Inspection on 18/04/07 for Eastbury Manor

This inspection was carried out on 18th April 2007.

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

Eastbury Manor 27/09/05

Eastbury Manor 11/05/05

Eastbury Manor 20/10/04

Eastbury Manor 26/05/04

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 Eastbury Manor The Street Compton Guildford Surrey GU3 1EE Lead Inspector Mavis Clahar Unannounced Inspection 18th April 2007 09:15 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 Eastbury Manor DS0000017608.V333196.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. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastbury Manor Address The Street Compton Guildford Surrey GU3 1EE 0113 381 6100 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) eastburymanorall@bupa.com www.bupa.com BUPA Care Homes (BNH) Limited Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Of the 33 beds in this home, up to 5 beds may be used for short-term respite or short-term convalexcent care. In respect of this service, Service users may be admitted from the age of 60 years. In respect of up to 5 service users receiving short-term respite or convalescent care, the age range may be from 50 years and over. 27th September 2005 Date of last inspection Brief Description of the Service: Eastbury Manor Nursing Home is a substantial detached property that has been converted to provide nursing accommodation for up to thirty-three service users. The home is owned by BUPA Care Homes. The home is located in the village of Compton, near Guildford, Surrey. The home is arranged on two floors with both chair lift and passenger lift access to the upper floors. 22 of the rooms are for single occupancy, nineteen of which have en-suite facilities. There are two double rooms with en-suite facilities. The home is situated in extensive grounds of seven and a half acres, which is mostly laid to lawn, and some areas of flowerbeds; there is also a large lake. Car parking facilities are available in the grounds. Fees at this home are in the range of £478 to £1339.50 per week. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit, which forms part of the home’s first key inspection to be undertaken by the Commission for Social Care Inspection (CSCI) was undertaken by Mrs Mavis Clahar on the 18th April 2007 and lasted for eight hours and fifteen minutes; commencing at 09:15 hours and concluding at 17:30. The majority of the service users spoken to were able to express their thoughts and feelings about the care they receive. The information contained in this report was gathered mainly from observation by the inspector, speaking with one visitor to the home, speaking with a number of service users, and speaking with care staff. Further information was gathered from records kept at the home; and from the pre inspection questionnaire sent to CSCI by the home. The first part of the inspection was spent observing the registered nurse administering medication to service users. This was followed by time spent discussing the inspection process with the Senior Registered Nurse, as the manager was away on a training course, followed by a tour of the home which included time spent in discussion with service users, care workers and the Chef. The senior nurse and staff are aware of the Laws regarding equality and diversity and this was reflected in the staff mix, and a number of care workers have commenced the Equality and Diversity training course. All service users in this home are Caucasian. Service users spoke highly of the home, the staff and the care they receive. One service user said “I have been here for the last eight years and during that time I have never seen any behaviour of the staff that I can criticise; this is a good home and by and large you would be hard pressed to improve on this”. These comments were also supported by one relative who told us she has recommended the home to her friend who is looking for a home for her relative. All records sampled were mostly up to date with care plans being signed by the service users or by relatives. Requirement relating to the upgrading of the statement of purpose, the necessity of maintaining strict observance to the home’s policy of disposal of medicines and the maintenance of the outer structure of the home were made. The inspector would like to thank all the service users, care staff and chef who made the visit so productive and pleasant on the day. What the service does well: Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 6 The home has endeavoured to comply with the requirements made on the last inspection. Observations of care staff interactions with service users indicated that service users were treated with dignity and respect. It was also observed that great care was taken in respect of the service users personal belongings and standards of cleanliness in bedrooms ensured service users lived in a safe, well-maintained environment. The home has a stable work force, which should benefit the service users. What has improved since the last inspection? What they could do better: The home continues to provide a good standard of care to the service users. Special attention must be made to the disposal of medication, in that the consignee must sign the records to show the medication has been disposed of correctly. The outer structure of the home must be kept in the same excellent condition as the inside of the home. Ensure that the home’s statement of purpose is kept up to date. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 8 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 Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 13 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their relatives have the information needed to choose a home, which will meet their needs and respite care service users are assured their independence will be maintained. EVIDENCE: The home has a policy and procedure on admission and discharge of service users. Within the admission policy all service users must have an assessment prior to being admitted into the home. The manager who is trained in the principles of assessment of service users’ needs based on what the care the home says it will provide carries out all pre admission assessments. Review of a random sample of service user’s files demonstrated that pre admission assessments are being carried out. Service users admitted for respite care are helped to maximise their independence and to return to their homes. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 10 There is a new manager in post since 10/02/07, and the statement of purpose has not been changed to reflect this. A requirement was made on this standard. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good and clear care plan in place for service users, which also includes appropriate risks assessments. This forms the basis for care based on the agreed care needs of the service users and demonstrated that health and personal care needs were met. Care staff receives training to meet the assessed care needs of the service users ensuring that competent staff supports service users and their health and care needs are met. The home’s medication policy on receiving, storing and administering of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. However some improvement must be made to the return of medication practices to ensure the safety of service users. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 12 EVIDENCE: The randomly selected care plans were clear and easy to read, identifying potential and actual risks to service users. The daily work sheet along with discussion with service users demonstrated that service users care needs are fully met. One service user at the time of inspection told us he managed his own medication and this was in line with the homes’ policy on service users managing their own medication Good clear records are kept of medication receipts, storage, and administration. The consignee collecting the returned medication is not signing the records, and we found medication that was stopped since August 2006 still in the Control Drug cupboard. A requirement was made on this standard. Care staff identified as capable to administer medication are requested to leave a specimen of their signature in the medication trolley. All service users have a recent photograph included in their medication record to reduce the risk of mistakes happening during medication administration. There was one visitor to the home who spoke with the inspector. This relative was happy with the care given to the relative. She said the staff are always polite to her and she was free to visit any part of the home her relative was using. The relative said “ I am satisfied with the car my relative receives at this home and I have also recommended the home to my friend who was looking for a home for her relative”. Service users were observed being treated in a friendly but respectful manner by care workers. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The home employs an activity-co-ordinator who provides a range of activities based on the needs of the service users. This activity can be one to one as observed on the day of the inspection or in a group. It was noted that care workers were also involved in the exercises with their service users. On the day of the visit the home hoisted a “Victorian Communie-Tea Party”, where members of the community were invited. Both service users and visitors said Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 14 this was a great success and the two ladies who entertained us with their songs were marvellous. Visiting is open, and service users can entertain their guests in their bedrooms in private or in the spacious communal areas of the home. The Church of England (C/E) Vicar visits on a regular basis. Three of the service users spoken to said they had choice in their clothing. Sometimes they receive help from their key worker. One service user told us he is self-caring, dresses himself, manages his medication and takes himself off to Reading, Godalming, Kingston and Guildford on his own. Since he has given up driving he uses taxis or public transport. On the day of inspection all service users were dressed appropriately for the warm weather. Service users spoken to say the food was very good and plentiful and they can have more if they wish. The Chef operates from a four-week menu with the winter menu being in use now. There is always a choice of two hot meals per day at mid-day, or salad at mid-day or the service user can choose their own food e.g. omelette etc. On the day of inspection service users had a choice of two main dishes, followed by dessert. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults’ policies are in place to protect the service users from abuse EVIDENCE: CSCI Eashing/Oxford received no complaints about the home. Five substantiated complaints were logged at the home, and were all dealt with satisfactorily according to the home’s records; and within the home’s time scale for dealing with complaints. The deputy manager told us that both her and the manager are in touch with service users on a daily basis and issues raised are dealt with immediately; this reduces the incidents of formal complaints. Service users and relative spoken to said they have no need to complain, as they are able to discuss everything with the manager. The home has a complaints procedure and policy, which is fully adhered to. The care workers were aware of the homes’ policy and procedure on Safeguarding Adults and felt secure in the knowledge that if they had to use Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 16 the whistle blowing procedure the manager and the Owners of the company would support them. A random sample of care workers training record demonstrated that care workers are being trained to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables service users to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: In discussion with service users and care workers it became clear that the management and staff encourage service users to see the home as their own home. It presents as a comfortable, attractive home, which has all the specialist adaptations, needed to meet the service users needs. It was noted that call bells were left within reach of each service users and service users said the bells are answered promptly. The home has attractive gardens, which are well maintained and there is good access to the gardens from various parts of the home. Some service users told the inspectors that they try to go out Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 18 daily weather permitting to enjoy the gardens. The inspector noted that adverse weather would not stop service users enjoying the garden, as the windows are low enough to allow service users to view the gardens from their armchairs. It was noted that service users were able to personalise their bedrooms with small items of furniture, paintings on the wall and many family photographs. One service user told us she has her pet cat with her at the home. It was noted that some slates were missing from the roof over the balcony to the rear of the building. A requirement was made on this standard. Generally, the home presents as clean, safe, pleasant, hygienic and tidy and free from offensive odours. Random review of care workers training record demonstrated they have had training in infection control and this was evident in the storage of waste. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of the service users. EVIDENCE: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was adequate to meet the assessed care needs of the service users. The home has a programme of planned training in place and all members of staff have an individual training record. Over 50 of care workers have attained the National Vocation Qualification at Level 2 (NVQ L2). Care workers are encouraged and enabled to undertake developmental training as well as the mandatory training. . All newly appointed staff undertakes an induction programme. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and from review of care workers training records. It was noted that staff turnover at the home is relatively low. All care workers are Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 20 checked prior to commencing employment, and they are in receipt of terms and conditions of employment as evidenced in their randomly selected files. We were told that supervision record were up to date and this was verified during random sampling of care workers files Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35.38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience to run the home and works to continuously improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home. The views of service users and their relatives are actively sought in the running of the home Service users financial interests are safeguarded. The service provides training on health and safety issues for all staff and service users are involved in the running of the home. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 22 EVIDENCE: In discussion with the manager on 19/04/05, she has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. She is a Registered nurse with many years experience of caring for the elderly, and will be starting the Registered Managers Award course in May 2007. During discussion with the manager it was evident she was knowledgeable about the care needs of the service users and the training needs of the care workers to meet these identified needs. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection aware of their role and responsibilities. Some of the service users in this home are unable to participate in the running of the home. However, the manager told us that relatives’ involvement is encouraged. The one visitor who spoke with the inspector supported this. In discussion with service users they confirmed their involvement and that of relatives in the running of the home. The deputy manager told us that this years Quality review is not yet completed, but as a result of the findings from last years Quality Review, changes were made to the Activities programme and the Chef invited service users and visitors to sample the food and give constructive criticism in order that the food presented to service users would be constantly reviewed and improved The home does not become involved in service user’s finance. The relatives/court manages all their finance. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, water temperature fridge and freezer recordings were regularly checked. Random sample of care workers’ training files demonstrated that up to date and relevant training were carried out by care workers to protect service users’ health, welfare and safety. In discussion with care workers they discussed their understanding and implementation of appropriate procedures to safeguard service users. Furthermore they spoke about their understanding of promoting safe working practices based on their health and safety training. Throughout the service there is a highly evolved understanding of the equality and diversity needs of the individual service users and three Registered General Nurses and one carer has commenced the Equality and Diversity course. Care workers are confident in delivering high quality outcomes for service users in the areas of age, sexuality, gender, disability and belief. Although the care workers are knowledgeable about issues relating to race and equality and diversity, they are not able at the moment to put this knowledge into practice, as the current service users are all Caucasians. Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 23 Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 24 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 2 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 4 Requirement The statement of purpose must be updated to reflect new manager and change of address for CSCI The policy regarding disposal of medicines must be implemented and consignee must sign for medicines removed for disposal. The tiles missing from the roof over the balcony must be replaced. Timescale for action 18/06/07 2 OP9 13 (2) 18/06/07 3 OP19 23 (2) (b) 18/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Eastbury Manor DS0000017608.V333196.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!