Inspection on 20/03/07 for Eastcroft

This inspection was carried out on 20th March 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Eastcroft 17/11/05

Eastcroft 24/08/05

Eastcroft 27/10/04

Eastcroft 30/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Eastcroft Woodmansterne Lane Banstead Surrey SM7 3EX Lead Inspector Joseph Croft Unannounced Inspection 20th March 2007 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 Eastcroft DS0000013317.V327613.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. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastcroft Address Woodmansterne Lane Banstead Surrey SM7 3EX 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) 01737 357962 01737 352719 eastcroftnh@aol.com Mr Ioannis Andreou Mrs Soteroula Andreou Mr Ioannis Andreou Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20), of places Physical disability over 65 years of age (8), Sensory Impairment over 65 years of age (3) Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the 20 (twenty) service users accommodated up to 20 (twenty) may fall within the category DE(E), dementia over 65 years of age Of the 20 (twenty) service users accommodated within categories DE(E) or OP up to 8 (eight) service users may also fall within category PD(E) Physical Disability over 65 years of age. Of the 20 (twenty) service users accommodated within categories DE(E) or OP up to 3 service users may also fall within category SI(E) sensory Impairment- over 65 years of age. 17th November 2005 3. Date of last inspection Brief Description of the Service: Eastcroft is a care home providing nursing care for older people. Service provision includes dementia care and care of older people with physical disabilities and sensory impairment. The home is in private ownership and managed by the provider. The building is a large, detached property with car parking facilities, situated in a quiet residential area. Banstead village is within walking distance where there is a wide range of shops and other community amenities. Communal sitting and dining facilities are on the ground floor. These areas are tastefully decorated and comfortably furnished. The bedroom accommodation is arranged on the ground and first floor, accessible by passenger lift. The home has 16 single bedrooms and two shared bedrooms with en-suite facilities. There is an attractive, enclosed garden to the rear of the premises. The fees for the home range from £600 to £650 per week. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) undertook an unannounced site visit on the 20th March 2007 using the new ‘Inspecting for Better Lives’ (IBL) process. This inspection was conducted by Regulation Inspector Mr J Croft and was assisted throughout the site visit by the manager, who is also the registered person. The inspection took place over a period of 5 hours commencing at 10:00 and concluding at 15:00 hours. The inspection process included a tour of the premises, sampling of residents’ care plans, risk assessments, staff training records and staff recruitment files. Other documents sampled included policies and procedures, staff duty rota, menu, medication and records of medicines. Discussions took place with the manager and staff on duty at the time of this site visit. Discussions also took place with residents relatives who were present, who informed the Inspector their relatives are appropriately cared for by staff working at the home. Due to their needs, residents were not able to converse with the Inspector. Comment cards returned to the Commission For Social Care Inspection Surrey Local Office from residents, relatives and other associated professionals have been used as a source of evidence for this report. The manager informed the Inspector that a pre-inspection questionnaire was not received. Feedback was provided at the end of the inspection to the manager. The inspector would like to thank the staff and residents for their cooperation during this site visit. What the service does well: What has improved since the last inspection? Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 6 There were only two requirements made at the previous inspection, which have been complied with. 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. The summary of this inspection report can be made available in other formats on request. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of residents have been assessed prior to their admission to the home. EVIDENCE: The inspector sampled the care files of two residents living at the home. These evidenced that residents had a pre- admission assessment of their needs undertaken. The manager, who is the registered provider, undertakes an assessment of needs at residents’ homes or current placements. Information in these assessments included personal care, mobility, communication, physical illness, pressure sores and personal safety. This information was used to form the basis of the residents’ care plans, which identified the actions that carers should follow to assist an individual living at the home. Relatives spoken to during the site visit informed the inspector they had visited the home for a day prior to their relative moving in. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 9 The manager informed the Inspector that the home does not offer intermediate care. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Care plans sampled during this site visit were appropriately maintained with personal care needs documented and regularly updated. Members of staff were able to give an account of the contents of the care plans for the residents with whom they key work, and were aware of the need to review care plans on a monthly basis. Staff informed the Inspector that they encourage residents to make choices about their lives, the activities they like to do and the food they like to eat. Risk assessments included frequency of falls, nutrition, Waterlow score for skin care and moving and handling. Evidence was observed that risk assessments are reviewed on a regular basis. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 11 Residents are registered with the local General Practitioner and have access to all NHS services as required. Records of appointments are maintained in individual care files and on the daily notes maintained in the home. Records of nutrition are maintained, including monthly monitoring of weight. The home has a policy in place for the Administration of Medication, which the manager stated is due to be reviewed this year. A local pharmacy supplies all the medication to the home in blister pack form. The medication recording charts sampled were appropriately maintained, and medication is stored correctly. The manager informed the Inspector that only the qualified nurses administer medication. No current resident self-administers or is taking a prescribed controlled drug. The home has a contract in place for the disposal of medication. The manager informed the Inspector that the Pharmacist regularly visits the home to offer advice and support. During discussions relatives informed the Inspector that residents are able to see the GP when required. Staff on duty were interacting with residents in a supportive manner, addressing residents by their first names, and encouraging residents to be as independent as they were able to be. Staff informed the Inspector that privacy and dignity is respected through treating residents as individuals, staff knocking on bedroom doors and providing personal care in the privacy of residents’ bedrooms. The home has a policy in regard to Privacy and Dignity. During discussions visitors informed the Inspector that their relatives are encouraged to make choices, can access a telephone with support and receive their personal mail. Visitors to the home and cards received from visiting professionals were complimentary about the standard of care provided by the staff at the home. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to make choices about their lifestyles and social activities, and to maintain contact with their family and friends. Residents receive a healthy and varied diet according to their assessed needs and choice. EVIDENCE: The manager informed the Inspector that activities are organised each day for residents to take part in if they wish to. These activities include listening to music, reading, dominoes, craftwork and visiting local parks and garden centres. A “music man” visits the home on a monthly basis and organises sing-a-longs. The home has its own transport, which enables residents to enjoy external trips to the seaside and other attractions. The religious backgrounds of residents living at the home are Roman Catholic and Church of England. Church leaders visit the home regularly, and give Holy Communion on a weekly basis. During discussions the manager and staff informed the Inspector that visitors are welcome at the home, and residents can choose to see them in the communal areas or in the privacy of their bedrooms. Comment cards returned Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 13 to the Commission For Social Care Inspection informed that visitors could meet with their relatives in private. The home uses a five-week rolling menu that was viewed during the site visit. Menus offered a balanced diet and included fresh meat, fish and vegetables. The cook has been working at the home during the last five years, and had a good knowledge of residents needs. The home caters for the needs of residents who require a special diet. The cook maintains records of alternative meals provided. During this site visit it was noted that there was no fresh fruit available in the home. The cook informed the Inspector that fresh fruit is bought every Tuesday and Fridays, and had not yet arrived. The cook stated residents are provided with fresh fruit every day. Lunch was observed on the day of the inspection. This was a relaxed, unhurried meal, and there were sufficient numbers of staff available offering assistance and support where necessary. Relatives informed the Inspector that the food is always good, freshly cooked and nicely presented. The kitchen has been totally refurbished with new fridges, freezers, microwave and cookers. The home recently had an Environmental Health inspection and is currently attending to the recommendations that were made. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 were assessed. 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 complaints system to enable residents and their families to raise concerns. Staff having knowledge and understanding of adult protection issues protects residents, however, training in this area requires updating. EVIDENCE: The Commission For Social Care Inspection Surrey Local Office has not received any complaints about this home since the last inspection. The home has a Complaints Policy and Procedure that includes time scales and the Commission For Social Care Inspection Surrey Local Office details. A copy of this is kept in the entrance to the home and the Service Users’ Guide. Inspection of the complaints book indicated the home had not received any complaints. Comment cards received from residents and relatives indicated that they knew who to talk to if they wished to make a complaint. The home has received many letters from residents and their relatives expressing their gratitude for the care provided by the home. The home has a Protection of Vulnerable Adults Policy that had a review date of 2006. However, the home did not have a copy of the Surrey Multi-Agency Procedures of February 2005, therefore a requirement has been made that the Protection of Vulnerable Adults Policy must be reviewed to ensure it is written Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 15 in line with the Surrey Multi-Agency guidelines on the Protection of Vulnerable Adults of February 2005. During discussions, staff gave an account of whom they would report their concerns to regarding the protection of adults’ issues, and the procedures to be followed. Sampling of staff training files evidenced three staff had attended training on the Protection of Vulnerable Adults in 2005; other staff had received this training in 2003, and therefore requires updating. The manager informed the Inspector that he would immediately book this training for all staff employed at the home, and make an application for a place on the Surrey Multi-Agency training for himself. The home has a Whistle Blowing Policy and Procedure. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 16 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): Standards 19 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good communal and individual living space making it a safe and comfortable place to live. EVIDENCE: A tour of the premises was undertaken. The accommodation consists of sixteen single and two double bedrooms. Bedrooms and communal spaces were brightly decorated, and residents had their own personal possessions that included photographs, televisions and radios. Bedrooms viewed had call bells within easy reach of residents. The manager informed the Inspector that there is an ongoing programme of redecoration throughout the year. Relatives spoken to stated that the bedrooms are pleasantly decorated and are always very clean and tidy. All communal areas are accessible to residents. The home has grab rails, ramps and a service lift that helps residents to maintain their independence. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 17 On the day of the site visit the home was very clean, tidy and free from offensive odours. The home employs one domestic staff who undertakes all cleaning duties. The home has an Infection Control Policy. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing are satisfactory, ensuring staff have the qualities and training to meet the needs of residents. EVIDENCE: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to residents for any twenty-four period was adequate to meet the assessed care needs of the residents. Staff on duty includes qualified nurses, carers, a domestic, cook and two waking night staff. The manager informed the Inspector that he is supernumerary to the rota, but works at the care home full time. Observations at the time of this site visit confirmed good practice care delivery and positive relationships between residents and staff. The manager informed the Inspector that four members of staff had completed the NVQ level 2, and seven qualified nurses work at the home. The manager stated there had been difficulties retaining staff once they had completed their NVQ training. New staffs recently employed at the home are due to enrol for NVQ training upon completing their induction and foundation training. The manager informed the Inspector that staff training has also included Dementia, Wounds and Tissue Viability. The home has a Recruitment Policy and Procedure in place. The manager has complied with the requirement made at the previous inspection in regard to Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 19 obtaining Protection Of Vulnerable Adults (POVA) checks on staff, however, it was noted that one member of staff had commenced employment before the outcome of the POVA first check was received. The manager informed the Inspector that new staff do not work unsupervised with residents until all checks have been completed. The manager must ensure the outcome of POVA first checks have been received before staff commence their duties. The manager was advised to read the guidance on the Commission For Social Care Inspection website in regard to Criminal Record Bureau and POVA first checks. Recruitment files sampled contained an application form, two written references and Criminal Record Bureau checks. It was noted that one application form did not provide a full employment history. A requirement in regard to this has been made. Staff are provided with the General Social Care Council (GSCC) code of conduct, and a copy was maintained in the home. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for management and administration ensure the home is run in the best interests of residents, and the safety of residents is promoted and safeguarded. EVIDENCE: The registered person is the manager, and has worked at the home for twentytwo years. He informed the Inspector that he is a qualified registered nurse and holds a management qualification in care at NVQ level 4 and the Registered Managers Award (RMA). During discussions staff informed the Inspector that the home is appropriately managed, that the manager has an open door style of management. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 21 Quality assurance is undertaken by the home through questionnaires for residents, their relatives and other associated professionals. The last survey was undertaken in September 2006. Monthly staff meetings are held and minutes of these were viewed during this site visit. Relatives control all residents’ financial affairs; the home does not hold money for residents. Staff files sampled included notes of supervision undertaken by the manager. The Commission For Social Care Inspection Surrey Local Office had received regulation 37 notifications, however, during the sampling of records, it was observed that one resident had an accident that had not been notified through the Regulation 37. A requirement has been made that all events in the care home which adversely affects the well-being or safety of any resident must be notified to the Commission For Social Care Inspection in writing. The home’s staff training programme included training in first aid, moving and handling, fire safety, health and safety and infection control. However, it was noted that some of this mandatory training requires updating. The manager informed the Inspector that this would be addressed immediately. Sampling 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 and fridge and freezer recordings were regularly checked. Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 2 3 Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP18 Regulation 13 (6) Requirement Timescale for action 20/04/07 2. OP29 19 (1) (b) 3. OP37 37 (1) (e) The registered person must review the Protection of Vulnerable Adults Policy and Procedure to ensure it is written in line with the Surrey MultiAgency guidelines on the Protection of Vulnerable Adults of February 2005. The registered person must 20/04/07 ensure all application forms provide a full history of employment. The registered person must 27/03/07 ensure that all events in the care home which adversely affects the well-being or safety of any resident must be notified to the Commission For Social Care Inspection in writing. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Eastcroft Refer to Good Practice Recommendations DS0000013317.V327613.R01.S.doc Version 5.2 Page 24 Standard Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 25 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 Eastcroft DS0000013317.V327613.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!