CARE HOME ADULTS 18-65
Fairmont 30 Watling St Road Fulwood Preston Lancashire PR2 8DY Lead Inspector
Ms Susan Dale Key Unannounced Inspection 4th September 2007 10:00 Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 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 Fairmont DS0000009842.V338358.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Fairmont Address 30 Watling St Road Fulwood Preston Lancashire PR2 8DY 01772 715228 01772 713768 jtcare@hotmail.com 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) J.T. Care Homes Limited Care Home 28 Category(ies) of Physical disability (28) registration, with number of places Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th June 2006 Brief Description of the Service: Fairmont is a residential care home for twenty-eight adults both male and female with a physical disability. The home is situated in Fulwood, Preston close to local shops and several other amenities. The home is a purpose built three-storey building with a passenger lift that facilitates access to all parts of the building. A large lounge is situated on the ground floor and a smokers lounge on the lower ground floor. The front door of the home is automatic providing easy access for all wheelchair users. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 4 hours. The inspector was able to speak to service users, staff and the manager. There were no relatives/friends visiting the home at the time of the inspection. A tour of the premises took place. Prior to the inspection a number of comment cards were delivered to service users, relatives/friends and health professionals. A number of comment cards were returned; 11 from service users; 1 from a relative/friend and a General Practitioner. The inspection and comments were all very positive. What the service does well:
The home provides a secure base with an informal atmosphere, service users are able to please themselves with regard to meals and meal times, getting up and going to bed and are supported by the staff to be as independent as possible. Service users are able to pursue hobbies and interests and friendships within the home and in the wider community. The home itself is well maintained both inside and outside and there are several areas for service users to go when they wish to be on their own or with others. Meals and meal times are flexible and individual choices are recognised. The home is well placed for any involvement with the local community and service users appreciate this. Staff are able accompany service users when they wish to go out as long as the outing is planned ahead. Visitors to the home are made to feel welcome at any time. Comments from service users and staff include the following: “Treated like family” “Couldn’t have been treated any better. Couldn’t have made a better decision.” “If there are any problems the staff and manager are very polite with the residents and they care about their care and well being.” Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection?
There have been several improvements over the last twelve months. There is now a new manager who has a nursing qualification and lengthy experience in the provision of care. This has brought some stability to the home and a chance to determine new strategies to improve the procedures within the home. Several areas of the home have been improved with a complete refurbishment of the kitchen and the lounge now has a plasma large screen TV as well as a smaller TV. There are plans to enlarge some of the smaller bedrooms in line with others and the TV has been removed from the smoking room to encourage less time spent within a smoky atmosphere; this strategy appears to be working. A large patio area has been made at the rear of the home with seating and a barbecue has been purchased. The outside of the home has been improved with the removal of overgrown bushes and trees, which has opened up the space and allows more light. A licence has been applied for and obtained in order to hold ‘Film Nights’ and the service users are able to choose which films they would like to see. An Activities person attends the home twice a week now instead of once and the hairdresser now comes once a week instead of once a fortnight. Changes have been made to meetings held for service users with the emphasis being that it is their meeting and not one for managers to enforce policies and procedures as it was previously. Service users now have more of a say on how the home is to be run and voice any concerns they may have. Service users are also now able to choose the gender of their key worker and changes are being made to the documentation to record which staff member has been allocated to each service user. A record is now being kept of any service users’ wishes with regard to their death. The manager has ensured that a wider use is made of other General Practitioners (GP) in the area, as previously one GP practice was favoured above others. Service users are now able to have more choice of drinks at mealtimes, coffee, tea or squash. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 7 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. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome group was adequate. The assessment pro-forma should be expanded to include emotional/psychological needs such as hobbies or education, family and social contacts. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user records were examined and an assessment takes place that covers all physical and health requirements; the assessment pro-forma does not take into account any hobbies, interests or cultural or religious requirements. The manager confirmed that she has to use standard assessment pro-formas used in other older persons homes owned by J.T. Care Homes Ltd; and they are not as suitable for younger adults. The inspector is satisfied by talking to service users that their wishes with regard to hobbies and interests is taken into account and they are encouraged and assisted in all aspects of their physical and emotional requirements including contact with family. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome group was adequate. A care plan is devised that could be improved with regard to the recording of any individual risks. Service users are now encouraged to participate more in how the home is run. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The assessment process leads to the development of a care plan that covers all areas of physical need. As detailed in the previous section, the care plan only covers physical needs described as ‘problems’ and do not record emotional requirements. Any risks connected with the care plan are examined and recorded however many of the strategies detailed to reduce any risk are the same and do not reflect the individual concerned. There was no evidence of a signature from the service user on the plan. A recommendation was made that the pro-formas for assessing and examining any risk are changed to a more flexible version that could record any potential risk to the individual. The care plan should also record any hobbies, interests etc. and examine any individual risk connected with carrying out these requirements.
Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 11 The care plan now includes any service users’ wishes with regard to death whilst in care. Service users are also now able to choose the gender of their key worker and changes are being made to the documentation to record which staff member has been allocated to each service user. The care plans are reviewed once a month but the out of the care plans examined only one had been updated following health problems, otherwise a review consists of ‘no change’ and a date. A recommendation was made that a comprehensive review should be undertaken on a regular basis to ensure that there has been no changes and that relevant persons have been invited to the review including service user, relatives, health professional, key worker as appropriate. Service users confirmed that they receive encouragement from staff and lead independent lives as much as possible, socialising visiting the shops and pubs, reading and watching TV. Strategies are in place via the care plans to ensure service users co-operate where there is an element of risk to other service users and staff through their behaviour e.g. excessive drinking. There has been an improvement with regard to the participation of service users in the running of the home. At the last inspection the service users meetings were used to dictate management instructions and did not allow the service users to set the agenda or discuss any issues they would like to raise. There was evidence that service users are now able to set the agenda and put forward their wishes and views on the running of the home. It was recommended that a recording is made of who attends the meetings. There were 11 comment cards returned from service users and all of them were positive with staff generally listening and acting on what was said to them and they were allowed freedom at all times. Comments included: “Treated like family” “Couldn’t have been treated any better. Couldn’t have made a better decision.” “He gets taken out by the staff when they can which he loves.” “If there are any problems the staff and manager are very polite with the residents and they care about their care and well being.” Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome group was good. Service users are encouraged to participate in activities, integrate with the local community and maintain relationships with family and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users and staff confirm that opportunities are provided to maintain and develop social, emotional, communication and independent living skills. Service users are provided with information about local churches and encouraged to access social activities in the community. The home is situated close to local shops and public houses and is situated on a bus route, which provides access to the town centre. Service users confirmed that they are encouraged and supported to participate in the local community. Service users are able to go out accompanied as necessary by a staff member. The only draw back to this is that the outing has to be booked in advance, as an additional member of staff has to be on duty for the outing.
Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 13 Service users spoken to confirmed that a range of activities is provided. A dedicated Activities Co-ordinator is employed by J.T. Care Homes Ltd. to attend the home now two days a week. The home has now obtained a film licence and film nights are being planned with the choice of film decided by the service users. Activities include shopping trips either in a group or individually; quizzes, chess, scrabble and carpet bowls. The home has purchased a table football and pool table and the lounge has been fitted with a large plasma TV. Service users are also assisted to go on holiday individually and are encouraged to be as independent as possible and pursue their chosen hobbies and activities. The hairdresser visits the home now once a week instead of once a fortnight Service users confirmed that they are supported in maintaining links with family and friends. Service users are able to maintain friendships outside the home and lead as independent a life as possible. The home has a very attractive dining room in which meals are served at individual tables. Meals and mealtimes are flexible and hot meals are provided at lunch and teatime according to choice. Coffee and tea are now available at mealtimes as well as squash drinks. Service users confirmed that the meals are excellent and a relative made the following comment: “I feel the home does well looking after the peoples needs. I never hear anyone complaining about the food and the home is scrupulously clean.” Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome group was good. The physical and emotional health needs of the service users are met with appropriate policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are facilitated to take control and manage their own healthcare. One General Practitioner’s (GP) practice was generally used by the home previously and the new manager has ensured that service users were able to have more choice with regard to a GP. There was evidence in the documentation of visits by GP’s as well as hospital visits and other healthcare facilities such as Dentists and Opticians. The communication book contained some very personal details on individual service users; the book should be used for more general notes and any personal details should be recorded on the individual files. A comment card was received from a General Practitioner who confirmed that staff had an understanding of the health needs of the service users and made the comment that the staff were experienced and competent. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 15 Service users spoken to confirmed, that they have a choice with regard to meals, bed and bath times and are able to choose their own clothes, make up etc. Technical aids and equipment were in evidence to assist services user with their day-to-day requirements. Consent to medication was obtained from service users and recorded in their individual plans. Procedures, documentation and suitable storage were in place for anyone wishing to self-medicate but because of the nature of the home and its service users all were deemed unsuitable to self-medicate. Medication was administered by internally assessed members of staff and supervised by the manager. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome group was good. There are suitable procedures in place for the service users to express their views and to protect them from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a suitable complaints procedure that is publicised within the statement of purpose and service users guide. The complaints record was examined and there was only one recording made since the last inspection. There have been no complaints received by the Commission for Social Care Inspection since the last inspection. Service users confirmed that they are aware of the complaints procedure. Staff spoken with confirmed that they had been provided with training on Adult Abuse and Whistle Blowing and would know what to do in the event of any abuse. The home has a policy on Adult Abuse and Whistle Blowing. Suitable policies and procedures are in place with regard to service users’ financial affairs. A safe is available for the storage of any valuables. Staff policies ensure that staff do not benefit from service users’ wills. New staff are cleared with the Criminal Records Bureau and checked against the Protection of Vulnerable Adults Register (POVA). Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome group was good. The home is well maintained and provides a comfortable homely environment that promotes the independence of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A maintenance programme is on going and there have been general improvements throughout the home including a complete refurbishment of the kitchen. The lounge now has a large plasma TV at one end of the lounge and a smaller TV at the other end. The TV has been taken out of the downstairs smoking lounge in order to encourage service users not to stay in a smoky atmosphere and this has proved very successful. Outside the home there is a new patio area with seating and a barbecue. Trees and bushes have been cut back and this has opened out the space, allowed more light and is far more attractive. Plans are in place to extend some of the smaller bedrooms and knock through to ensure the space is more suitable for wheelchair users.
Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 18 Environmental adaptations have been fitted within the home and particularly within the bedrooms, according to the disability requirements of the individual concerned. Storage facilities are provided for wheelchairs/mobility equipment. Service users are able to bring their own possessions into their private accommodation and the rooms seen reflect the occupants hobbies and interests and taste with regard to the décor. All areas of the home were clean and tidy. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome group was good. The service users needs are being met by suitably trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A key worker system is in operation and service users and staff spoken to confirm that there are adequate numbers of staff on duty to meet the requirements of the service users. The only problem appears to be when a service users wishes to go out and requires to be accompanied; an additional staff member has to be allocated and therefore the outing has to take place when this is possible. One staff member commented that it was sometimes difficult in the evenings when service users were being showered and there were only 3 staff. The manager of the home stated that they do not use agency staff. Staff files were examined and correct recruitment procedures had been followed including 2 references and clearance with the Criminal Records Bureau and the Protection of Vulnerable Adults Register (POVA). One of the staff member had a reference that was ‘To whom it may concern’ and the manager was advised that this type of reference was not suitable and every referee should be written to and include a job description.
Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 20 All staff are provided with induction training and basic foundation training. Several service users have challenging behaviour and this has been detrimental to both service users and staff. Recommendations have been made previously that some training is provided and there was evidence on staff files that staff have received some training on Challenging Behaviour. There are 14 care staff and 4 ancillary staff including Cook, handyman, domestic and activities person. Six staff have a National Vocational Qualification (NVQ) in Care (including 3 seniors with NVQ 3) and two staff are in the process of obtaining the qualification. Other staff are completing Skills for Care and will proceed to do an NVQ. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome group was good. The home is well run; the new manager needs to apply to be registered with the Commission for Social Care Inspection. Policies and procedures are in place that protects the health and safety of the service users and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A new full time manager has been appointed who has lengthy experience in care and has a Nursing qualification. The manager must apply to be registered with the Commission for Social Care Inspection (CSCI). The manager has regular meetings with other managers employed by J.T. Care Homes Ltd The wishes of the service users are taken into consideration at all times and there was evidence to show that the views of both service users and relatives Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 22 are sought via questionnaires and their opinions are taken into consideration at management meetings. Policies and procedures have been devised with regard to all health and safety procedures. Staff that were seen were aware of key policies and procedures and there was evidence on the files showing that staff have been provided with the information. The home has an accident reporting system and several examples were seen at the time of the inspection. Staff confirmed that they had received training in Moving and Handling and that they received training in fire procedures and weekly fire drills. Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA37 Regulation 18 Requirement The manager must apply to be registered with the Commission for Social Care Inspection (CSCI) Timescale for action 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA2 YA8 YA9 YA18 Good Practice Recommendations The assessment pro-forma should be expanded to include emotional/psychological needs such as hobbies or education, religious needs and family and social contacts. A record should be kept of who attended any service user meetings. Recorded risk assessments should be specific to the individual service user. The communication book should be used for more general notes and any personal details should be recorded on the individual files. Two appropriate written references should be obtained when recruiting new staff. YA34 Fairmont DS0000009842.V338358.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Fairmont DS0000009842.V338358.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!
