Inspection on 04/01/07 for College House

This inspection was carried out on 4th January 2007.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

College House 01/10/09

College House 08/07/08

College House 13/07/07

College House 07/10/05

College House 13/12/04

College House 27/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE College House College House 20 College Road Fishponds Bristol BS16 2HN Lead Inspector Ashley Fawthrop Key Unannounced Inspection 09:30 4th January 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service College House Address College House 20 College Road Fishponds Bristol BS16 2HN 0117 9651144 NONE 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) Highcleeve Limited Mr Benoy Kumar Oograh Care Home 21 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (6), Old age, of places not falling within any other category (21) College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 21 persons aged 65 years and over requiring personal care only. The home may at any one time accommodate up to 6 people with mental disorder (not dementia) aged 65 years and over Complete a fire risk assessment and amend the current fire policy to take account of the increase in bed numbers and also the sit tight policy. Assess the dependency levels of service users and, if necessary, increase staffing levels accordingly. 7th October 2005 Date of last inspection Brief Description of the Service: College House is registered to provide accommodation and personal care for older people. It is located in the Fishponds area of Bristol close to the local amenities and shops, Post Office and banks are all in easy walking distance for those who are able to mobilise independently.Each bedroom has been furnished to service users individual choice and 10 of these rooms have ensuite facilities. The dining room and lounge area are on the ground floor and are easily accessible to all service users. This also applies to the conservatory, which looks out onto a very attractive garden with lawns, shrubs and trees. There is a chair lift to aid those less mobile service users to move around the home along with other aids, such as a hoist and rails etc.College House has recently been renovated to include a new extension to accommodate up to 4 people with mental illness. This addition to the building has provided 4 new bedrooms with en-suite facilities and also includes a new lounge and shower room. On the 4th January 2007 the level of fee was levied between £348.00 and £400.00. Additional charges are levied for Hairdressing, chiropody, newspapers and personal toiletries. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out without prior notification and was conducted by one inspector over the course of one day. The inspection started at 9.30am and finished at 4.00pm. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and incidents, the action plan submitted following the previous inspection, and reports from other agencies, i.e., the Fire Officer. This information was used to plan the inspection visit. The inspector case tracked four people using the service. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Pre inspection information was received before the visit was done and on the day of the inspection the manager and staff were open and helpful throughout. The inspection included looking at records such as care plans and reviews of the care for people using the service and other related documents. The inspector also read policies and procedures relating to the protection of vulnerable adults and health and safety. The views of the manager, staff and people using the service were gathered either by face- to- face discussions or by surveys. The inspector fed back his findings to the manager at the end of the inspection. What the service does well: The home is warm, clean, decorated to a good standard and well maintained. The personal needs of individuals appear to be met. Activities are meaningful and where possible individual activities are provided so that people can carry on their hobbies. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 6 The staff receive inductions on employment and training so that they can meet the needs of the people using the service, they were aware of the home’s policies and procedures and were able to explain how they were used. Feedback from people using the service was positive and where concerns were raised these were acted on in a positive manner by the manager. 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. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. The home does provide sufficient information to allow people wishing to use the service to make an informed decision as to whether the home can meet their needs or not. There is insufficient evidence that there is enough information for staff to commence appropriate care from the day of admission, although the information obtained is relevant. EVIDENCE: The statement of purpose and the service users guide are written as one document and was available in the home. There was sufficient detail to allow any one wanting to use the service to make the decision as to whether the home could meet their needs or not. There was some information that could have been misleading: this related to College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 9 offering rehabilitation and providing specialist activities which the home does not. The manager agreed to remove the information and replace it with more appropriate wording. The inspector looked at the pre admission assessment information of four people in the home. Those that had come from hospital or other care placements did have discharge information or existing care plans: this information was used to start the new care plan. This is good practice because staff have the information to allow them to be consistent in delivering the care. The manager informed the inspector that he takes care staff with him when assessing the needs of people before coming into the home, but there was no written evidence with the exception of the initial assessment that was normally dated within the week of admission. Staff should have the information before the admission so they are ready to begin the care from the date of the admission. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 SEE BELOW Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the home. Care plans are not detailed enough to allow staff to provide the care to a high standard. They contain too many technical terms for staff to understand and do not give clear instructions to staff to take appropriate action should problems occur. Risk assessments are inadequate. Other professionals such as GP’s or district nurses said that they were happy with the care provided and said that the level of communication had improved. The home’s medication administration practices are safe. The dignity. Privacy and choice for people using the service appears to be important. People who use the service were seen to enjoy the privacy of their own rooms. …. EVIDENCE: The care plan documents both the physical and if required mental illness in detail, some of the recording is written in medical jargon and when I asked staff what some of these medical terms mean they did not know. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 11 This is not good practice: it makes it difficult for staff to understand how people are affected by their illness if they cannot understand the wording. To assist staff to provide the best care for the person it is most important they understand what their illnesses are, therefore care plans should be written in plain English. While the care plan identifies the person’s problems, there are no instructions on what action to take should a situation arise. This is not good practice: where a risk is identified then there must be clear instructions to staff as to what action to take. These related to risk assessments where nutritional assessments should have been done or where observations of specific incidents should have been monitored. There is information about the person’s activities, social interests and family contacts. This is good practice as there is evidence that the person using the service is seen as a whole and that the service does not concentrate on their disability. Activities are therefore more meaningful and individual. Care plans are reviewed periodically but there is no clear recording of what has changed. On the care plans inspected where a review of the care had taken place the change was often written on the plan where the previous risk had been written. This is not good practice: where care plans are reviewed and changes are made there should be clear recording of what the new risk is or what has improved and if required the care plan needs to be completely updated. When care plans are reviewed there is a statement that says that the person who the plan relates to has agreed to the content. The care plans are not written in a style that the individual would understand as there are too many medical terms used so the plan does not have the feel that it has been written with the involvement of the individual but they have signed it without fully understanding its content. The recording of accidents is inadequate as not enough detail is available. It was agreed with the manger that a pre printed accident recording book be obtained so that all the information that should be recorded is available. The procedures for the ordering, administration and recording of medications were seen to be safe. There is a policy available to staff. The home no longer keeps common remedies. All medications are now prescribed individually; this reduces the risks of mistakes and is safe practice. Staff are given information at induction about how to maintain peoples, College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 12 dignity, privacy and choice. This is good practice because staff understand how important it is that people in care are cared for with respect. There is a preferred name written on the care plan to make sure that people are addressed with respect. There is one shared room and I was informed by the manager that this room is only used as a single room and it is the policy of the home only to use the room as a twin if two people who are married or who are in a relationship are admitted. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. The social needs are seen as important. Visitors are encouraged into the home and community links are maintained. The meals are varied and appear to be nutritional EVIDENCE: Peoples preferred activities and past interests are written in the care plan, this makes sure that socialisation is seen as important. There is evidence that individual pastimes are encouraged as well as the group activities that are offered on a daily basis, these include bingo, listening to music, exercises to music and discussing current affairs from daily papers. There is evidence that the needs of people from other countries and backgrounds are met as well as those who follow different religious practices. This is good practice: the manager and staff have recognised that people are individual and have diverse social needs. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 14 Most of the people said that they enjoyed the activities and some said that they didn’t join in through their own choice or that they preferred their own company. Visitors are made welcome in the home but if they wish to visit after 9.00pm the home should be informed. Visitors are welcome to see their relatives and friends in their own bedrooms or one lounge. This has been done due to some people being disturbed by large numbers of visitors in the lounges. The manager informed me that the new arrangement is to be added to the visitor’s policy. People are encouraged to maintain contact with family and friends in the community. The home also has links with local churches and groups such as the cubs and scouts. The manager said that he encourages the contact between the generations because people in the home enjoy the experience and he feels it gives young people an opportunity to speak to older people and listen to their experiences. The menus change each week over four weeks. There is a choice at each meal with a vegetarian choice on most days. There are fresh vegetables, salad and fruit available though out the week and the diet appears balanced. People said that they enjoyed the meals, they were nice and hot and their preferred foods were available on the menu. Staff with the input of people living in the home plan the menus. The preferred foods of people from other countries are also recognised and made available on an individual basis if desired. Fish and chips are always available on a Friday as everyone enjoys this. I watched how staff assisted people at the mid day meal. The atmosphere was relaxed and unhurried. Staff did not hover over people or rush them. If staff though assistance was needed they asked the person before acting. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the home. The need for a complaints procedure is recognised by the home but people are not protected by the standard of the investigation or the recording. People living in the home are protected by the policies, procedures and training about the Protection of Vulnerable Adults. EVIDENCE: One complaint was investigated by CSCI this year and the outcome was satisfactory. There is a complaints procedure in place that is available to both people using the service and their families and representatives. People spoken to say they knew how to complain and who to complain to in the home. Complaints and complements are kept together which is good because it gives a balanced view of the home performance. On reading recorded complaints I found the system of recording to be poor. I told the manager that when a complaint is made all the information relating to the complaint, the investigation, the outcome and what action had been taken must be recorded. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 16 There are policies and procedures about the Protection of Vulnerable Adults and “Whistle blowing “. All staff have attended training in Adult Protection and those staff I spoke to were able to describe how they would act and who to report suspected instances of abuse. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home. The home provides a well-maintained, safe and comfortable environment and promotes individuality through personalisation of bedrooms. EVIDENCE: The home is clean, bright and tidy. It is in a good state of repair and there is a programme of redecoration. Bedrooms are furnished individually and people moving into the home can furnish their own rooms with furniture and personal possessions making them individual and giving them a feel of ownership. People have the option of do not disturb signs that are attached to all doors and all bedroom doors have locks and keys are available to the room’s occupant. This is good, as it makes sure of privacy. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 18 The lounges and dining rooms are furnished appropriately, There were no offensive odours and staff separate to care staff clean the home. The laundry is fitted with a washer with a sluice facility and a drier and there were cleaning materials and equipment available for cleaning the home. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the home. The home is staffed to a good level. Inductions and training are seen as important although the content of induction needs to be updated. People who use the service are protected by the Recruitment and Selection process. EVIDENCE: The rota in place indicates that three staff, with the manager and ancillary staff are in the home until 6:00 Pm. Staffing levels fall to two staff and the deputy from 6:00 pm. At night one person is awake and two asleep in the premises. There are cleaning staff employed separate from those who provide care. All staff do an induction on starting employment, These are recorded with the dates and signature of the person assessing the new starter’s understanding of the training. The current induction information does not meet the up to date standards. It was agreed with the manager that he would contact “Skills for Care” and update his inductions. His staff would benefit, as the updated training would College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 20 be evidence towards NVQ awards. There are three staff that are qualified at NVQ level 2. Two other staff are undertaking NVQ training at level 2 and one at level 4. Other training includes Mental Health Awareness and Fire safety. The manager informed me that he was having difficulty accessing training at this time but other statutory training was being arranged for later this year. I asked him to inform me in writing when the dates were confirmed. Personal files of staff were inspected: most of the information required was available. On two the application was not there and only one reference was available but these were of staff that had been employed for some time. On looking at the application forms for staff there was no record of past employment. This is not good as the work histories cannot be examined and gaps in employment could not be seen. This could lead to people being put at risk because the manager could not guarantee that any of his staff had been dismissed from any previous employment. It was agreed with the manager that the application forms would be changed to include this information. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the home. Although the home appears to be run in the best interests of the people using the service, the way that the quality of the service is checked needs to be significantly improved. People using the service and staff are protected by the Health and Safety policies and practices and by the financial procedures of the home. EVIDENCE: The manager has professional qualifications that are appropriate for his role, there is evidence that he has undertaken training and continues to be familiar with conditions and illnesses associated with old age. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 22 The home does not deal with any finances: fees are paid by direct debit or cheque directly into the home’s accounts The home does hold some personal allowances for safekeeping. The records were looked at and were found to be accurate. Receipts were available for purchases. There is recorded evidence that the Health and Safety policies and procedures have been updated since the last inspection. Maintenance of the equipment and essential services such as gas and electricity supply are up to date. There is no quality assurance system in place where the views of the people using the service are asked for and taken into account. However, there is evidence that service user meetings take place and their ideas and suggestions are acted upon. This needs to be developed in to a formal system where the views of individuals are sought and where needed action taken in response. The results of these surveys and any action taken in response must then be made available to people using the service to make sure that they have a say in the day to day development of the service. College House DS0000040202.V305429.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 3 College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15(1) Requirement The service user must be consulted on the content of the care plan so that they have their views on their care recorded. Where risks are identified there should be clear instructions to staff what action they should take should an incident occur Details of the action to be taken by staff when a risk has been identified must be recorded. Accidents records must be recorded using an appropriate records book and written in such a way that all the required information is available The registered provider must ensure that all complaints are investigated and the outcome recorded in detail. The application for employment must include a work history. The registered person must develop a system where the views of people using the service and their representatives are recorded and taken into consideration as the service develops. DS0000040202.V305429.R01.S.doc Timescale for action 30/06/07 2 OP8 15(1) 30/06/07 3 4 OP8 OP8 Schedule 3(m) Schedule 3(j) 31/05/07 31/03/07 5 OP16 22(3) 31/03/07 6 7 OP29 OP33 19(1)(a) 24(3) 31/05/07 30/06/07 College House Version 5.2 Page 25 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 Refer to Standard OP7 Good Practice Recommendations The recording in the care plan should be written in plain English so that staff can understand the medical terms. College House DS0000040202.V305429.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 College House DS0000040202.V305429.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!