Inspection on 28/07/06 for Culwood House

This inspection was carried out on 28th July 2006.

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

Culwood House 26/09/08

Culwood House 09/04/08

Culwood House 20/04/07

Culwood House 07/02/06

Culwood House 24/05/05

Culwood House 10/01/05

Culwood House 17/08/04

Culwood House 28/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton 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 Culwood House 130 Lye Green Road Chesham Bucks HP5 3NH Lead Inspector Christine Sidwell Unannounced Inspection 28th July 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 DS0000022968.V289735.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. DS0000022968.V289735.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Culwood House Address 130 Lye Green Road Chesham Bucks HP5 3NH 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) 01494 771012 N/A webbecj4572@aol.com www.culwoodhouse.co.uk Mrs Anita Larkin Mr Larkin Mr Chris Webb Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places DS0000022968.V289735.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom residential accommodation with both board and care is provided at any one time shall not exceed 14 (fourteen) The Home is registered to accommodate older people 7th February 2006 Date of last inspection Brief Description of the Service: Culwood House is a privately run care home providing personal care and accommodation for 14 older people. The home is in an Edwardian building, located on the outskirts of Chesham about one mile from the town centre. There is dropping off space and parking at the front of the building. There is a mature garden with shady seating areas for residents. A part of the home is the private residence of the manager. The home is not purpose built and does not have a lift. All bedrooms are single and have en-suite facilities (WC and sink). The fees range from £550 pounds per week. Additional costs include hairdressing, chiropody, papers and personal effects. Information about the home can be obtained by contacting or visiting the home. DS0000022968.V289735.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of four days and included an unannounced one-day visit to the home. Prior to the visit all previous information about the home was reviewed. Comment cards were sent to residents and their families and to other professionals who have contact with the home. Two residents, two family members, two general practitioners and the district nurse returned the comment cards. The care of two residents was case tracked. Residents, staff and the manager were spoken to on the day of the unannounced visit. The home’s approach to equality and diversity was observed. What the service does well: What has improved since the last inspection? What they could do better: The new care planning documentation should be fully implemented and residents’ care needs reviewed on a monthly basis or as necessary. It is also recommended that resident’s care needs should be reviewed and recorded after their initial trial period and that the manager ensures that care manager reviews are held annually. An activities programme should be devised with the input of residents and taking into account their likes and dislikes. Residents should be actively involved in planning the menus, which should be reviewed by a dietician to ensure that they are nutritionally sound. DS0000022968.V289735.R01.S.doc Version 5.2 Page 6 All staff should have protection of vulnerable adult training and basic mandatory training with annual updates. A plan to ensure that 50 of staff hold the National Vocational Qualifications in Care at level 2 should be developed. The manager should complete a management qualification and update his knowledge and skills regularly. Records of training should be kept. The recruitment policies and procedures should be reviewed in line with guidance published by the Commission for Social Care Inspection. The offensive odours in some rooms should be eliminated. Fire doors should not be propped open and the advice of the fire officer sought on whether hold open devices can be used in these areas. A quality assurance system should be implemented and a system of formal staff supervision be set up. 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. DS0000022968.V289735.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 DS0000022968.V289735.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 outcome area is good. This judgement has been made using available evidence, including an unannounced visit to this service. Potential residents are assessed prior to their move to the home and have the opportunity to stay at the home to assess whether their needs can be met prior to moving permanently. EVIDENCE: The care of two residents was case tracked. Their files contained evidence that their care needs had been assessed prior to moving to the home. Two residents said that they had had the opportunity to stay at the home to see whether they liked it before they moved permanently. This was confirmed by the daughter of one. The pre-assessment documentation has recently been revised and meets the National Minimum Standards. There was no written evidence that care needs were reviewed formally at the end of the four-week trial period and it is recommended that this be done. The home manager said that residents from some social service areas have their care plan reviewed annually although was unable to find the documentation to show this. It is recommended that the manager contact the care managers for all residents who are supported by social care and arrange for them to have their annual review. DS0000022968.V289735.R01.S.doc Version 5.2 Page 9 The home does not offer intermediate care. DS0000022968.V289735.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 outcome area is adequate. This judgement has been made using available evidence, including an unannounced visit to this service. In general the health and personal care needs of residents are met. New care plans have been implemented but they do not yet contain sufficient information to describe in full the care needs of residents and neither are they updated and reviewed regularly either by the home or, where appropriate, by care managers. EVIDENCE: New documentation has been introduced to record residents’ care plans. This contained some detail about the residents’ care needs but has yet to be completed in full. There was no evidence in the care plans to show that they had been updated monthly as they have not been in place for a month at the time of the visit. The residents spoken to said that they were consulted about their care needs although they were not shown their care plan. It was not clear within the documentation whether those residents who had a social service care management plan had had that reviewed annually. There was evidence in the files to show that the general practitioner visits regularly. One resident was unwell and he had been seen by his general practitioner. The home had acted promptly to get additional help to care for this resident at DS0000022968.V289735.R01.S.doc Version 5.2 Page 11 night. Two general practitioners returned the comment cards and both said that the home communicated clearly with them, implemented their advice and took appropriate decisions when they could no longer manage the care needs of the resident. The residents spoken to all said that they could see their doctor in private and one resident was particularly pleased that she had been able to stay with her own general practitioner, whom she had known for many years. The district nursing team provide assistance with pressure prevention aids and continence aids where necessary. There have been some delivery problems recently and the manager has contacted the appropriate services to ask that this be rectified. There is a medication policy in place. Medication is dispensed by the local pharmacist and delivered in individual dosette boxes, which are stored securely. The manager stated that residents could self administer their medication if they wish but that none had chosen to do so. The carers confirmed that they had received medication training from a local pharmacist, although no training certificates were given. Eye drops were stored in the domestic refrigerator and were labelled as to when they were opened. The residents said that they always received their medication on time. There were no controlled drugs being dispensed at the time of the visit. The residents spoken to and those who returned the comment cards said that their privacy was respected. All residents were wearing their own clothes. The families spoken to said that they were welcome at any time. Staff said that the general practitioners saw residents in their own rooms. This was confirmed by the general practitioners who returned the comment cards and by one resident. All rooms have telephone points and there is a house phone in the hallway. A portable handset is available if required. DS0000022968.V289735.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 outcome area is adequate. This judgement has been made using available evidence, including an unannounced visit to this service. Residents have a choice as to how they spend their day although staffing levels are such that the opportunities for staff to assist residents and provide recreational activity in and outside the home is limited. Mealtimes are a sociable occasion although the menus could be improved nutritionally and residents could be more actively involved in menu planning. EVIDENCE: The routines in the home are flexible. There is no formal activity programme and on the day of the visit most residents were in their rooms or sitting in the lounge reading or watching the television. Staffing levels are such that the staff do not have the time to take residents out and do not usually participate activities with residents. Residents’ likes and dislikes are not recorded. Families are made to feel welcome at any time and the families and residents spoken to said that they valued this. Residents can meet with their families in their rooms, in one of the lounges or in the garden. The residents spoken to said that they had a choice in how they spend their day although mealtimes are at a set time. Three full meals are offered. On the day of the visit the main meal was fish, chips and peas followed by crème caramel. The portions were small although DS0000022968.V289735.R01.S.doc Version 5.2 Page 13 the residents said that they were sufficient. There is no formal menu plans and residents are not offered a choice of main meal, although the staff said that alternatives would be provided if residents did not like the meal on offer. The meals offered are recorded although not planned in advance. The menu provided to the Commission for Social Care Inspection with the pre inspection documentation did not demonstrate that five portions of fruit and vegetables are offered daily. The meals are served plated and residents do not have the opportunity to serve themselves. Meals are taken in the dining room at a large dining table and are a sociable occasion. No one required a special menu on religious or cultural grounds. The residents spoken to said that the food was generally satisfactory although one said that she would have preferred more choice. DS0000022968.V289735.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 outcome area is adequate. This judgement has been made using available evidence, including an unannounced visit to this service. Complaints are dealt with promptly and families feel that their concerns are addressed. The protection of vulnerable residents should be strengthened by ensuring that staff are adequately trained and recruitment procedures are robust. EVIDENCE: There is a complaints policy in place. A complaints log is not kept. The manager said that complaints were dealt with promptly and that no written complaints had been received by the home. One family member who returned the comment card said that ‘ although not aware of the complaints procedure, concerns raised had been acted upon in good spirit’. There is a protection of vulnerable adults policy. The manager has attended a training course in the protection of vulnerable adults although the staff have not. This training should be provided. Not all staff have had references taken up prior to employment although criminal records bureau disclosures have now been sought for all staff. This is described in the staffing section of this report DS0000022968.V289735.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 outcome area is adequate. This judgement has been made using available evidence, including an unannounced visit to this service. Residents’ rooms are personalised and they said that they liked them. There is a need to improve fire safety, access to the garden and hygiene if residents are to be safe. EVIDENCE: The home is generally well decorated. Residents had personalised their rooms with their own belongings. Those spoken to were happy with the standard of the room. The gardens are attractive although the main pathway was blocked by the washing line and overgrown bushes, which made the gazebo, at the end of the garden, inaccessible for residents without help. There is a ramp to the garden from the dining room but this does not have a handrail. A number of clearly labelled fire doors were propped open with spring doorstops. These doors were closed after the inspector arrived, although one resident was heard to say ‘why is this door shut it is usually open’. The manager said that all fire doors are shut at night. The kitchen was clean and tidy on the day of the visit, although cluttered. A control of infection policyhaaas been drawn up and staff DS0000022968.V289735.R01.S.doc Version 5.2 Page 16 training in this topic is planned. The laundry facilities are separate from the kitchen. There was a strong odour of urine in one resident’s bedroom. The staff said that they cleaned the rooms as often as possible but that they did not have a carpet washer. Suitable equipment to maintain the cleanliness of the home should be provided. DS0000022968.V289735.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 outcome area is adequate. This judgement has been made using available evidence, including an unannounced visit to this service. Recruitment procedures have improved since the last inspection but further improvements are necessary if residents are to be protected form the employment of unsuitable people. The training and development of carers must be improved if they are to have the knowledge and skills necessary to care for frail elderly residents. EVIDENCE: There are thirteen members of staff covering the rota. The inspector was told that there are three staff on duty in the morning, although there were only two on duty at 10.00 am when the visit commenced. One of those members of staff was preparing the main meal. There is one waking night staff who said that she undertook regular checks of residents. These are not recorded. This member of night staff also works in the evenings and during the early morning. Four of the staff hold the National Vocational Qualifications in Care at Level 2, 30 of the total staff. The manager and deputy manager said that they had had difficulty identifying a suitable training provider and that it was difficult to release staff. The induction programmes were not recorded and although forms to record staff training have been introduced they have not yet been completed. It was not possible to ascertain from the records whether staff had had basic mandatory training. Six staff records were examined. Not all longstanding staff had had references taken up and only two of the files had two references in. Three of the application forms were incomplete and it was not possible to trace the staff member’s work history. These members of staff DS0000022968.V289735.R01.S.doc Version 5.2 Page 18 had worked in the home for a long time and the manager stated that their performance was satisfactory. All the records seen had evidence that a Criminal Records Bureau disclosure had now been obtained. Although the recruitment files have improved future recruitment must be undertaken in line with Care Homes Regulations. DS0000022968.V289735.R01.S.doc Version 5.2 Page 19 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, 36 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence, including an unannounced visit to this service. The home’s management systems are informal and systematic approaches to monitoring and improving the quality of resident’s care have not been implemented. EVIDENCE: The manager has had experience in managing care homes. He registered to undertake the National Vocational Qualification in Care and Management at Level 4 in October 2003 although he has not yet completed this. He manages one care home. He has undertaken limited training this year although has undertaken a course about the Protection of Vulnerable Adults. He has a job description although it is not dated and refers to meeting the Care Homes Regulations 1984 and requires updating. The manager stated that there is no formal quality assurance system, although in conjunction with the sister home a questionnaire modelled on that used by the Commission for Social Care Inspection is being developed. No other form of systematic internal audit is DS0000022968.V289735.R01.S.doc Version 5.2 Page 20 undertaken. Policies and procedures have now been written and have been updated within the last year. The responsible individual does not undertake regular quality assurance visits in line with Regulation 26 of the Care Homes Regulations and action has not been taken to implement the requirements of previous reports in a timely way. The home does not handle residents’ money on their behalf and any expenditure incurred on their behalf is invoiced to them. The manager has not yet set up a system of formal supervision of staff although states that ongoing supervision is informal, in that he is in the house for most of the time. There are moving and handling policies and procedures in place and the staff spoken to said that they had received training. First Aid boxes have now been bought and two staff have received first aid training. The manager stated that all staff who handle food have had food hygiene training although this could not be confirmed from the training records which are not complete. The maintenance schedules showed that regular maintenance is undertaken. A Legionnella assessment has not yet been undertaken. DS0000022968.V289735.R01.S.doc Version 5.2 Page 21 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 1 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 1 X 2 DS0000022968.V289735.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes DS0000022968.V289735.R01.S.doc Version 5.2 Page 23 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 Requirement All residents must have a care plan which is developed with them and which is updated monthly. This is an unmet requirement of previous reports and a new time scale has been set. An activities programme should be developed in consultation with residents. Residents should be offered a choice of main meals and menus should be reviewed by a dietician to ensure that they are nutritionally sound and meet the needs of the elderly. All staff should have Protection of Vulnerable Adults training. Carpets and flooring should be kept clean and offensive odours eliminated. The registered manager is required to develop a training programme to ensure that all staff have the basic mandatory training with annual updates. Training records must be maintained to demonstrate that this has been implemented. This is an unmet requirement of previous reports and a new time scale has been set. A plan must be developed to ensure that 50 of care staff DS0000022968.V289735.R01.S.doc Timescale for action 31/12/06 2 3 OP12 OP15 16 16 31/12/06 31/12/06 4 5 6 OP18 OP26 OP30 13 16 18 31/12/06 31/08/06 31/12/06 7 OP28 18 31/12/06 Version 5.2 Page 24 8 9 OP30 OP31 18 9 10 OP33 24 11 12 OP36 OP38 18 23 hold the National Vocational Qualifications in Care at Level 2 All new staff must have an induction programme, which is recorded. The manager should continue to undertake a management qualification and update his skills and knowledge regularly. The registered manager is required to develop or adopt a method of quality assurance for the home. This is an unmet requirement of previous reports and a new time scale has been set. Regular formal supervision for staff should be implemented. Fire doors must not be propped open. If it necessary to have these doors open the advice of the Fire and Safety officer should be sought as to the use of ‘hold open devices’. 31/12/06 31/12/06 31/12/06 31/12/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 4 Refer to Standard OP3 OP7 OP29 OP31 Good Practice Recommendations Residents care needs should be reviewed with them at the end of the four-week trial period. Residents care needs should be reviewed with their care managers on an annual basis or more frequently. The recruitment policies and procedures should be reviewed inline with guidance issued by The Commission for Social Care Inspection. The manager should update his job description, with the responsible person to reflect his responsibilities under the Care Standards Act 2000 and the Care Homes Rgulations 2001. DS0000022968.V289735.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 DS0000022968.V289735.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!