Inspection on 31/10/05 for Dormers

This inspection was carried out on 31st October 2005.

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

Dormers 04/01/07

Dormers 10/05/05

Dormers 13/12/04

Dormers 07/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Dormers Foxon Lane Caterham Surrey CR3 5SG Lead Inspector Vera Bulbeck Unannounced Inspection 31st October 2005 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 Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dormers Address Foxon Lane Caterham Surrey CR3 5SG 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) 01883 330927 Surrey County Council - Adults & Community Care Christine Whiting Care Home 47 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (33), Physical disability over 65 years of age (5) Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Accommodation and Services may be provided to named persons aged 60 - 65 years with the prior written agreement of the CSCI. Intermediate Care may be provided to one Service User on Rose Unit the remaining beds on Rose Unit will only be used for Respite Care. Respite Care may be provided to a maximum of 5 persons at the same time. Bluebell Unit will be used exclusively for Dementia Care. A maximum of 6 Service Users with Dementia may be cared for in other parts of the Home. In addition to Service Users accommodated at the Home, Day Care may be provided on the Day Care Unit to a maximum of 7 persons. 10th May 2005 Date of last inspection Brief Description of the Service: Dormers is located in a quiet residential area close to local amenities. Care and accomodation is to provide older people some of whom have dementia. The home is operated by Surrey County Council and was purpose built in 1982. Accomodation is arranged in 6 units at ground and first floor level. Each unit has its own bathroom and toilet facilities and a communal lounge/dining area. All bedrooms are single. Offices are situated on the ground floor and first floors. All floors are accessed by means of a shaft lift. The main kitchen is located on the ground floor. In addition, part of each communal area is also equipped as a kitchenette. The home has ample off street parking and an enclosed garden. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection to be undertaken by the Commission for Social Care Inspection for the year April 2005 to March 2006. For details of how each standard was met please refer to the main body of the report. It will be necessary to review both inspection reports for 2005-06 to obtain a full understanding of the extent to which the home meets The National Minimum Standards for Older People. The inspection was announced, which meant that visitors, staff and residents were aware of the inspection prior to it commencing. The inspector had the opportunity to speak with a number of residents who live at the home. They were all very complimentary about the home and spoke affectionately of the registered manager and staff. Vera Bulbeck, Lead Inspector for the service, carried out the inspection. Mrs C Whiting, Registered Manager was present. The home is registered for fortyseven places. There are currently thirty-eight residents living in the home. A full tour of the premises was undertaken. Three care plans were observed and three staff files were inspected. Four members of staff were spoken with during the inspection as well as ten residents and one relative. The inspector did not receive any comment cards sent out several weeks ago, which are always welcome by the Commission for Social Care Inspection. The staff was observed to be courteous and the atmosphere within the home was relaxed and friendly. The inspector wishes to thank the residents and staff for their co-operation and hospitality during the inspection. The residents living in the home wish to be called residents, therefore service users will be referred to as residents throughout the report What the service does well: Dormers offer a homely environment for its residents who spoke well of the home, its staff, and the facilities. When asked about the home, comments such as “Very nice indeed.” and “Haven’t found any fault.” were typical. Residents also commented positively on the staff, one saying “All staff are very good.” and another telling the inspector “Staff are very nice here.” The home has three visiting hairdressers, who work in the home over a period of two days a week, two hairdressers who were working in the home on the Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 6 day of inspection informed the inspector during the three days the majority of residents are able to have their hair done. The handyman/gardener working within the home is an asset; the garden is well kept and pleasant for residents to enjoy. However, on the day of inspection the pathways were full of leaves and very dangerous, the handyman/gardener was already attempting to sweep the leaves with a broom at the time of the inspectors arrival. This is obviously an ongoing process with so many trees to contend with. Perhaps it would be more serviceable for the home to purchase an electrical leaf vacuum. Considering the majority of residents require a considerable amount of attention the staff team appear to manage to residents on an individual basis. 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. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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 Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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): 2, 3, 4, 5 and 6. The individual written contracts are up to date and regularly reviewed to ensure that all relevant information is available. The home is able to demonstrate their capacity to meet the assessed needs of the residents accommodated at the home. Relatives and persons acting on behalf of the residents are involved and kept fully up to date. The home offers intermediate care following a full assessment to ensure the home is able to meet the needs of the resident and to maximise their independence to enable the person to return home. EVIDENCE: Each resident is admitted to the home following a needs assessment to ensure that the home can meet the residents identified needs. The home is able to demonstrate their capacity to meet the assessed needs of the resident’s accommodated at the home. The home offers intermediate care to one resident who is placed within the respite unit. Full needs assessments were undertaken prior to a trial period of admission. The services and facilities of the home were overall suitable to meet the home’s stated purpose. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 9 Three residents files were examined during the course of the inspection. These files contained detailed information on each resident including assessment regarding their health and care needs, risk assessments and details of reviews. Contracts were in place for all residents and found to be well documented. Residents spoken to confirmed that their needs were being met. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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 and 9. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practices are in place to ensure the safe administration of medication. EVIDENCE: It was noted that some relatives had been involved with the care plans and had signed to indicate they were satisfied with the care plan. Night care plans were particularly informative and would ensure staff could support residents in the most appropriate way. Generally the care plans and records were found to be well documented, and included a number of risk assessments for each resident. However, the staff should ensure, residents personal wishes are fully documented in their care plan. Personal information was passed to the inspector at the time of speaking with a resident. The key-workers for the residents need to reassure the residents they are being listened too. Medication was checked for three residents who the inspector had completed an audit trail on, and was found to be well documented and administered appropriately. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 11 Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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 and 15. The activities provided by the home are varied, well planned, and include contact with the local community both within and outside the home. Contacts with family and friends are encouraged. The meals in this home are good, offering both choice and variety and catering for special dietary needs. EVIDENCE: A number of residents have contact with family and friends. An advocate is involved with one resident and visits at least three times a week. It was pleasing to note that a number of relatives are constantly visiting the home and some on a daily basis. The inspector was informed they are always made very welcome and kept up to date with any issues or information particularly regarding their relative. Visiting times in the home are variable and there is no time restriction for relatives. The activity organiser has a programme that she covers and this involves the majority of residents. Outings are arranged and a number of residents have been able to enjoy visits to garden centres and Godstone farm. A pantomime is to be booked for some residents in January and various groups provide entertainment in the home. Photographs were seen of the V.E party and residents enjoyed pie and mash, all the staff were involved and dressed up for this occasion. The staff undertakes fund raising for the home to enable the residents to have a full and varied entertainment programme. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 13 One resident commented that though the food was good, they never knew what it was until it arrived. A member of staff confirmed that the menu was in the main kitchen and residents were generally happy with the food. It was noted that the majority of residents had a good appetite. It is recommended that a weekly menu, in a format accessible to most residents, be displayed prominently. Staff will need to continue to explain the menu to those residents who would not be able to benefit from a printed version. The menu is nutritious and appetising and is changed according to the seasons. The records maintained in the kitchen need to be signed and dated. The last Environmental Health visit was on 23/05/05 and the officer’s report indicated two requirements and one recommendation. The report generally was good, and the requirements have been attended too. However, a copy of the report must be kept in the kitchen, to enable the chef to undertake the action required by the EHO. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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. All required policies and procedures are in place to ensure that residents are safeguarded from harm or abuse. EVIDENCE: The home has an up to date complaints procedure and has incorporated details of the Commission for Social Care Inspection. All residents or relatives have been provided with a copy of the complaints procedure. There were no recorded complaints. A relative commented that if she had any problems or complaints she would speak with the manager to discuss what action would be taken. The homes policies and procedures for the protection of vulnerable adults and a whistle blowing policy were in place and all staff has received POVA training. Staff confirmed they had undertaken this training and were aware of the procedures. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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, 21 and 26. The location and layout of the home and gardens are suitable for their stated purpose. The home is looking very tired and in need of redecorating. However, the home is kept clean, pleasant and homely in which to live. EVIDENCE: The home is looking very tired and needs to be completely redecorated, A number of areas around the home are in need of being updated, paint was found peeling off walls particularly a toilet, and some bedrooms, wallpaper was peeling off. However, the management and staff strive to make the home comfortable and homely, with many nice touches including ornaments and pictures around the home. An area for the library and telephone is situated under the stair well. The dining rooms were nicely laid and residents obviously appreciated this, One resident commenting on the nice table linen, and furnishings were homely. All residents spoken to said they liked their bedrooms, the majority of bedrooms were carpeted and well kept. Bedrooms have been provided with a lockable facility. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 16 The premises were found to be clean and hygienic all staff to be congratulated on the cleanliness of the home. There were a few areas that require attention. These include a toilet, which the lock needs to indicate if anyone is using the toilet. The sluice room must be kept locked at all times not with a bolt as found on the day of inspection. The room contained various cleaning materials including bleach, disinfectant, fly spray killer and furniture spray polish. A number of wheelchairs were stored around the home for example, in bathrooms, and at the end of one corridor a wheelchair and carpet cleaner /hoover. The home needs a storage area and items not in use to be stored appropriately. A cleaning schedule needs to be re introduced in the kitchen to ensure a regular clean takes place. On the day of inspection the ceiling was found to be in need of cleaning and the fluorescent lights needed cleaning. The chef informed the inspector there has been difficulty employing kitchen staff and at times he has been working on his own and at other times with agency staff. This has now been rectified and there is now a full staffing complement. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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, 29 and 30 The numbers and skill mix of the staff meets residents needs. The home has a comprehensive staff recruitment and training programme which incorporates all areas needed to ensure, as far as reasonably possible, that residents are in safe hands at all times. EVIDENCE: There is sufficient staff on duty during each shift, these include seven care staff, as well as a senior care member of staff, the registered manager and deputy manager, on a daily basis Monday to Friday who have the overall responsibility for care. The management of the home review the staffing levels on a regular basis. There is three domestic staff that covers seventy-three hours over a seven-day period. There is also a vacancy for a domestic worker 25 hours; agency staff currently covers this post. There is a chef, assistant cook and a kitchen assistant. A member of staff, who works 20 hours Monday to Friday, operates the laundry. A maintenance person/handyman is on site everyday, Monday to Friday. The night-time arrangements are one senior and three care assistants. Full recruitment procedures are being followed. All staff has been checked against the Criminal Records Bureau (CRB) before working in the home. Staff records were observed and found to be well documented, including contracts and terms and conditions. Training has been ongoing and the majority of staff has attended a number of training courses. A senior member of staff keeps the training plan up to date. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 18 All new staff receives an induction-training programme. And all staff has received (POVA) protection of vulnerable adults training. Thirteen members of staff have completed NVQ Level 2, and six have completed NVQ Level 3. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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): 33, 34, 35, 36, 37 and 38. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the residents. Policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of residents and staff. EVIDENCE: The management approach of the home creates an open and positive atmosphere with progressive steps being taken towards developing a thorough quality monitoring and improvement system. A newsletter has been produced for residents and a copy is sent to all relatives on a regular two monthly basis. Questionnaires are sent out yearly to all residents, relatives, advocate, care managers and health professionals. Visits undertaken by a responsible person need to be undertaken on a regular monthly basis and should be unannounced. The last recorded reports on file were dated 09/08/05, 07/06/05 and 08/04/05. Copies of the reports should be sent to the CSCI. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 20 Staff are supervised on a regular basis and goals are set for training needs and identifying how the home can improve the care provided. A number of records were observed and the majority were found to be well documented these include the accident book, the management of the home have introduced monthly monitoring forms which are colour coded to enable management to monitor the number of falls, time and where falls are happening. The fire records were well documented. However, there is a need to undertake a fire risk assessment on the whole premises, this would include offices and all areas in the home. Management needs to produce an emergency plan for use in the event of any emergency and details must be kept in the fire record folder. Other records seen include training, residents and staff meetings; as well as health and safety records. It was also noted that correction fluid had been used on the rota, the rota is a legal document and must not be defaced in any way. It was noted in the administration office that fluorescent lights were without covers, this is a health and safety issue and should be attended to. Records demonstrated that some aspects of health and safety such as infection control were well managed by the home. However, bars of soap were found in use in bathrooms and toilets this practice is not acceptable and is a possible area at risk from cross infection. It was also noted that a member of staff was seen walking with an uncovered commode, this practice is inappropriate and staff need training and are aware of the correct procedures. The bursar of the home and the administrator are responsible for resident’s finances, relatives are involved and a number of residents have Power of Attorney who controls their finances. Some residents have their own solicitor. Families of some of the residents provide the home with a sum of money for hairdressing and toiletries. Records were seen and found to be well documented. The home has a member of staff who runs and manages the trolley shop and sells a variety of items to residents on a weekly basis. The member of staff undertakes the purchasing of the goods and the receipts are passed to the bursar for recording and monitoring. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 3 3 3 2 2 Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 22 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 19 Regulation 23 Requirement An action plan to be completed with timescales for the home to be redecorated and a copy sent to the CSCI. A cleaning schedule for the kitchen needs to be reintroduced. A storage area for equipment including wheelchairs needs to be introduced in the home. All staff requires training on privacy and dignity. Visits by a responsible person must be undertaken on a regular monthly basis. The use of correction fluid must not be used on the rota, which is a legal document. Bars of soap must not be used in communal areas. Fluorescent lights in the administration office require a cover. The cleaning cupboard must be appropriately locked at all times. An emergency plan to be implemented. A risk assessment to be implemented to cover the whole DS0000033582.V260692.R01.S.doc Timescale for action 09/12/05 2 3 4 5 6 7 8 9 10 11 19 22 30 33 37 38 38 38 38 38 23 23 18 26 17 16 23 13 13 13 09/12/05 09/01/06 09/01/06 09/12/05 04/11/05 04/11/05 04/11/05 04/11/05 09/12/05 09/12/05 Dormers Version 5.0 Page 23 premises of the home. 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 8 19 21 33 Good Practice Recommendations Management to ensure residents personal requests are included in their care plan. To consider purchasing a garden hoover for the leaves. A toilet lock needs attention. Documented meetings to include an action plan. Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Dormers DS0000033582.V260692.R01.S.doc Version 5.0 Page 25 - 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. 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