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Inspection on 10/04/07 for Eliot House Nursing Home

Also see our care home review for Eliot House Nursing Home for more information

This inspection was carried out on 10th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This home provides a pleasant, homely and clean environment for residents. The home has provided evidence prior to this inspection which shows that the home continues to meet the needs of the residents. One visitor spoken to expressed his satisfaction about all aspects of the care provided. The care staff are a competent team who were observed to be kind and polite when speaking to residents. The commission sent resident questionnaire forms (Have Your Say About...) to the home prior to this inspection and four were returned. Relatives of residents completed the majority of questionnaires and some were not completed. The manager and staff are good at developing positive relationships with each resident and their relatives. The home also has a training profile for all care workers detailing what training has been undertaken.

What has improved since the last inspection?

The home has taken action to address those requirements made in the last inspection of this home. Nationally recognised vocational training has now been made available for staff to ensure that adequate numbers of trained care workers are available in the home. The home carries out risk assessments on those residents who use walking aids and have had falls. The home has now carried out relatives meetings and started a quality monitoring system, which will be published for the information of residents and visitors.

What the care home could do better:

Those nursing staff who administer medication to residents need to ensure that they record immediately when they have administered medication to residents, to ensure that no lapses occur or are overlooked. Domestic staff have not had any infection control training to ensure that they have the knowledge to keep the home as far as possible free from possible infectious diseases.

CARE HOMES FOR OLDER PEOPLE Eliot House Nursing Home Crooked Billet Street Morton Gainsborough Lincs DN21 3AH Lead Inspector Mr Doug Tunmore Key Unannounced Inspection 10th April 2007 09:30 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 Eliot House Nursing Home DS0000063148.V333670.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. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eliot House Nursing Home Address Crooked Billet Street Morton Gainsborough Lincs DN21 3AH 01427 617545 01427 611718 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) MPS Care Homes Ltd Karen Bowler Care Home 29 Category(ies) of Dementia (29), Mental disorder, excluding registration, with number learning disability or dementia (29), Old age, of places not falling within any other category (29) Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal and nursing care for service users of both sexes whose primary needs fall within the following categories: Dementia - over 55 years of age Mental Disorder, excluding learning disability or dementia - over 55 years of age Old age, not falling within any other category The maximum number of service users to be accommodated is 29. Date of last inspection 19th April 2006 Brief Description of the Service: Eliott house is a care home providing personal care and nursing care for 29 people who are accommodated within the category of older people all within the category of dementia or mental disorder. The care home is set in the village of Morton, which can be found on the outskirts of Gainsborough. The care home is a listed building, a new extension has been added to the rear of the property. It is surrounded by its own gardens which are totally fenced in providing security for service users staying at the care home. There are a number of patio areas outside the home where service users can sit in the summer months. There are public transport services to the care home and parking is provided at the front of the home. Additional on street parking is available. There are local shops and public houses within walking distance of the care home. The first floor of the care home can be accessed by staircase or a lift. The home has 21 single rooms and 4 double bedrooms. Thirteen of the rooms have toilet facilities. The current scale of charges at this home is from £380.00 to £569.50. Additional costs are made for hairdressing, chiropody and newspapers and escorting residents to hospital etc. These are all private arrangements and the individual service users meet these costs. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced key visit to the home. This visit took into account any previous information held by The Commission for Social Care Inspection (commission) including the homes previous inspection reports, both key and random and their service history. The site inspection consisted of talking to three residents and tracking their care which, including looking at their records and assessing their care. The regulator joined residents for lunch and observed the care they received throughout this visit. The inspector spent time with the senior nurse on duty and spoke to the cook, a carer, a domestic worker and the laundry worker. One visitor was also spoken to during the visit. The registered manager was on holiday during this inspection, but contact was made on the 11/04/07 and issues relating to the running of the home were discussed. A partial tour of the home and a review of a sample of the records were also included. What the service does well: What has improved since the last inspection? The home has taken action to address those requirements made in the last inspection of this home. Nationally recognised vocational training has now been made available for staff to ensure that adequate numbers of trained care workers are available in the home. The home carries out risk assessments on those residents who use walking aids and have had falls. The home has now carried out relatives meetings and started a quality monitoring system, which will be published for the information of residents and visitors. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 6 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. Eliot House Nursing Home DS0000063148.V333670.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 Eliot House Nursing Home DS0000063148.V333670.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): 1,3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home carries out care assessments on all prospective residents prior to admission, which helps ensure that their care needs would be met. Prospective residents have information to help them make a choice of where to live. EVIDENCE: A review of all information available prior to this visit including a key visit made to this home in April 06 and evidence seen at this inspection in residents files and care plans, showed that the home does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming whether they can meet the residents care needs or not. The registered manager contacted the regulator and confirmed that not all files have care needs pre-admission forms prior to her appointment. However, she confirmed that these files are being updated with current care needs assessments to bring them up to date. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 9 A visitor stated that his wife had been visited prior to admission and an assessment had been undertaken. However, he could not remember getting a letter from the provider confirming that they could meet her needs. Three of the four questionnaires confirmed that residents had information about the home prior to admission. A written comment made in a questionnaire was, ‘good reports received from other carers (relatives) about good conditions at Eliot House’. This home does not provide intermediate care. Eliot House Nursing Home DS0000063148.V333670.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): 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. Care plans are in place and provide information to enable residents to develop their lifestyles as they may wish. There is good care planning in this home, which helps ensure that the general health and welfare of residents is addressed. EVIDENCE: A review of all information available prior to this visit and one previous visit carried out in April 06 showed that residents had detailed care plans, which described their health and welfare needs. Care records included admission details, assessments of daily living activities, personal history, moving and handling assessments, risk assessments, care plans and daily records. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 11 Individual care plans evidenced that accidents are recorded in the homes accident book and in the residents daily notes. Accidents resulting in bruises or abrasions are recorded on the residents body map, which could be used for the mapping of any cuts or abrasions over a period of time. This inspection showed that GPs, community nurses and chiropodists visit the home on a regular basis to attend to the health care needs of residents. Those questionnaires returned by residents showed that two felt that they always receive the medical support that they need and two felt that they usually received the medical support that they need. One resident commented that he felt that staff were always available when they need them and two felt that staff are usually available when they need them. One resident stated that staff are sometimes available when needed. Written comments made by residents/relatives were, ‘The staff are very good, Matron and staff, including kitchen staff and cleaners go out of their way to be helpful and very kind’. One visitor seen on the day of the inspection stated that he is a regular visitor and felt that his wife’s needs were met at this home. Residents medication given at breakfast by the nurse on duty was seen to be delivered to residents in the appropriate container, in line with the homes medication policy. However, two medication sheets were not completed immediately by the senior nurse on duty. A previous visit in April 06 found that the homes training file evidenced that five nurses at the home are undertaking a twelve-week course at Grantham College on the safe handling of medication. The pharmacist visited the home on the 21/03/07 and recorded that ‘administration of records are well kept’. Staff were seen to treat residents with respect and maintained their dignity as far as possible when transferring them from chairs to slings to undertake personal care. A visitor confirmed that his wife’s privacy is maintained and that staff are very good. A carer stated that she is aware of being mindful of residents privacy and that she talks to residents when undertaking intimate care needs. Eliot House Nursing Home DS0000063148.V333670.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): 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. Residents receive a nutritious, varied diet meeting individual preferences and health requirements. Relatives and friends of residents are made welcome in this home by the carers. A range of stimulating activities are available to residents which they can benefit from. EVIDENCE: A previous visit in April 06 found that the home undertakes a variety of activities for residents. This visit showed that there are weekly activities sheets for five days of the week. Activities are made available by those carers who have an interest in promoting activities for residents. The activity sheets showed - gentle exercise is undertaken by throwing a soft ball to each other, birthday celebrations, facials, hairdresser visits, walks in the village and singa-longs. Over the Easter period there was a raffle. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 13 One visitor confirmed that he is made welcome at the home and that he feels that the staff are a ‘good bunch’. He further commented that there are activities as well as two outings, one to the coast and the other on a riverboat. During the visit to this home in April 06 a relative confirmed that he joins in activities with his wife. Four residents questionnaire showed that one felt that activities are available to him always; one resident commented that activities are usually available, with two stating that activities are sometimes available. A previous visit to the home also showed that a resident confirmed that she could take her visitors to her bedroom. The homes assessment form identifies all the likes and dislike of a resident and demonstrated that residents are to be consulted about those aspects of their daily living. Life histories are also available on residents files giving care staff information about the background of residents and any hobbies or friends they might have had. The inspector joined residents and a relative for lunch and found that the meal was hot and very tasty and that choices were available. Some residents eat with the support of care staff or visiting relatives and it was noted that care is taken in ensuring the residents dignity during this process. At previous visits, visitors commented that the meals are very good and they are encouraged to stay for lunch. The cook stated that she was aware of residents dietary needs and had information relating to any allergies. Residents/relative questionnaires showed that one always liked the meals provided and two were unable to comment on behalf of their relatives who were unable to offer an opinion and one questionnaire was blank. One relative wrote that ‘ I have not had a meal at the home, but I have seen what is on offer and it looks very good’. Eliot House Nursing Home DS0000063148.V333670.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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are kept safe by good policies, procedures and staff knowledge. Staff are aware of how to respond to a complaint or an adult protection allegation. EVIDENCE: A random inspection dated October 06 found that the providers complaints format ensured that residents/relatives are kept informed throughout the complaints process. The homes pre-inspection questionnaire evidenced that there had been two complaints since the last inspection but no information was available as to whether they were substantiated or not. Residents questionnaires showed that two residents were aware of how to make a complaint, with two questionnaires blank. Two questionnaires showed that the residents/relatives knew who to speak to if they were unhappy. Two questionnaires were again blank. A written comment was that ‘matron is usually available, or one of the nurses’. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 15 One member of staff demonstrated that she was aware of the action to take if she became aware of a safeguarding vulnerable adults issue. The homes pre-inspection questionnaire showed that the home has had one safeguarding adults issue. The provider has informed the Social Services Department as well as the police to ensure that the resident’s best interests are acted upon. A visitor commented that he feels his wife is safe in this home and has had no falls since being admitted. A carer stated that she has undertaken safe guarding vulnerable adults training, as have most of the workers at the home. She confirmed that this training is a annual event. Eliot House Nursing Home DS0000063148.V333670.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): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and residents are enabled to personalise their rooms. The home is clean and tidy, with a pleasant smell throughout. EVIDENCE: The homes maintenance book was seen and showed that the handyman, who also undertakes the decoration of the home, carries out general maintenance. The home was seen to be in a good state of repair with residents rooms personalised with photographs and other memorabilia. At a previous inspection, a resident confirmed that she was happy with her room. Questionnaires returned showed that one resident/relative felt that the home is fresh and clean and one felt that it was usually fresh and clean. A written comment was that ‘some of the furniture is in a worn state but most has now Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 17 been replaced and the decorations are being carried out on the walls and ceilings’. Pathways outside the home and corridors inside were clear of potential hazards and there was room for residents to move freely. Equipment such as hoists and wheelchairs were stored in a safe manner. Hazard signs were on display for wet floors. This inspection found that the home was clean and well-aired and no unpleasant odours evident. Gloves and aprons are available and the home has an infection control policy. The home has one domestic cleaner who is supported by the kitchen assistant. The domestic confirmed that she had no training relating to infection control, but was to undertake nationally recognised vocational training in the near future. Eliot House Nursing Home DS0000063148.V333670.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): 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. Adequate staff numbers are on duty to meet the needs of residents during the day and night at this home. EVIDENCE: A review of all information available prior to this inspection including the homes pre-inspection questionnaire and the outcome of the additional random inspection in October 06 evidenced that; the home now provides nationally recognised induction training for all carers who do not currently have this training. The homes pre-inspection questionnaire evidences that training is undertaken by care staff and proposed training for 2007 is in place. The random inspection also found that the registered manager also carries out appropriate checks for all new workers before they commence work at this home. Might want to give examples such as refernces and crb/pova All care workers have been given The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 19 Four care workers have completed NVQ training and twelve are currently at various stages of completing their NVQ training. A carer stated that she has NVQ levels 2 & 3 and had undertaken training, including dementia awareness, health and safety, moving and handling and basic food hygiene. The homes pre-inspection questionnaire and the duty rota sent to the commission showed that adequate staff numbers are on duty to meet the needs of residents during the day and night in this home. A carer said that the numbers of staff on duty at the busiest times are able to cope with the numbers of residents. Eliot House Nursing Home DS0000063148.V333670.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): 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. Management approaches and arrangements are in place to ensure the health, safety and welfare needs of residents are met. EVIDENCE: The Commission undertook a fit person interview in 2006 and found the manager to be suitably qualified and has the appropriate training and experience to manage this home. A visitor and care staff alike made positive comments about the way in which the manager runs this home, finding her approachable, supportive and able to keep confidential information to herself. Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 21 The manager conducts an in house quality check by using questionnaires for both residents and visitors. The managers report will be completed when all questionnaires have been returned. The random inspection found that the manager undertakes residents/relatives meetings with the last meeting two meetings being held on the 21/09/06 and 07/03/07, evidencing that residents/relatives have a voice and feel free to express opinions. A visitor confirmed that he attended both of the above meetings. One residents allowance was checked during the random inspection in October 2006 and it was found that it was kept in individual plastic wallets and an accurate record was kept with receipts available relating to monies spent. A visitor confirmed that he looks after his wife’s finances and that the manager gives him receipts for monies spent. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. The homes pre-inspection questionnaire has evidenced that maintenance and service histories of all aids and adaptations are carried out as required by law. Eliot House Nursing Home DS0000063148.V333670.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 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 3 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 Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Eliot House Nursing Home DS0000063148.V333670.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!