Inspection on 06/03/07 for Chaldon Mead

This inspection was carried out on 6th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Chaldon Mead 10/10/07

Chaldon Mead 24/11/05

Chaldon Mead 16/06/05

Chaldon Mead 07/12/04

Chaldon Mead 11/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Chaldon Mead 50 Rook Lane Chaldon Surrey CR3 5AB Lead Inspector Mavis Clahar Unannounced Inspection 6th March 2007 Chaldon Mead DS0000013590.V330013.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 Chaldon Mead DS0000013590.V330013.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. Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chaldon Mead Address 50 Rook Lane Chaldon Surrey CR3 5AB 01883 383820 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) Surrey and Borders Partnership NHS Trust Ms Mary Bergin Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (7) of places Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: Chaldon Mead is a detached property located in the village of Chaldon. Accommodation and care is provided for up to sixteen service users with learning disabilities. Service users benefit from a day care centre, which is situated next to the home. All bedrooms are single. There are adequate communal areas including a quiet room. There is a large enclosed garden to the rear of the property backing onto a golf course. The home has its own transport for service users and there is ample car parking space to the front of the property. The weekly fee at this home is £917.38. Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit, which forms part of the first key inspection to be undertaken by the Commission for Social Care Inspection, (CSCI) was undertaken by Mrs Mavis Clahar on the 6th March 2007 and lasted for five hours; commencing at 10:15 hours and concluding at 15:15 hours. The first part of the inspection was spent talking to the service users who were waiting to be seen by the community opticians visiting the home. This was followed by discussion with the senior support worker, who informed the inspector that the registered manager was on maternity leave; (CSCI was notified) and that the deputy manager was on her day off. The change to the inspection processes under inspecting for better lives CSCI has implemented was explained. An outline of how this visit would be conducted was discussed and agreed. The second part of the visit was spent reviewing service users care notes, which were up to date and sampling selected policies and procedures. The information contained in this report is gathered mainly from service users notes and records kept by the home, from direct observation by the inspector, along with discussions with care workers present on the day of the visit. Further information was obtained from service users’ returned pre inspection questionnaires along with relatives and visiting professionals returned pre inspection questionnaires. The direct views and opinions of the service users are not included in this report as due to their mental health it was not possible to get answers to questions asked of them A tour of the home and gardens was conducted. Each service user bedroom is personalised by the service user to suit their likes and tastes. It was noted that all service users bedrooms were particularly clean and tidy, their clothing neatly folded and stored. Generally the home is clean and tidy. The final part of the visit was spent giving feedback to the senior support worker about the findings of the visit. No requirement was made on this visit. The inspector would like to thank all the service users, relatives and visiting professionals who completed the questionnaire; service user and staff who spent time speaking with the inspector. What the service does well: Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 6 The home continues to provide a good service to the service users living at the home. Contact with family and friends are encouraged and service users are able to entertain their visitors in the privacy of their bedroom if they so wish. The registered manager complies with given requirements under the Care Homes Regulations 2001 within the given timescales. The documentation of individual care plans is easy to read, gives the reader a full picture of the services users likes and dislikes, communication needs and risk assessments and care needs. The questionnaires returned to CSCI by service users, relatives and visiting professionals revealed the high level of care and support offered to service users. The home has demonstrated that the care needs of the current service users living at the home are well catered for and met. Observations of care staff interaction with service user indicated that service users are treated with dignity and respect. It was also observed that great care was taken in respect of the service users personal belongings and standard of cleanliness in bedrooms ensured service users lived in a wellmaintained environment. The home has demonstrated its capability to cater for service users from ethnic minority whose assessed needs are identified, documented and met. The home does not have an Equality and Diversity policy, but they do have an equal opportunities policy, which they use in selecting inducting and preparing carers from overseas to work within the British culture. The senior support worker said the manager had a good grasp of Equality and Diversity and that she uses it in her daily work with the staff and service users. What has improved since the last inspection? What they could do better: Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 7 The home continues to provide service users with a safe and homely environment. 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. Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 8 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 Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 9 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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are not made until a full needs assessment has been undertaken to ensure the home can meet the needs of the service user. The assessment is conducted professionally and sensitively and involves the service user and their family or representative where appropriate, and the psychologist, and the occupational therapist. Where the assessment is undertaken by social services, the home obtains a copy and a copy of the care plans also. EVIDENCE: Review of service users files demonstrated that the home has established a good process of assessing service users needs. This has been enhanced by the joint development of service users care plans with service users. The assessment contains the documented evidence of the psychiatrist, psychologist and occupational therapist. The home uses the Person centred approach to care, and this is documented using the “widget” method, which is a method of communication suitable for persons with learning disabilities. It was noted that no two service users assessment of needs were identical. The senior support worker said the service users are more involved in their assessment and so are able to make decision with support about their care and leisure pursuits. Chaldon Mead DS0000013590.V330013.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): 679 Quality in this outcome area is, good. This judgement has been made using available evidence including a visit to this service. Service users are involved in the review of their care, and agreed changes are documented in their care plans, thereby ensuring all care workers have access to this new information. The home encourages service users to make decisions about their daily lives, and to take risks as part of their independent lifestyles, with assistance from the key worker when necessary. EVIDENCE: Random review of service users files demonstrated that service users assessed needs are documented in the care plans and the evaluations demonstrated that changing needs are recorded. How much the service users are currently aware of this was hard to ascertain as only one service user was present during the visit and he nodded to every question asked. It is obvious from the information contained in the care plan that the service users were involved in Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 11 assessing their changing needs, and achieving their personal goal. One service user expressed a wish to become fitter and this service user was being supported in achieving their goal. Care workers spoken to say the assessment of needs is carried out over a period of time and that the service users and their families are very involved. It was apparent that service users made decisions about their lives. The inspector was shown the home’s computer which, service users are encouraged and supported to use to document their changing needs using the widget form of communication. The home’s documentation on service users’ choices is based on Respect, Independence, Community participation and Community presence. In discussion with care workers the inspector was told service users are involved in the care of their home. The inspector observed one service user vacuuming the hall on her arrival at the home. They have a weekly menuplanning meeting followed by food shopping which involves the service users. Some service users are encouraged to do their own laundry with the support of their key worker Chaldon Mead DS0000013590.V330013.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. This judgement has been made using available evidence including a visit to this service. The service has a strong commitment to enabling service users to develop their skills, including social, emotional, cultural communication and independent living skills. Service users are encouraged and supported to identify their goals, and aspirations and work to achieve them Service users are able to make choices in accordance with their abilities and are provided with balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The observed relationship between care workers and service user was relaxed and friendly creating a warm and friendly homely feeling. Service users are encouraged to live a full life and to partake in age related activities such as going to the pub, having meals out attending day centres, shopping, the ladies regularly attends the nails bar to have their manicure done: and going to the cinema. Their religious beliefs are acknowledged and encouraged. Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 13 Review of service users records and in discussion with care workers it was documented that Service users are encouraged to make friends outside of the home and to keep in touch with their friends and families as they wish. Service users are enabled to entertain their guest in the privacy of their bedroom if they so wish. The Senior support worker said the home is run on the basis that it is a family home where each member is allocated tasks within their capabilities and sometimes tasks are allocated that will stretch the service user, who is always supported and enabled by their key worker and service users achievements are always acknowledged. The care workers aided by the service users provide catering service for all at the home. The inspector did not sample the mid-day meal but the service user said it was delicious, and the amount was right. Today the midday meal was sandwiches as there were so many visitors to the home. Along with the CSCI inspector were the Opticians, the Aroma therapist; the district nurse, and visitors from the wheelchair company. The inspector noted a good amount of dry, frozen and fresh food in the home. Service users were observed making drinks as they wish with assistance from their key worker. Chaldon Mead DS0000013590.V330013.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. This judgement has been made using available evidence including a visit to this service. Carers understand the principles of giving personal care and support and are responsive to varied and individual requirements of the service users. They recognise that the delivery of personal care is highly flexible, consistent and reliable ensuring that service users receive personal care and support in the way they prefer; and that their emotional and health needs are met. None of the service users at this home are assessed as capable to selfadminister their medication. Medication is administered by staff trained to do so, thereby being protected by the home’s policies and procedures on administration of medication EVIDENCE: Discussions with Senior support worker and care workers and review of care plans indicated each service user received the agreed personal care and support as directed in the care plans. Physical and emotional needs identified in the care plans are also met. The care plans are reviewed on a regular basis, visits to the doctor dentist, and dietician are carried out on an as required Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 15 basis. Daily care notes are documented dated and signed by the key worker or other care worker as necessary. Review of randomly selected service user files revealed that no service user at the home is risk assessed as capable to self-administer their medication. A review of the medication records demonstrated that medication is being administered within the home’s policy and guidelines of administration of medicines. Chaldon Mead DS0000013590.V330013.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. This judgement has been made using available evidence including a visit to this service. The home operates in a manner that supports service users to air their views and concerns, which are acted upon before they can become complaints. Robust safeguarding policies are in place to protect the service users from abuse neglect and self-harm. EVIDENCE: CSCI Eashing office has not received any complaints about this home since the last inspection. Included in the service users information pack kept in their bedroom is the homes’ complaints policy and service users’ guide, developed in pictorial and widget symbol format. The senior support worker informed the inspector that issues raised by service users are dealt with instantly before they can become complaints. Random sample of care workers files and in discussion with care workers it was evidenced that care workers are being trained to recognise and report any act or suspicion of abuse to service users. The senior support worker supported this by the production of the staff training records. Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. The physical layout of the home enables service users to live in a safe, wellmaintained and comfortable environment, which encourages independence. EVIDENCE: The home has a well-maintained environment, and service users are encouraged and enabled to personalise their bedrooms. Service users bedrooms were clean and tidy. It was apparent that great care was being taken of service users personal clothing and possessions, which were all in excellent order and condition. The home presents as a safe place to live with bedrooms that meet the needs of the service users. The management has a good infection control policy: they seek advice from external specialists, e.g. infection control, and encourage their own staff to work to the home’s policy and procedures to reduce the risks of infection. It was noted during discussions with care workers that they attend regular training sessions on Health and Safety issues. The training records presented Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 18 for review substantiated this. Care workers spoken to were knowledgeable about suitable storage and disposal of waste. The home presents as comfortable with attractive gardens which is easily accessible to service users. Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care workers in the home are trained, skilled and in sufficient numbers to support the service users who live at the home, and to support the smooth running of the home. The homes’ recruitment policy and the training given to care workers ensure suitably selected and qualified staff meets service users needs. EVIDENCE: Review of service users care plans indicated their named key worker supports service users. In discussions with care workers they indicated the manager encourages and enables carers to undertake external qualifications beyond the basic requirements to enable staff to assist the service users achieve the agreed care and social needs. Reviewing of service users files could not support this statement, as there was no access to the files in the registered manager and deputy manager’s absence. In discussion with the senior support worker and care workers, it was revealed that staff training is high on the agenda for the home. Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 20 Review of the staff rota indicated that adequate numbers/skill mix of care workers are on duty over any twenty-four hour period to meet the needs of the service users. Two carers cover night duty. In discussion with care workers it was verified that the home provided training and regular updates for them. The home has a good recruitment policy and procedure, based on their equal opportunities policy that has the needs of the service users at its core, however it was not possible to evidence if this is being adhered to, as there was no access to staff files in the absence of both registered manager and deputy manager. It was noted that all members of staff were recorded as having had an application to the Criminal Record Bureau (CRB). Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 21 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. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems to ensure service users views are obtained and acted upon. The manager ensures that care workers follow the policies and procedures to maintain the health, safety and welfare of the service users EVIDENCE: The home has a manager registered with Commission for Social Care Inspectorate, who is a registered nurse with many years experience in caring for and managing care needs of people with a learning disability. Currently, the manager is on maternity leave, but in discussion with care workers and the Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 22 senior support worker it was evidenced that the manager displays a strong ethos of being open and transparent in all aspects of the running of the home. The manager is service user focused and leads and supports a strong staff team who have been recruited and trained to a high standard, as evidenced in discussion with care workers. It was difficult to measure how confident service users were that their views underpin all self-monitoring, review and development by the home. Documented evidence from service users/care workers meetings was available for review. Although all service users were present on the day of the visit none was able to answer questions asked by the inspector. The inspector observed that service users were relaxed in the company of care workers and although the service users were not communicating with each other, they would smile at the care workers and at the inspector during attempts at conversation. The senior support worker informed the inspector that service users and care workers opinions were listened to and acted upon. Service users are encouraged and supported to make choices even when these choices might involve some degree of risks, for which appropriate risk assessment is completed. Each service user is registered with the local GP practice, which they access as required, plus the GP visits the home every Monday. Chiropody service and dental service is also accessed as required. Service users have access to the wider primary health care services and the senior support worker said the manager is aware of whom to contact if the need arises. The manager ensures that at all times the health, welfare and safety of the service user and care staff are promoted and protected by having suitable numbers of trained care workers on duty at all times to meet the assessed needs of the service users as evidenced by the duty rota Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 23 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 X 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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 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 3 X Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Chaldon Mead DS0000013590.V330013.R01.S.doc Version 5.2 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!