Phoenix House. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 19 This arrangement needs reviewing so that service users have the choice of spending weekdays in their own home, in particular now that the service users do not all have day placements for five weekdays. At night there is one member of staff sleeping-in. The staff were committed to their jobs, supporting service users and further training. Both staff on duty were undertaking NVQ’s in care. One other member of staff had an NVQ level 3 in care. The provider needs to ensure more staff undertake NVQ’s in care, level 2 or above, so that the home achieve a minimum 50 of staff having an NVQ in care. This level should have be met by 31.12.05. Some staff were said to have to pay for their training and there was no incentive for completing a NVQ qualification such as financial enhancement or promotion. Consideration could be given to this to encourage staff to train and remain working for the organisation. The staff advised that they had received training in infection control, health and safety. Recent training in administration of medication was not recalled. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 20 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): 37,39,42 The home has established management arrangements. A quality assurance system should be introduced and aspects of safe working practices developed. EVIDENCE: The registered manager has worked at the home for some years. She commenced on the manager’s course in January 2005 and has passed one unit. A quality assurance programme has yet to be introduced by the provider (previous requirement). The standard on Safe Working Practices is wide ranging and a sample were considered with the following noted: The home had a variety of risk assessments for the premises and vehicles, which were suitable but needed to be kept up to date and developed. Training Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 21 for senior staff in risk assessing and risk management has already been commented upon in this report on page 11. The cleaning products had not been risk assessed and were kept in an open cupboard in the kitchen. However the member of staff on duty considered there was no risk to service users. Nevertheless this practice should be evidenced in a risk assessment and monitored – for example when a new product is introduced, a new service user is admitted or if there is a change in the level of understanding for any of the existing service users. Staff on duty had received up to date training in some safe working practices – infection control, health and safety. Staff still need courses on abuse awareness, medication, food hygiene, health and safety led by qualified/professional and trainers. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 2 X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cedar Gardens Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 2 X X X X X X DS0000018639.V261728.R01.S.doc Version 5.0 Page 23 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. 1 Standard YA6 Regulation 15 Requirement Each service user must have an up to date plan indicating their lifestyle, goals, personal and health care needs. All risk assessments carried out in respect of service users’ activities must be reviewed (timescale of 31/03/05 partially met) All staff must receive up dated medication training from a qualified person or accredited trainer. (timescale of 31/05/05 partially met) The fire doors must be adjusted to close properly. The home must have a programme, with timescales, for redecorating and refurbishment with the kitchen as a prioity. A copy to be submitted to CSCI A quality asurance sysytem must be introduced in accordance with the requirements of regulation 24 and Standard 39/. (timescale of 31/05/05 not met) All staff must receive training in safe working practices - abuse awareness, medication, food hygiene, health and safety. DS0000018639.V261728.R01.S.doc Timescale for action 31/01/06 2 YA9 13,15 31/01/06 3 YA20 13 31/01/06 4 5 YA24 YA24 23,13 23 16/12/05 31/01/06 6 YA39 24 28/02/06 7 YA42 13,18 31/01/06 Cedar Gardens Version 5.0 Page 24 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 4 5 6 7 8 9 10 Refer to Standard YA9 YA16 YA19 YA20 YA23 YA10 YA30 YA30 YA33 YA35 Good Practice Recommendations Senior staff would benefit from training in risk assessing and care planning Service users should be given keys to their bedrooms and the front door unless it is assessed and recorded that there is a risk. The arrangements for weighing service users should be reviewed. Staff, who are designated to give out medication, should provide a sample signature on record. Two signatures should be sought for financial transactions of service users money. Statements on confidentiality should be given to partner agencies. Paper towels should be provided in toilets, bathrooms and laundry. Consideration should be given to using the dishwasher. The house should be staffed when service users are not attending day placements during the week. Staff should be encouraged to undertake NVQ’s in care so the home meets the recommended 50 of staff having an NVQ in care, level 2 or above. Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Cedar Gardens DS0000018639.V261728.R01.S.doc Version 5.0 Page 26 - 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!