Inspection on 02/03/09 for Fieldhead Court Nursing Home

This inspection was carried out on 2nd March 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fieldhead Court Nursing Home 04/03/08

Fieldhead Court Nursing Home 28/02/07

Fieldhead Court Nursing Home 27/07/06

Fieldhead Court Nursing Home 10/01/06

Fieldhead Court Nursing Home 10/11/04

Fieldhead Court Nursing Home 27/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fieldhead Court Nursing Home Rectory Park Church Lane Thornhill Dewsbury West Yorkshire WF12 0JZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karen Summers     Date: 0 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Fieldhead Court Nursing Home Church Lane Rectory Park Thornhill Dewsbury West Yorkshire WF12 0JZ 01924459000 01924459000 fhcourt@rochehealthcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Roche Healthcare Limited Name of registered manager (if applicable) Mrs Kathryn Tanner Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Fieldhead Court is a care home providing accommodation, personal and nursing care for up to forty older persons. It is owned by Roche Health Care Ltd that is a private limited company with other registered care services in the district. The accommodation is a converted former rectory operating over two floors, which are accessed by a passenger lift, and stair lifts. There are thirty-two single rooms, of which 28 have en-suite facilities. There are four double rooms, 3 lounges and a small dining room. The accommodation is set within large grounds in a conservation area and has car-parking facilities. The provider informed the Commission for Social Care Inspection on 2nd March 2009 Care Homes for Older People Page 4 of 28 care home 40 Over 65 40 0 Brief description of the care home that the fees range from £368.12 to £624.00 per week. There are additional charges for hairdressing, newspapers and magazines. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 4th March 2008. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This report refers to an inspection, part of which included an unannounced visit, on the 2nd March 2009, commencing at 8.40 am, and the length of the inspection was 9.25 hours. There were 38 people living at the home on the day of the visit. Care Homes for Older People Page 6 of 28 We did this inspection with an expert by experience who spoke to people who are using this service. An expert by experience is a person who either has a shared experience of using services or understands how people in this service communicate. They visited the service with us to help us get a picture of what it is like to live in or use the service. This is important because the views and experiences of people who use services are central to helping us make a judgment about the quality of care. Also as part of the inspection, the manager was asked to complete an annual quality assessment document. This she did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. To enable people who use the service to comment on the care it provides, we sent surveys to ten people living at the home, six of which were returned, ten to staff, three were returned, and five to local doctors and health care workers (social workers, community nurses), three were returned at the time of writing this report. The comments in the surveys were positive about the standard of care provided by the staff at the home. The provider informed the Commission for Social Care Inspection on the day of the visit that fees range from three hundred and sixty eight pounds and twelve pence to six hundred and twenty four pounds. Additional charges include hairdressing, private chiropody, newspapers, magazines, and personal toiletries. We would like to thank all people who gave feedback about the home, and would like to thank the manager and staff for their co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: Steps should be taken to ensure that no one trips over the uneven red carpet located on the first floor, and the heavily stained carpet outside of the kitchen should be replaced. Steps should also be taken to ensure that the home is odour free. To ensure that no one is burnt, the radiator outside of the staff room should either be of a low surface temperature of appropriately covered. Care Homes for Older People Page 8 of 28 As good practise, staff should have a minimum of two fire lectures each year, as this will ensure that they are up to date in the procedure to follow in the event of a fire. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to them moving into the home to ensure that their needs can be met. Evidence: The information received from the home prior to inspection said that people are admitted following an assessment from a competent person, to ensure that their needs can be met and to allow the home to prepare for admission. The care records of three people were examined, and this included a person who was admitted to the home in an emergency. When an emergency admission is requested, the manager said that she receives an assessment of that persons needs which has been carried out by the social worker. The information is then discussed with the social worker to ensure that the persons needs can be met. There was evidence in all three records that pre admission Care Homes for Older People Page 11 of 28 Evidence: assessments had been carried out. The admission documentation for the person who was admitted in an emergency was not dated or signed, and this was completed on the day of inspection. The manager is aware of the need to date and sign all documentation. With the exception of one person who was admitted to the home in an emergency, people confirmed that they received enough information about the home before they moved in so they could decide if it was the right place for them. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans outline the level of support and care each person requires in ensuring their health and welfare needs will be met. The recording and administration of medication is satisfactory. People are treated with respect. Evidence: Three peoples care records were looked at, and evidence showed that their needs had been identified, and care given to meet those needs. Their social, cultural, religious needs, and likes and dislikes were also recorded, and people confirmed that staff respect individuals privacy and dignity. One person said, The carers seem very dedicated. Whilst another person said, My aunt seems happy. There was also evidence of involvement from peoples doctors, physiotherapists, opticians, dentists and other health care professionals where needed, and a comment from a health care professional includes, Whenever I visit the staff seem to be aware of the patients healthcare needs and seek assistance when and where appropriate. Care Homes for Older People Page 13 of 28 Evidence: The home have implemented the Gold Standards Framework for the end of life care, and the feedback from the monitoring visit indicated a good outcome for people. When asked if the service responds to the different needs of individuals, in relation to race, ethnicity, age, gender, and faith. People said that they usually did. Care reviews had taken place, and the care plans had been updated monthly or as the needs of the person changed, and this was with the involvement of the person or their relative. There was evidence that people have access to advocates and information leaflets are available in the entrance to the home. Following the last inspection, care records are now stored in accordance with the data protection Act 1998. On the day of the visit, samples of three peoples medication were checked. The storage, administration and recording of the medication were done correctly. The nursing staff carry out monthly checks on the medication to ensure that there are no discrepancies and safe practises are maintained. All staff that administer medication have had training. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples cultural, religious, social and recreational needs are being met, and they are supported to maintain contact with their family and friends. A variety of meals are offered that take into account peoples likes and dislikes. Evidence: The home employs an activities co-ordinator, who works 4 hours a day, Monday to Friday. There was a notice board located in the dining room letting people know what activities were available each day however, the writing was not clear and therefore difficult to read. This was discussed with the manager together with the need to advertise in other parts of the home the activities taking place. The activities person now records in each persons file, their enjoyment of the activity that they have taken part in. In addition to this, she has also produced a large booklet of a sample of photographs of the events, and this was located in the entrance to the home for visitors to see. Within the dining room, photographs of events were also displayed however; the photographs were faded, and not clearly visible. We discussed with the manager that people might like to be asked at the next residents/ relatives meeting if they are happy with how the photographs and information relating to events are displayed. The manager also agreed that the faded photographs need to be updated, Care Homes for Older People Page 15 of 28 Evidence: and that she would put a copy of the booklet of photographs in the lounges for people to see. Activities that place include; crafts, bingo, skittles, sponge ball, aromatherapy, reminiscence, dominoes, singing songs etc. People said that relatives are encouraged to help with activities e.g. Christmas cards and Easter bonnets. Fund raising events take place e.g. raffles, summer Fayre, to help fund trips out and there were photographs of people and their family and friends enjoying these occasions. There was also evidence and people confirmed, that entertainers visit the home regularly. One person who completed the survey said that there were always activities that they could take part in. Three people said that there usually were, and two people said that sometimes there were activities that they could take part in. At the time of the visit gentle exercise was taking place in one of the lounges. The room was full and extra chairs were brought in. There was a friendly atmosphere, which the people said that they had enjoyed. During part of the day, the television in the blue lounge was loud and people were having difficulty holding a conversation. We discussed with the manager the need to look into ways of addressing this issue, e.g. the use of earphones. Ministers from various denominations visit at different times each month, and there was evidence that people who wish are escorted to the local church, and people confirmed this. For those people who choose they have their own newspapers delivered. The menus offered a variety of food, and were on display for people to see. Unfortunately, as with the activities board, the writing was not clear and therefore difficult to read. The manager said that she would ensure that the writing was made legible. Drinks were served at various times throughout the day, and for those people who wish, fruit smoothies were also available in the evening. The people living at the home had agreed at a residents meeting that they would like to try fruit smoothies as an alternative to having fresh fruit, and the manager said that this would be reviewed at future resident meetings. We also discussed that drinks should be made available for people to help themselves throughout the day. The staff have recently attended training regarding Protected meal times, and this was in practice on the day, as the atmosphere in the dining room was relaxed, with Care Homes for Older People Page 16 of 28 Evidence: minimal interruptions, and staff were available to assist people with their meal in a dignified, unhurried, manner. People also chose what they would like to eat, and made the comments, Foods all right and theres plenty of it. All the meals are lovely If I dont want something, they give me something else that I like. Oh, I dont think anybody can complain about the meals, theyre lovely. As a tribute to the standard of food provided the home has received a Silver award in association with Kirklees Councils Health Choice Award. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected from abuse and they can be confident that their complaints will be listened to and acted upon. Evidence: There is a complaints procedure, which is located within the entrance to the home and in the service user guide. Unfortunately the print was small which made it difficult to read and the manager said that she would ensure that the document was available in a larger print. People who use the service said that they knew how to make a complaint and knew who to speak with if they were not happy. One person said, I usually go and see the matron on duty. The manager keeps a log of any complaints received and there was evidence that peoples concerns had been taken seriously and the appropriate action had been taken to resolve the matter wherever possible. There are policies and procedures in place to reduce this risk of abuse. Records seen showed that staff commencing employment have a CRB (Criminal Records Bureau) and a POVA (Protection of Vulnerable Adults) check before starting work in the home. The manager is a safeguarding (adult protection) trainer, and all staff have received training which provides information on how to protect people from abuse. Care Homes for Older People Page 18 of 28 Evidence: Those staff who completed the CSCI surveys, and those who were spoken with during this visit, knew about how they would report poor care practice and abuse, and also what to do if a person had concerns about the home. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers people a homely, and comfortable environment. However, in one part of the home there is an odour of which the manager is taking steps to address. Evidence: As part of the inspection a tour of the home took place, which included the communal areas, a number of bedrooms and the laundry. The atmosphere on the day of the visit was warm and friendly and people looked comfortable whilst sitting in various parts of the home. Ongoing refurbishment continues to take place, and includes the purchase of new dining room table, chairs and floor covering, and also the carpet outside of the staff room has been replaced. The plans to renew the existing extension have not as yet commenced as the Town Planners have asked for an environmental report ensuring that there are no bats that may need relocating. The first floor, red floor covering is thin and stained and there are areas where the carpet is starting to lift and could be a potential trip hazard. We were informed that this carpet would be replaced within the refurbishment programme when the new Care Homes for Older People Page 20 of 28 Evidence: extension is built. We discussed with the manager that in the interim period, steps should be taken to ensure that no one could trip over the uneven carpet. The corridor wall in this area was also showing signs of wear, and we were informed that this area would be affected when the extension is built and therefore would then be redecorated. The carpet which is located outside of the kitchen is very heavily stained and cannot be cleaned properly. Steps should be taken to replace this carpet. Discussion was also held regarding the radiator outside of the staff room, and an area which people who live at the home may walk past. In order to protect people from the potention risk of burning, the radiator should either be of a low surface temperature or thermostatically controlled. The bedroom area where the new extension is to be built had a very strong odour, which the manager is taking steps to address. There were areas around the home when we first visited that also had an odour however, on completion of the inspection these areas were revisited, and apart from one room, the odours were not apparent. Out of the six people who completed the surveys, three said that the home is always fresh and clean. One person said, Usually and two people said, Sometimes fresh and clean. One of these people also said that sometimes, Strong smell of urine. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by qualified, competent and experienced staff in sufficient numbers and that has had all the necessary checks before working with people so that they are kept safe Evidence: There were thirty-eight people in residence, and the duty rota confirmed that there were sufficient staff on duty to care for the number of people living at the home, and the manager also confirmed this. When asked if the care staff have the right skills and experience to look after people properly, health care professionals said that they did, and one person made the comment, The staff appear to have the right skills and experience, from the nurses, senior carers and carers. And one of the people said that staff often attended the training courses. People receiving care said that staff were available when they needed them. A relative made the comment, There are always members of the staff about to ask about my Aunts health. Care practice observed during this visit, and the relationship between staff and people being cared for was positive. Samples of recruitment records were inspected and the correct information and checks had been carried out. There was also evidence in the staff records and staff confirmed Care Homes for Older People Page 22 of 28 Evidence: that they had induction training, first aid, fire, palliative care, dementia awareness, infection control, and movement and handling training. The staff also benefit from an in house NVQ (National Vocational Qualification) trainer, and fifty three per cent of care staff have an NVQ level two or above. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the management approach of the home and the manager ensures so far as reasonable practicable that the health, safety and welfare of people and staff are protected. The home is run in the best interest of people who live there. Evidence: The manager is a registered general nurse with a number of years experience of working in nursing home settings. She has NVQ level 4 qualifications in management and the Advanced Care Management City & Guilds. It was clear from speaking with staff, and people living at the home that the manager is a well like and respected. For those people who wish small amounts of personal monies are held safely at the home. The financial records of three people were examined and satisfactory records were maintained. Receipts are kept of all transactions made. Meetings involving people who live at the home continue to take place every three Care Homes for Older People Page 24 of 28 Evidence: months and minutes are kept. Quality assurance surveys are sent out by the home each year and the results of those surveys are distributed to all who participated, and made available within the home. The home should be congratulated on achieving the Investors in People Award which is a standard to improve the way people work. They have also implemented the Gold Standards end of life Framework, which will give the staff the necessary knowledge and skills to look after people who need end of life care. Feedback from monitoring visits indicates good outcomes for people. Records were seen to suggest that staff have regular supervision, and staff confirmed this. Record show that routine fire alarm and emergency lighting test take place, and staff take part in fire drills and lectures. Following discussion with the fire safety officer, as good practise guidance, staff should have a minimum of two fire lectures each year. This will ensure that they know the procedure to follow in the event of a fire Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 19 16 The carpet outside of the kitchen must be replaced. The carpet is very heavily stained and cannot be cleaned properly. 30/04/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 The radiator outside of the staff room should be either of a low surface temperature of appropriately guarded to ensure that no one is burnt. Steps should be taken to ensure that no one could trip over the uneven red carpet located on the first floor. Steps should be taken to ensure that all the areas of the home are odour free. Following discussion with the fire safety officer, as good practise guidance, staff should have a minimum of two fire lectures each year. This will ensure that they know the procedure to follow in the event of a fire. 2 3 4 19 26 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!