Inspection on 10/08/06 for Cornerways

This inspection was carried out on 10th August 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cornerways 19/12/09

Cornerways 19/06/09

Cornerways 22/06/07

Cornerways 16/01/06

Cornerways 25/07/05

Cornerways 22/02/05

Cornerways 17/08/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Cornerways Church Lane Kings Worthy Winchester Hampshire SO23 7QS Lead Inspector Mr Roy Bega Unannounced Inspection 10th August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cornerways DS0000040361.V304241.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. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornerways Address Church Lane Kings Worthy Winchester Hampshire SO23 7QS 01962 882060 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) Hampshire County Council Mrs Hazel F Hiskett Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Old age, registration, with number not falling within any other category (40) of places Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2006 Brief Description of the Service: Cornerways is a registered care home providing personal support and accommodation for up to forty older people. Hampshire County Council owns the home, the manager is Mrs Hazel Hiskett. The home is divided into four units, which comprise of ten single bedrooms, a communal lounge, dining room and kitchenette. Both units on the ground floor accommodate residents who require dementia care. The two remaining units on the first floor accommodate physically frail older people. The home surrounds a courtyard garden. Attached to the home is a purpose built day centre which residents attend if they wish, this is not registered or inspected by the Commission. The home is situated in the quiet village of Kingsworthy, three miles away from Winchester. A small local shop is within walking distance from the home. Current weekly fees are £392 to 434 with additional costs being made for hairdressing, newspapers, chiropody and sundries. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is an assessment of how the National Minimum Key Standards for Care Homes for older persons were being met at the time of the inspection This inspection site visit took place over one day, 10 August 2006, between 9-30 a.m. and 5 p.m. a total of seven and a half hours. Opportunity was taken to look around the home, view records and policies and talk with, residents, staff and relatives. One of the two requirements raised resulting from the previous inspection has been assessed as being met. The inspector was told the refurbishment of the bathroom in unit two is to commence Monday 14 August A further requirement has been raised resulting from this inspection visit. What the service does well: What has improved since the last inspection? What they could do better: Due to current staffing levels there are concerns regarding the ability of staff to deliver residents assessed personal care and health needs in accordance with written care plans. Ensure staffing levels are sustained to meet the number and needs of residents. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 6 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. Cornerways DS0000040361.V304241.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 Cornerways DS0000040361.V304241.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): 3. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. Prospective residents and their representatives have the information they need to make an informed choice with regards to moving into the home EVIDENCE: An informative and well-presented welcome pack for the home was seen. Residents and relatives spoken with stated they were fully involved in the assessment process and found the packs very useful. Comments were made to the inspector to the effect, “Management and staff were so kind and helpful before, during and after the move”, “We had a lot of information given to us about the home” and “We had opportunities to and did visit the home before making a decision”. A sample of two detailed pre admission assessments were seen. Staff spoken with informed the inspector that they are made aware of prospective new service users and their needs prior to them moving into the home. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 9 An individual member of staff is allocated to a new resident to give them information and special attention to help them feel comfortable in their surroundings. Staff indicated that they find this very helpful in getting to know the resident better and it assists them to adjust to new surroundings and a new way of life. Residents and relatives spoken with commented that having a “link” member of staff is very helpful as a point of contact to help in adjusting to new surroundings and way of life. Cornerways DS0000040361.V304241.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. Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. The health and personal care, which a resident receives is based on their individual needs. Due to current staffing levels however, there are concerns regarding the ability of staff to deliver residents assessed personal care and health needs in accordance with written care plans. The home works to an effective medication policy supported by procedures and practice guidance. The principles of respect, dignity and privacy are put into practice. EVIDENCE: A sample of 4 care plans that covered all aspects of residents assessed needs and wishes were seen. They included detailed information with regards to personal health needs, daily, evening and bathing routines and wishes. For example – What time they liked to get up, what they like to do during the day, news papers read, the preferred temperature of bathing water and brand of toiletries. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 11 Observations, discussions and available training records indicated that staff have the skills and experience to deliver care effectively. Staff were observed to inform residents what they were going to do with regards to care before carrying it out. Residents spoken with informed the inspector that staff are very kind when they are not feeling too well. However due to staffing levels the availability of to ensure the care needs of residents (See also the section on Staffing of this report.) The need to respect residents’ privacy and dignity when delivering health and personal care is a key principle of the home’s aims and objectives. Staff spoken with are aware that this applies to all areas of residents lives. Staff were observed ensuring residents privacy and dignity were maintained. Comments received from residents and relatives included – “ Staff are very helpful”, “They are so kind”, “Staff work really hard”, Staff promote residents rights of access to the health and remedial services that they need, both within the home and in the community. Regular appointments are seen as important and there are systems in place to make sure residents to ensure appointments are not missed. Records show that the home arranges for health professionals to visit residents as required. Records also show that staff keep regular check on health aids, making sure they are working effectively and that each resident has the necessary aids to improve their quality of life. Residents spoken with informed the inspector that staff are very kind when they are not feeling too well and if asked or think it necessary will contact their doctor. Due to current staffing levels however, there are concerns regarding the ability of staff to deliver residents assessed personal care and health needs in accordance with written care plans. For example, residents were sat at the breakfast table at 12 noon. The inspector alerted staff to the needs of residents sat in the lounge who had become incontinent of faeces. (See also the section on Staffing of this report.) Medication within the home is administered primarily through a monitored dosage system. The inspector was informed that if any resident wished to administer medication they would be supported to do so as per the home’s policy and procedures. Evidence was seen that staff who administer medication have completed appropriate training. Records seen were well maintained and up to date. Procedures for medication to be taken as required were in place. The staff member who assisted the inspector with the auditing of this standard also was able to demonstrate an understanding of the medication currently being used and appropriate storage. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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 area is good. This judgement has been made using available evidence including a visit to the service. Residents’ benefit from social, cultural and recreational activities that meet their expectations. Residents receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: Information and discussion indicated that residents are involved in making decisions in respect of recreational/entertainment activities in the home. One resident confidently told the inspector that whilst others had enjoyed the previous evening’s singing duo she had not. She continued by saying that generally however, activities provided are good and staff do their utmost to arrange things that have been requested. For example, bar-b-cue’s, and outings. Other residents spoken with echoed this second comment. Information with regards to visiting entertainers was distributed on notice boards around the home. During the day relatives/friends visited and took residents out. The home is included in the heritage and recreation programme that provides funding for activities including arts and crafts for which a room has been set aside. Staff spoken with made reference to not being able to spend as much time with residents on a one to one basis as they would like due to pressures in ensuring physical care needs are met. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 13 Visitors informed the inspector that they feel welcome and know they can visit the home at any time. Observations and discussions indicated that staff always make time to talk to visitors. As well as a visitors room the layout of the home provides seating areas within communal areas where residents can entertain their visitors, in addition to the privacy of their own room. Available menus indicated a varied and balanced diet is provided. A record of food provided that varies from the main menu was seen. Residents readily expressed their general satisfaction with regards to the quality, quantity, and choice of food provided. They told the inspector that they are always given a choice of two main meals for lunch and if they do not like them then an alternative is provided. The only negative thing is that sometimes the vegetables are a little undercooked. (This was passed on to management) Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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 area is good. This judgement has been made using available evidence including a visit to the service. Residents and their representatives have access to an effective complaints procedure. Staff awareness policies and procedures protect residents from abuse. EVIDENCE: The service has a clear complaints procedure that highlights the importance of complaining or making suggestions for improvement. The complaints procedure is provided to residents and relatives in the home’s information pack. Residents and visitors demonstrated a clear understanding of how to make a complaint They also informed the inspector that they are satisfied with the service provision and feel safe and well supported. Policies and procedures are in a place with regards to the protection of vulnerable adults. Staff spoken with portrayed a good knowledge and understanding of what action to take if they had any concern. Evidence was seen that staff have completed an adult protection course as part of the home’s training programme. The home ensures through training and supervision that care staff comply with the policies and procedures provided in relation to protecting and safeguarding the rights of the residents. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. The home is accessible, safe, clean and well maintained. It meets residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: The home is divided into four separate living units each providing accommodation for up to ten residents. Each unit has it’s own kitchenette/dining area, lounge and other small seating areas. New carpets have been fitted in all hallways since the last inspection visit. Management informed the inspector that refurbishment of the bathroom in unit two was to commence the Monday after this visit. The home provides a variety of adaptations and equipment to enable residents to maximise their independence. Residents were observed to walk freely around the home independently or with the assistance of various walking aids. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 16 A sample of three residents bedrooms were seen. They were well decorated and equipped. It was noted residents had personalised rooms with their own possessions. Bedrooms are individually and naturally ventilated with windows conforming to recognised standards. They are centrally heated with residents having the ability to control the temperature. Radiators and pipe work are guarded to prevent possible burns from hot surface temperatures. At the time of the visit the premises were clean, hygienic and free from offensive odours throughout. When incidents occurred that needed attention, staff managed them proficiently. Systems are in place to control the spread of infection. Clinical waste is properly managed and stored. Staff spoken with had a good understanding of the home’s policy and procedures and have received training in respect of infection control. During the visit staff were observed to use the appropriate protective clothing when providing personal care and assisting at meal times. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. Staff are well trained but not sufficient in numbers for the size, layout and purpose of the home. Thorough staff recruitment procedures are in place and carried through. EVIDENCE: The following issues of Serious Concerns with regards to staffing levels were identified. By using the formula suggested by the “Residential Forum”, Hampshire County Council senior management has allocated the home a total of 604 waking care staffing hours per week for 35 service users. This is equivalent to16.34 full time staff. Discussions, and rotas seen covering the four-week period from 16 July to 12 August 2006 identified that there was a shortfall of 191.75 hours, which equates to 6.39 fulltime staff. Records seen and discussions indicted that all service users require assistance with washing/bathing, 20 require assistance with dressing/undressing, 18 require assistance with toileting, 11 are doubly incontinent and 4 require 2 or more staff to undertake their care. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 18 On arrival at the home at 9-30 a.m. the inspector noted several residents were sat at the breakfast table. They were still there at 12 mid-day. Staff spoken with informed the inspector that due to service users level of care needs and number of staff on duty this is frequently the way things are. Staff were still getting service users up and bathing them at 11-30 a.m. Again staff spoken with informed the inspector that due to service users level of care needs and number of staff on duty this is frequently the way things are. It was noted that due to pressure on staff to ensure service users needs were being met on waking, there were not any care staff in the communal areas. One service user was wandering around half dressed. Other service users sat in lounges had been incontinent of faeces presenting dignity issues and an adverse odour. When this was brought to their attention, staff managed these matters appropriately. Care staff informed the inspector that they did not have their scheduled supervision with line management due to ensuring the care needs of service users were being met. The home’s management told the inspector that they have been instructed by senior management, due to budget restraints not to employ agency staff to fill any voids. A member of Hampshire County Council’s senior management was contacted by telephone during the visit. The inspector was informed that unit managers have been instructed to ensure the safety of service users at all times. Also there has not been a directive to unit managers not to use agency staff. However, there was not any agency staff on duty in the home at the time of the visit. A written immediate requirement was made at the time of the visit for Hampshire County Council to inform the commission of the action they plan to take in order to address the issue of insufficient staffing levels. An immediate requirement letter detailing the concerns was sent by the commission to Hampshire County Council on 15 August 2006. The Registered Individual for Hampshire Council assured the commission in a telephone call on 15 August that the issue of staffing levels will be given immediate attention. One of the assistant unit managers has the responsible for staff training. Available records and discussion indicated that 10 of the current care staff compliment of 24 have completed the National Vocational Qualification (NVQ) in care level 2 or 3. Two staff have been registered to access the NVQ level 2 course in September 2006 and January 2007 respectively. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 19 A sample of four staff training records were seen which included mandatory courses such as – moving and handling, fire safety, adult protection and infection control. Staff spoken with had a positive attitude towards training. Records seen and staff spoken with demonstrated that the recruitment procedures followed in the home protect residents. All necessary checks were in place prior to staff commencing work. The sample of one record for the most recently recruited member of staff was seen which included a comprehensive induction-training programme. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 20 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, 33, 35 and 38. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. The manager is experience and competent to run the home. Management and administration of the home is based on openness and respect. An effective quality assurance system is in place. Safeguards are in place to protect the interests of the residents. as is reasonably practicable the health, safety and welfare of residents and staff is promoted. EVIDENCE: The manager is registered with The Commission for Social Care Inspection (CSCI) to run the home. She has several years experience at a senior level and has completed the registered managers award (RMA) and NVQ level 4 in care. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 21 Discussions with staff and observations showed there are clear lines of accountability within the home. Also the management approach of the home creates an open, positive and inclusive atmosphere. Minutes of staff and resident meetings were available. Residents and relatives spoken with commented that the management team are very approachable, always make themselves available and readily help with any problems. Good relationships between staff on duty and staff and residents’ was evident. Staff portrayed a strong loyalty towards their work and management. Residents’ spoken with had nothing but positive comments to say about staff which included – “They really care”, “They don’t rush you” and “Staff like a laugh”. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 OP8 Regulation 12 (1 a, b) Requirement Timescale for action 1 OP27 18 (1a) A service user plan of care generated from a comprehensive 10/08/06 assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. Due to current staffing levels however, there are concerns regarding the ability of staff to deliver residents assessed personal care and health needs in accordance with written care plans. Staffing numbers and skill mix of qualified/unqualified staff are 10/08/06 appropriate to the assessed need of the service users, the size, the layout and purpose of the home, at all times. Number of staff /hours in respect of service user needs based on guidance recommended by Department of Health. Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 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. Refer to Standard Good Practice Recommendations Cornerways DS0000040361.V304241.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cornerways DS0000040361.V304241.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!