Inspection on 17/07/05 for Firbank

This inspection was carried out on 17th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Firbank 11/07/06

Firbank 20/02/06

Firbank 19/01/05

Firbank 25/05/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Firbank 8 Crescent Road Shanklin Isle of Wight PO37 6DH Lead Inspector Janet Ktomi Unannounced 17th July 2005 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 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. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Firbank Address 8 Crescent Road, Shanklin, Isle of Wight, PO37 6DH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01983 862522 01983 863490 Georgia Rose Residential Care Limited T/A Firbank Mrs Margaret Jones Care Home 26 Category(ies) of Dementia - over 65 years of age (2), Learning registration, with number disability over 65 years of age (2), Old age, not of places falling within any other category (26), Physical disability, over 65 years of age (7) Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 19/1/2005 Brief Description of the Service: Firbank is a registered residential home providing care and accommodation for up to 26 people over the age of sixty-five years with a range of physical, social and emotional needs. The home is situated in a quiet tree-lined avenue in Shanklin close to local amenities, shops and public transport. Accommodation is provided on three separate floors all of which may be accessed by a passenger lift. The home has installed hand and grab rails at various points around the building to assist service users with mobility difficulties. Externally there is a patio area and extensive sea views from some bedrooms and the communal lounges. The home is owned by Georgia Rose Residential Care Limited and managed by Mrs Margaret Jones. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first unannounced inspection of this inspection year, core and additional standards were assessed. Core standards not assessed during this inspection will be assessed during the second unannounced inspection. The inspection was undertaken on a warm Sunday afternoon and lasted four hours during which a full tour of the building was undertaken. Discussions were held with the visitors, service users and staff on duty. Many of the service users living within the home were met during the inspection and those able gave the inspector their views about the service. All the service users stated that they enjoyed living at the home and that the staff were nice and helpful. Records and documentation identified in the report were viewed. The manager was not present during the unannounced inspection, the inspector telephoned her following the inspection to clarify points identified in the report. What the service does well: The home provides a pleasant, safe, homely environment for staff and service users. Service users and visitors confirmed that they felt social, health and care needs are met. Appropriate numbers of care staff, supported by ancillary staff, are available. Service users were very complimentary of the food provided at the home. Service users stated that they would recommend the home to a friend or relative in need of a residential care home. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4. Standard 6 is not applicable as the home does not provide intermediate care. The home fully assesses potential service users prior to admission to ensure that their needs may be fully met. EVIDENCE: The care plan containing the pre-admission assessment of the most recent admission to the home was viewed during the unannounced inspection. Preadmission assessments for other service users were also seen within their care plans. The manager or deputy manager carry out pre-admission assessments on prospective service users using a specific tool which covers all the relevant areas required in the assessment of prospective service users. Initial assessments are often carried out in the service user’s home or the hospital. Information was also seen from relevant professionals such as care managers, GPs, District Nurses or the hospital to ensure a full and accurate assessment is completed. Service users spoken with during the inspection stated that they felt all their needs were being met at the home. Care plans were seen to contain guidance Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 9 and specific advice from external professionals such as district nurses and community learning disability nurses as well as GPs. Staff spoken with confirmed that they have training as required to meet service users’ general and specific needs. A variety of training certificates are displayed on the walls of the home’s hallways. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. The home meets service users’ health, personal and social care needs whilst ensuring dignity and privacy are upheld. EVIDENCE: All service users were found to have individualised care plans. Four were selected at random and inspected. It was clear that these had been developed from the home’s initial assessment process. It was also evident that information had been gathered from a variety of sources including GPs, Care Managers, family members and the service users themselves. Care plans detailed how specific needs should be met by care staff. Significant events are recorded within care plans. The care plans contained detailed monthly reassessment/reviews that would clearly indicate if a service user’s needs had changed requiring amendment to their care plan. Also held within care plans were risk assessments, information about family members, contact with health professionals and any other specific relevant information. The care planning system was both thorough and accessible. Some service users the inspector spoke with were aware that care plans were held and confirmed that they were involved in decisions as to how their care needs would be met. Other service users appeared unaware about the existence of care plans. It is however the inspector’s opinion that this is not an indication that they have not been Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 11 informed or involved in care plans but that these service users may have age related health needs. Service users’ individual care plans demonstrated that health professionals including District Nurses, GPs and Community Psychiatric and learning disabilities Nurses are consulted as and when required. Service users spoken with confirmed that they could request to see their GP and this would be arranged. Care staff confirmed that the GPs were happy to visit the home when contacted. Wherever possible service users keep their existing GPs and these are only changed if the service user has moved to Shanklin from another part of the Island and their existing GP will not continue to provide a service. In this instance the home identifies which local GPs are taking on new patients and the service user is able to choose one to register with. District nurses are involved within the home and provide continence assessments, pressure area care and advice to staff in relation to specific health needs. Pressure relieving equipment was seen in use around the home. Care staff confirmed that two high dependency service users have pressure injuries. Their care plans indicated that these are being managed appropriately with the support of District Nurses. Service users are encouraged to remain active and there is a weekly exercise group as part of the activities programme. Hand and grab rails have been positioned around the home to promote independence and mobility. Chiropody services are provided by a visiting chiropodist for which service users pay individually. During the unannounced inspection care staff were seen consulting with the out of hours doctors in respect of a service user. Care staff were clearly aware of the actions they needed to take in the event of a service user requiring medical treatment out of surgery hours. The home has five bedrooms registered as twin rooms. At the time of the unannounced inspection all were being used as single rooms. Previous discussions with the manager indicate that rooms would only be used as shared if service users specifically requested this such as a married couple who wished to continue to share a bedroom. Service users spoken with during the inspection confirmed that all personal care is provided in private. Service users stated that they felt the quality of personal care provided was good with choice provided as to when and how care would be provided. During a tour of the building, staff were noted to knock on service users’ bedroom doors and addressed service users in a friendly polite manner. Service users stated that they liked the staff, who all treated them with respect and that their dignity was protected. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. The home meets service users’ social and leisure activities in a flexible and varied manner. Contact with family and friends is encouraged and supported and a varied, nutritious diet is provided which meets individual needs. Service users are provided with opportunities to make choices and to have control over their lives. EVIDENCE: During a tour of the building the inspector was able to see a number of certificates and awards received by individual service users for activities (spelling bee, darts, quizzes etc.) they had taken part in. The inspector was able to see a list of planned activities for the coming weeks displayed on the hall wall. Service users stated that external outings were also organised and a number of service users had enjoyed a recent outing. Within care plans and pre-admission assessment there is information detailing service users’ leisure interests, spiritual and social activities. Service users spoken with stated that they enjoyed the organised activities and were able to follow individual leisure activities such as reading, painting and knitting. Discussions with care staff indicated that they are able to join in the activities such as bingo and that Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 13 supporting and encouraging service users during their leisure activities is seen as part of their role as care staff. The home’s visiting policy is displayed on the entrance hall wall and states that visiting is possible at all reasonable times. Should service users request that specific people do not visit then staff would support their decision. Visitors are requested to sign a visitors’ book on arrival and on leaving the home. The home has two lounges, one of which is not often used and could be available should service users wish to receive visitors in private other than in their own bedrooms. Service users are encouraged to bring personal items including furniture to the home and the inspectors noted evidence of personalisation within all rooms. Wherever possible service users are encouraged to maintain control and management of their own financial affairs with care plans stating how personal finances would be managed and by whom. Discussions with service users showed that they felt able to make decisions and choices over day to day issues such as meals, times for getting up/going to bed, having personal care needs met and how and where within the home they spend their time. Residents and visitors spoken with during the inspection were positive about the food they receive at the home. Service users reported that they have a choice at all meals that may be taken wherever they wish, within their own rooms, the dining room or one of the lounges. The inspector was able to see care staff completing menus with service users as to their choice for their evening meal. Menus seen provided a choice of different main meals with the chef confirming that fresh fruit and vegetables are used whenever possible. Discussions with the chef confirmed that consideration is given to variety in meals and ensuring service users enjoy their meals. The inspector arrived shortly before lunch time and observed service users being served their Sunday roast lunch. Meals served during the inspection were well presented and had appropriate portion sizes. On admission service users’ individual likes and dislikes as well as special dietary requirements are assessed and recorded. Special diets and requests were catered for appropriately. Service users confirmed that they have access to snacks and hot and cold drinks inbetween meals and these were seen within the lounges around the home including a bottled water cooler in the main lounge. All required records in respect of food were in place and are compliant with the regulations. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Service users or their representatives are able to complain if they are unhappy with the service provided at the home. EVIDENCE: Service users spoken with during the inspection all seemed clear that they would discuss any concerns or complaints with the manager or one of the deputy managers. Service users spoken with stated they had no concerns or complaints at the time of the inspection. The home’s complaints policy, including reference to the Commission for Social Care Inspection, was seen on the entrance hall wall. Care staff were aware of the action they should take should a service user or visitor wish to make a complaint. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24, 25 and 26. The home is warm, clean and well maintained providing appropriate accommodation, both private and communal, to meet service users’ needs. EVIDENCE: During the inspection a full tour of the building was undertaken with all communal areas and a number of service users’ bedrooms seen. The home provides accommodation for service users on three floors, all of which are accessible by a passenger lift. One room is not served by the lift and occupied by a fully mobile service user. The home has an ongoing maintenance and redecoration programme. Externally the front of the home had an attractive range of bedding plants and hanging baskets with seating available for service users. Hand rails are provided around the home to assist service users who may have mobility needs. The home provides a dining room and two lounges, one on the ground floor and one on the first floor. Both lounges provide fine sea views. The ground floor lounge opens out onto a rear patio with another pleasant outside area to Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 16 sit at the front of the home. All the communal spaces are accessible to all service users via the passenger lift. Furniture within the shared areas was found to be in good repair and fit for purpose. All service users are accommodated in single bedrooms although shared rooms could be available in the larger bedrooms if specifically requested. All service users’ bedrooms were fully furnished with suitable bed, wash hand basin or ensuite facilities, call bell system, television, easy chair, table, drawers and hanging space. Bedrooms were carpeted and nicely decorated. Many service users’ rooms contained personal items such as small pieces of furniture and photographs creating a homely feeling. Service users spoken with were happy with their personal accommodation. Bedrooms all have individually controllable central heating and are naturally ventilated by windows. All bedrooms were found to be clean and free from offensive odours at the time of the unannounced inspection. The home employs domestic staff and on the day of the unannounced inspection the home was found to be clean, tidy and free from offensive odours. All WCs and communal bathing facilities were noted to have a supply of paper towels and liquid soap with guidelines available for staff around infection control and the use of chemical cleaners. Care staff informed the inspector that supplies of gloves and paper towels are freely available. The care staff confirmed that they have received training in infection control with certificates seen on the hall walls. The home has a laundry with industrial machines capable of washing to required temperatures. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29. The home employs sufficient care and ancillary staff to meet service users’ needs and ensures that care staff are appropriately recruited, trained and competent to do their jobs. EVIDENCE: The home employs five care staff and the deputy manager responsible for care during the morning, three care including senior during the afternoon/evening and two care overnight. In addition to the care staff employed the home also employs catering, domestic, maintenance, gardening and administrative support staff. Service users and visitors spoken with during the inspection reported that staff are very prompt in answering call bells and that they felt care staff had sufficient time to meet their needs. Staffing rotas were seen during the inspection and correlated to staff in the home at the time of the unannounced inspection. Additional shifts resulting from staff holidays or sickness are covered by the home’s own staff. Care staff stated that there were adequate numbers of staff employed at the home to meet service users’ needs and that every body worked together as a team. A newly recruited staff member described the recruitment process he experienced and this included two written references, interview and CRB/POVA check. The new staff member confirmed that he has received a statement of terms and conditions, induction training and has now been commenced on an NVQ level 3 course. Staff recruitment files will be inspected during the next inspection when the manager is present. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 18 Care staff confirmed that there are lots of training opportunities with a large number of certificates displayed on the hall walls around the home. Service users all described the care staff as being helpful, pleasant and kind. Observations of the interactions between care staff and service users during the inspection indicated that care staff treat service users with dignity and respect. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34, 37 and 38. The management arrangements within the home ensure that service users’ needs continue to be met and creates a homely atmosphere in which service users felt valued and well cared for. EVIDENCE: Staff described the home as being a happy place to work and that support is always available from the management team. Staff felt that they could make suggestions about changes within the home. Service users stated that the home was a nice place to live, that they felt safe, happy and that they would recommend the home to a friend. The home is regularly visited by a representative of the company with reports being made available to the Commission and the manager. Care staff confirmed that there are regular staff meetings. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 20 The home was full at the time of the unannounced inspection with care staff confirming that this was generally the case. Appropriate insurance certificates were seen displayed on the hall wall. The home would appear to be financially viable. During the unannounced inspection a variety of records was inspected. These included, duty rotas, pre-admission assessments, care plans, risk assessments, care records, staffing rotas, menus and food records, fire and emergency lighting equipment records. All were found to be well maintained and appropriately stored. During the unannounced inspection only one concern in respect of health and safety was identified. It was noticed that care staff had positioned an armchair directly beside the bed a service user was in. When asked about this care staff stated that it was to prevent the service user falling out of the bed. This was discussed with the manager by telephone who agreed that this was not acceptable practice and that the head of care would ensure care staff were aware of this and alternatives put in place should a risk assessment indicate that individual service users were at risk of falling out of bed. Staff stated that they receive training in manual handling, first aid, health and safety, fire awareness and food hygiene. Certificates confirming this were seen on the hall walls. Safety notices were seen appropriately positioned around the home and infection control equipment was available for care staff. Covers are fitted to all radiators. The home keeps all chemical cleaning items in a cupboard that was locked at the time of the unannounced inspection. Appropriate measures to ensure the security of the premises were in place and recruitment/employment and induction procedures should ensure that unsuitable people do not work within the home and that care staff have the necessary skills. Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x 3 x x 3 2 Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 22 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 38 Regulation 12 (1) (a) Requirement Following risk assessments only approved safety devices must be used. Timescale for action immediate 18-7-05 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. Refer to Standard Good Practice Recommendations Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 23 Commission for Social Care Inspection Mill Court Furrlongs Newport PO30 2AA National Enquiry Line: 0845 015 0120 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 Firbank H55H04_S12491_Firbank_V218293_130705 Stage 0.doc Version 1.30 Page 24 - 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. 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