Inspection on 31/10/05 for Dover Lodge

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 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dover Lodge 14/09/06

Dover Lodge 15/07/05

Dover Lodge 23/11/04

Dover Lodge 27/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Townley Road, 2-3

Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Dover Lodge Dover Lodge 41 Wood Vale London SE23 3DS Lead Inspector Lisa Wilde Unannounced Inspection 31st October 2005 10:00 Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 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 Dover Lodge DS0000060224.V261317.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dover Lodge Address Dover Lodge 41 Wood Vale London SE23 3DS 0208 693 5460 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) Odyssey Care Solutions for Today Ms Hazel Joy Elkamouri Care Home 7 Category(ies) of Learning disability (7), Mental disorder, registration, with number excluding learning disability or dementia (2), of places Sensory impairment (1) Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th July 2005 Brief Description of the Service: Dover Lodge is a large detached Victorian house situated in a residential road in Forest Hill. It is similar to other properties in the road and is not identifiable as a care home. It is not wheelchair accessible and it does not contain a lift. It can accommodate a maximum of up to 7 female service users with learning disabilities. The accommodation is laid out over 4 floors. The ground floor contains 2 sitting areas and a kitchen with dining area. The bedrooms and bathrooms are located on the 1st and 2nd floors. There is a large wellmaintained garden at the rear with mature trees and shrubs. It is conveniently located for public transport and is close to the local park. At the time of the inspection the home had no vacancies. This is one of a number of homes run by the voluntary organisation Odyssey whos vision statement says that they are working towards A society where a learning disability is not a barrier to somebodys perceived value or ability to make a meaningful contribution. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced took place over one day in October 2005 with the Registered Manager, staff and the service users who were at home on that day. The inspector also spoke with one relative who was at the home at the time. None of the service users or relative had any current problems and all said they were happy with the home. Service users said they liked the staff and their rooms. Overall the inspector found again that the home continues to offer a high standard of care and support to service users. There is an ongoing issue of a staffing review being necessary to find out if there are enough staff at the home to meet all the service users’ needs but this review was due to occur shortly after this inspection and the Commission will be informed of the outcome of the review and involved in discussion about the results. What the service does well: Of the standards assessed at this inspection the home showed that: • the needs and wishes of potential service users are fully assessed before someone is offered a place at the home and full assessments are made and guidelines drawn up to support service users with their care needs. • service users are given information to make decisions about their lives. • risks are assessed and plans put in place to manage or minimise those risks. • service users have responsibility for their own lives. • service users are supported to cook and eat a healthy, nutritious diet of their choice. • all service users’ personal, emotional and health needs are met by the staff team or by accessing community professional for specialist advice and input. • service users’ (and their families’) views are taken seriously and action is taken to address any concerns. • service users are protected from abuse. • the home and garden is bright, homely and clean throughout. • staff all hold the required NVQ in Care and are fully trained in the needs of the service users • generally service users are supported by an effective staff team in that there are usually enough staff on duty to support service users to undertake any activity they choose. • the home conducts reviews of individual service users care and attempts to incorporate those reviews into service development. • service users are protected by the operation of effective and robust systems for monitoring health and safety issues. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 6 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. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Service users and their families are not provided with all the information they need to make an informed choice about where to live and whether they are being offered everything that they should be. The needs and wishes of potential service users are fully assessed before someone is offered a place at the home. The staff team decide with the current service users group if they can meet he needs of someone who want to move in. EVIDENCE: There were prevous requirements that the Registered Manager must ensure that the Service User Guide must be drawn up in a format that can be understood by more people from the service user groups for which the home is registered i.e learning disabilities and the Registered Manager must ensure that the Service User Guide must cover all areas required by Regulation 5 and Standard 1. The timescales for these requirements had not elapsed by the time of this inspection. The Registered Manager has met with other managers in the organisation to discuss ways of changing the Service User Guide into other formats such as video and to ensure it is more meaningful for the service users. (See Requirements 1 & 2) Most of the service users have been at this home for a long time and no service users have moved to the home since the last inspection. The Registered Manager discussed the process as it had occurred for the last Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 9 person who moved to the home. A referral is received and the manager visits the applicant to assess their needs with them and their care team. The files showed that information is gathered prior to a decision being made as to whether the home can meet their needs. The current service users meet the prospective service users to assist with the decision as to whether they will fit in and if the home is suitable for them. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Full assessments are made and guidelines drawn up to support service users with their care needs. Care plans are not in place to enable service users to meet identified goals or develop skills. Service users are given information to make decisions about their lives. Risks are assessed and plans put in place to manage or minimise those risks. Service users are supported to take reasonable risk as part of a normal lifestyle. EVIDENCE: The files showed that full assessments of need are`made and support guidelines are drawn up to meet the day–to-day needs`of service users. Annual reviews take place as required and goals are identified within those reveiws. There are no care plans in place that focus on development and moving forward. One examples was that the Registered Managerhad described plans that were in place to assist with two service users who are having difficulties with each other, yet nothing of this was written in care plans to allow staff action to be consistent and progress reviewed regularly.The Registered Manger dsicussed that she felt this was an area that was being Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 11 looked at by the staff team currently and the recent training around Person Centred Planning has assisted with their thinking about this. (See Requirement 3) There was a previous recommendation that the Registered Manager should consider consulting formally with service users families and other stakeholders (in addition to service users) as to their views of the service provided by the home. The Registered Manager is sending out the seasonal newsletter soon and has copnsulted with the organisation as to whether to formally consult with families. The organisation is currently consistent planning to undertake consultation procedures across all their homes. This issue is now part of a requirement made under Standard 39. The inspector discussed with the manager and staff the systems in place for enabling service users to make informed decisions and take reasonable risks. Risk assessments are on file with plans and guidelines to minimise or manage those risks. Families are involved as much as possible and independent advocates attend reviews and are involved in supporting service users to make complaints or voice concerns. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 Service users have responsibility for their own lives in the home along with a responsibility to take part in activities that support the group living of the home such as cooking for the group. Service users individual rights are respected and the daily routines of the home do not impact negatively on those rights. Service users are supported to cook and eat a healthy, nutritious diet of their choice. Attention is paid to individuals preferences and requirements. EVIDENCE: Service users make their own choices around the lives they choose within the home. They are responsible for cleaning their own rooms with staff support and are as independent as possible given their varying support needs. Service users have recently been supported by staff and advocates to make complaints about how their day service has been withdrawn. Service users cook for the group one day each week with staff support as necessary. They choose what they will be cooking for that day. Service users make their own lunches with support and one service user said they liked the food at the home. Service users are supported with individual diets for Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 13 example one service user doesn’t eat pork. The home is introducing picture records of foods and meals so there can be more useful choices made around food. The home is also focussing on how to ensure service user receive five portions of fruit or vegetables each day. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 All service users’ personal, emotional and health needs are met by the staff team or by accessing community professional for specialist advice and input. The systems in place for the monitoring and recording of medication administration are not fully effective which means that the home is not keeping correct accounts of all medication held in the home. EVIDENCE: Discussions with staff and evidence from the files show that service users are fully supported to attend regular and ad hoc medical appointments. Staff showed a comprehensive knowledge of each service users individual needs. Service user at this home need low levels of support with personal care, requiring more support in the form of prompting and reminding to undertake tasks. One service user said they liked the staff and felt safe at the home. One family member said they had no problems with the way their relative was cared for at the home and when they did have day-to-day concerns they could approach staff and sort them out. The inspector checked the medication stocks and the administration records held at the home. There were some gaps in the recording of administration and the two medication stocks checked did not tally with the records. (See Requirements 4 & 5) Staff receive training from the community pharmacist. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Service users’ comments and complaints are taken seriously and action is taken to address any concerns. The views of service users’ families are also listened to and acted on. The policy, procedures and training for staff mean that service users are protected from abuse by staff holding an understanding of what to look out for and what to do if any abuse is suspected. EVIDENCE: Complaints are recorded, investigated and taken seriously. Recent complaints from staff about the withdrawal of funding for their day services have been copied to the Commission for information and showed that the home does all it can to make sure service users can voice their concerns and action is taken to attempt to resolve problems. The Registered Manager discussed one recent example where a service users’ mother had voiced concerns about healthcare and independent advice had been sought by the home to address those concerns. The home has an appropriate policy around protection of vulnerable adults. Management and staff showed awareness of what to do and who to inform if they suspected abuse. Some staff have received abuse training a few years previously but not all have had it. (See Recommendation 1) Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 & 30 The home and garden is bright, homely and clean throughout. There is decoration work planned for the kitchen but currently the kitchen environment is generally safe and free from hazard and still decorated and maintained to a comfortable standard. EVIDENCE: Bathroom and toilet numbers were sufficient and the whole house was homely and comfortable. Specialist aids and equipment are not necessary as the current service users do not have any mobility problems. The home is not wheelchair accessible. The home was clean and free from odours. There was a previous requirement that the Registered Manager must ensure that the planned work on the kitchen takes place. This had still not taken place ans the Registered Manager stated that it is planned for the 2007/08 budget. This previous requirement is ongoing (See Requirement 6) Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 & 35 Staff all hold the required NVQ in Care and this along with the additional training programme in place means that service users are offered support by a competent staff team. Generally service users are supported by an effective staff team in that there are usually enough staff on duty to support service users to undertake any activity they choose. On occasion this is not the case but it is not clear currently whether this is due to unforeseeable events or whether the rota’d staffing levels must increase. EVIDENCE: All staff hold the NVQ Level 3 in Care apart from one who is currently undertaking it. Staff hold a full knowledge of service users needs and how they should work to meet them. There is a new deputy manager in place who works evenings and weekends which ensures there is some management support around at the home for most of the time. There was a previous requirement that the Registered Individuals must ensure that the current staffing review takes place as a priority and that evidence that the home is providing enough staff to meet all service users identified needs is sent through to the Commission. The situation at the previous inspection had been that staff had stated the rota it is one occasion not possible to allow the service users to do all the activities that they have chosen. The manager Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 18 acknowledged that the rota is a little tight but that she felt it was appropriate given the number of service users they have had up to this point and that they have been carrying a deputy manager vacancy. Recently two service users have lost their day centre placements meaning that the home has to provide more cover during the day. The Registered Manager is due to review the staffing with their manager in the next two weeks. (See Requirement 7) The inspector will be examining the home’s recruitment files at the organisation’s head office at a later date this year. The training records and comments from staff showed that a full training programme is in place which offers staff the core statutory training and additional specialist training around the specific needs of the service users. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 & 42 The home does conduct reviews of individual service users care and attempts to incorporate those reviews into service development. The home does not fully ensure that service users views (or the views of their families) underpin the annual review and development of the home. Generally service users are protected by the operation of effective and robust systems for monitoring health and safety issues. The procedures for safe fire systems testing are not operated entirely consistently. EVIDENCE: The monthly visits required under Regulation 26 are carried out and sent through to the Commission. The home conducts annual reviews with the service users and completes quarterly returns to the borough organisation that report on identified indicators. There is a local business plan for the home. The home does not use an externally accredited quality assurance systems that focuses on the views of service users and the home does not conduct an annual review of the views of family and other stakeholders. (See Requirement 8 and Recommendation 2) Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 20 Health and safety monitoring is regular and thorough. All the required documentation is in place although some weekly fire tests have been missed and the last fire drill showed that service users are taking too long to react to the fire alarm and staff must undertake another drill when this is the case. (See Requirements 9 & 10) Dover Lodge DS0000060224.V261317.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dover Lodge Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 2 X DS0000060224.V261317.R01.S.doc Version 5.0 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 5 Requirement The Registered Manager must ensure that the Service User Guide must be drawn up in a format that can be understood by more people from the service user groups for which the home is registered i.e learning disabilities. Previous requirement but timescale for completion had not elapsed by this inspection The Registered Manager must ensure that the Service User Guide must cover all areas required by Regulation 5 and Standard 1. Previous requirement but timescale for completion had not elapsed by this inspection The Registered Manager must ensure that individual care plans are drawn up for service users that describe action to be taken by staff and others to enable service users to achieve identified goals and develop skills and further independence. The Registered Manager must ensure that all medication is signed for at the point of DS0000060224.V261317.R01.S.doc Timescale for action 31/12/05 2 YA1 5 31/12/05 3 YA6 15 31/03/06 4 YA20 13 (2) 30/11/05 Dover Lodge Version 5.0 Page 23 administration. 5 YA20 13 (2) The Registered Manager must ensure that systems for stock checking are effective and accurate records are maintained of all medication held in the home. The Registered Manager must ensure that the planned work on the kitchen takes place. Previous requirement: Unmet timescales 30/01/05 & 30/11/05 The Registered Individuals must ensure that the current staffing review takes place as a priority and that evidence that the home is providing enough staff to meet all service users identified needs is sent through to the Commission. Previous requirement: Unmet timescale 31/10/05 The Registered Manager must ensure that an annual survey (or other form of annual audit) of service users families and other stakeholders takes place that then feeds into the annual review of the service and the local business plan. The Registered Manager must ensure that the weekly fire system tests take place as planned. The Registered Manager must ensure that additional fire drills are undertaken if service users fail to respond to the fire alarm. 30/11/05 6 YA24 23 (2) (d) 31/05/06 7 YA33 18 (1) (a) 14/12/05 8 YA39 12 (3) 31/03/06 9 YA42 23 (4) (c) 30/11/05 10 YA42 23 (4) (c) 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Dover Lodge Refer to Good Practice Recommendations DS0000060224.V261317.R01.S.doc Version 5.0 Page 24 1 2 Standard YA23 YA39 The Registered Individuals must ensure that all staff undergo training around detection and prevention of abuse. The Responsible Individuals should consider investigating and employing a professionally recognised quality assurance tool within the home. Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 Dover Lodge DS0000060224.V261317.R01.S.doc Version 5.0 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. 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