CARE HOME ADULTS 18-65
Freeman College - 112 Brincliffe Edge Road 112 Brincliffe Edge Road Sheffield S11 9BZ Lead Inspector
Sue Turner Key Unannounced Inspection 3rd July 2007 09:15 DS0000065227.V337457.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 DS0000065227.V337457.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. DS0000065227.V337457.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Freeman College - 112 Brincliffe Edge Road Address 112 Brincliffe Edge Road Sheffield S11 9BZ 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) 0114 2130290 0114 2130299 john.pickin@fmc.rmet.org.uk Ruskin Mill Educational Trust Mr John Edward Joseph Pickin Care Home 2 Category(ies) of Learning disability (2), Mental disorder, registration, with number excluding learning disability or dementia (2) of places DS0000065227.V337457.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service Users between the ages of 16 and 17 years may be accommodated. 13th July 2006 Date of last inspection Brief Description of the Service: The home comprises of two properties that are an annexe to Freeman College, which is part of the Ruskin Mill Educational Trust. The home offers residential accommodation and personal support to three people during term time and young people return to their families during the college holidays. People live in domestic style houses and are cared for by house parents. House parents are employed by the college to create a warm, family atmosphere within the house so that people are living in a friendly environment. Individual bedrooms and communal living areas are provided. The houses are situated within a short distance of the college, within a residential area and close to shops, churches, bus routes and a public park A copy of the previous inspection report was available for anyone visiting or using the college and information about how to raise any issues of concern or make a complaint was on display in the entrance halls of the two registered properties. The registered manager confirmed that the range of fees from 1st April 2007 were from £48,102 to £67,515 per annum. A Statement of Purpose, Service User Guide and Student Handbook were available and provided to people that had an interest in the service. DS0000065227.V337457.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced key inspection carried out by Sue Turner regulation inspector. The site visit took place between the hours of 9.15 am and 3:15 pm. John Pickin is the registered manager and was present during the inspection. Prior to the site visit the registered manager completed an AQAA (Annual Quality Assurance Assessment) and one questionnaire was sent out to a person who had previously used the service. Also present during the site visit was the Neighbourhood Head, Alan Miggin and three house parents, who were interviewed. Their views and some information from the questionnaire are included in the main body of the report. At the time of the site visit there were no people using the places that are registered with the Commission for Social Care Inspection (CSCI). Opportunity was taken to make a partial tour of the two registered premises, inspect a sample of care records, check records relating to the running of the service and check the services policies and procedures. The inspector wishes to thank everyone involved in the inspection process for their time, friendliness and co-operation. What the service does well:
House parents talked with great enthusiasm about the activities that were accessed and enjoyed by the young people. Family groups met up in the park for games and a walking group had been set up for weekend country sight seeing. Particular favourites were going to the theatre and bowling. Family links and friendships were encouraged and people were involved in the daily routines of the home, which promoted involvement and encouraged independence. People were offered a variety of meals and food, which was mainly organic, and of high quality. House parents were aware of people’s likes and dislikes and menus were discussed and agreed by everyone living in the house. There was a complaints procedure and Adult Protection procedure in place, to promote peoples safety. House parents said they had confidence in the homes managers, who would listen to any concerns and take them seriously. The homes were spacious, clean and tidy. Health and safety procedures were identified and carried out, and systems were checked and serviced to maintain a safe environment.
DS0000065227.V337457.R01.S.doc Version 5.2 Page 6 A staff training record was in place, and individual training records were maintained. A recruitment procedure was in operation to ensure the safety of people living in the home. Staff supervision took place, to support and give guidance to staff on an individual basis. Records within the home were stored securely, to safeguard confidentiality. What has improved since the last inspection?
This was the second inspection carried out by the CSCI. Following the first inspection twenty requirements were issued, of which the majority (16) had been actioned. The home had compiled a Statement of Purpose and Service User Guide, which were given to people that had an interest in, or were using the service. Prior to being offered a place at the home people were assessed over a threeday period. Their individual strengths and limitations were closely monitored; this allowed the staff to place people within the most appropriate setting. Care plans were in place for all. These were well organised and easy to read. They set out all aspects of personal, social and health care needs and recorded the staff action required to ensure all identified needs were met. People’s health care was monitored and access to health specialists was available. Records of contact with any health care professional were maintained. All potential risks to people had been identified, and a written risk assessment undertaken. Medication Administration Records (MAR) sheets were completed for all medications administered by the house parents. Records seen were fully completed and consent to administer medication had been obtained from the young people or their representative. The complaints procedure provided to young people included the contact details of the local office of the CSCI. All staff had undertaken training in adult and child protection and full checks were being carried our during the recruitment process to ensure that people were kept safe. Support staff were provided with the organisations induction training and formal staff supervisions were taking place. The organisations quality assurance systems included a questionnaire, which was handed out to young people to obtain their views of the service provided.
DS0000065227.V337457.R01.S.doc Version 5.2 Page 7 The results of the annual audits were then reviewed and any appropriate action was taken. 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. DS0000065227.V337457.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 DS0000065227.V337457.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): Standards 1 and 2. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided sufficient updated and relevant information to inform people about their rights and choices. People who live at the home have their needs assessed, and staff review this so that they can continue to meet peoples changing needs. EVIDENCE: There was a Statement of Purpose, Service User Guide and Student Handbook available to all young people and their families. These offered a full range of information about many aspects of the college and home and people were encouraged to read all three. People interested in living at the home and attending the college were assessed over a three-day period. Staff met and talked to the person and talked to their family and other professionals about the support the person would need. This was good practice and helped to make sure people got the right kind of support they needed. DS0000065227.V337457.R01.S.doc Version 5.2 Page 10 House parents would meet the young person during the assessment process although it was not always possible for the person’s assessment to be undertaken in the house they would be living in. DS0000065227.V337457.R01.S.doc Version 5.2 Page 11 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): Standards 6, 7 and 9. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A care plan and risk assessments were in place for all. People were supported and encouraged to make decisions to promote independence. EVIDENCE: The inspector checked one care plan, however as the home was not caring for anyone with personal care needs the plan seen was observed as a ‘sample’. The care plan contained a lot of information about the persons needs and was in an easy to follow format. Care plans included specific information on the staff action required to meet any identified needs. Potential risks to the person had been identified, discussed with the appropriate people and a written risk assessment undertaken. DS0000065227.V337457.R01.S.doc Version 5.2 Page 12 The home followed good practices to encourage people to make decisions about their own lives. This included the risk assessments and records about what people liked and did not like. The house parents talked about ways they had supported people to consider the consequences of the decisions they made and how people’s decisions were respected. One example of this was a person who had decided to start smoking so that they felt “more in with the crowd”. House parents had talked to them about other ways of making friends and feeling more accepted. DS0000065227.V337457.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 15, 16 and 17. People who use the 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 get good support to follow the daily routines they prefer; they have good support to access community, leisure and education opportunities. A high quality and varied diet was provided to maintain health and accommodate individual preferences. EVIDENCE: During the day young people attend college and carry out vocational education and work experience schemes. During the evenings and weekends people are supported and encouraged to participate in leisure activities, which suit their own preferences and abilities. House parents talked about assisting people to such things as football, youth club, cinema, pub, churches and the mosque.
DS0000065227.V337457.R01.S.doc Version 5.2 Page 14 House parents said that they had very good relationships with people’s families and friends and were in constant contact with them. Evidence of this was seen in the care plans and house diaries. Great emphasis was put on encouraging people to eat healthily. The majority of food used was organic and people were involved in menu planning, shopping and cooking. House parents said that they were given sufficient funds to buy organic food which was often more expensive to purchase. One house parent had undertaken training in nutrition and was very interested in research into the positive effects that a healthy diet could have for individuals. His/her learning was being disseminated to other house parents as part of the training programme. It was important that there were clear schedules and routines for each house, however it was very evident that within this was the flexibility needed to ensure that individual’s needs were met and people remained happy and content. House parents were able to say ways in which they ensured that people’s privacy and dignity were maintained. DS0000065227.V337457.R01.S.doc Version 5.2 Page 15 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): Standards 18, 19 and 20. People who use the 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 get good health care support, to ensure they receive good personal care from the house parents, training should be provided. All staff had not been provided with medication administration training to ensure they followed safe procedures. EVIDENCE: People had information about their health care needs in their care plans. This helped staff give people the right support to maintain their health. The home had good links with health professionals and followed their advice and guidance. People had access to the college doctor and homeopathic medication was promoted and provided as part of the college ethos. DS0000065227.V337457.R01.S.doc Version 5.2 Page 16 In the past 18 months the home has only cared for one person who required assistance with their personal care needs. House parents said that they had not received any training in personal care and it is therefore necessary that staff are trained and their competencies maintained as they are not consistently practising and calling upon these skills. The manager agreed that house parents would benefit from undertaking some form of training in personal care. A policy on medication was in place and available to staff. Medicines were securely stored around the home in locked cupboards. Medicine Administration Records (MAR) checked were completed with staffs’ signatures and consent had been obtained from people and/or their representative. House parents administered medications. One house parent said he/she had received in depth training in medication administration, however two other house parents said they had not received medication training. DS0000065227.V337457.R01.S.doc Version 5.2 Page 17 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): Standards 22 and 23. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A complaints and adult protection policy and procedure was in place. So that people feel they are being listened to all complaints and concerns should be recorded. Staff had been trained in adult protection. EVIDENCE: People and their representatives had been provided with a copy of the homes complaints procedure, which was also on display in the entrance halls. This contained details of who to speak to at the home and informed the reader of who to contact outside of the home to make a complaint should they wish to do so. The Neighbourhood Head and Student Protection Officers dealt with any serious complaints. CSCI had not received any complaints about the home. The manager was aware of a number of concerns that people had raised and these were investigated as he became aware of them. The house parents also dealt with concerns as they arose. There was no written record of peoples concerns or complaints kept in the homes, this was discussed with the house parents and manager. To fully evidence that all concerns and complaints are responded to the inspector advised that a record was kept which also provided people with an opportunity to discuss and resolve issues before they developed into problems.
DS0000065227.V337457.R01.S.doc Version 5.2 Page 18 An adult protection procedure was in place and staff had undertaken training on adult protection to equip them with the skills needed to respond appropriately to any allegations. DS0000065227.V337457.R01.S.doc Version 5.2 Page 19 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): Standards 24 and 30. People who use the 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 live in a clean and comfortable home. It meets their needs and respects their preferences and dignity. EVIDENCE: Both registered properties were clean, comfortable and welcoming. Each was domestically furnished, one to a high standard, the other was beginning to look “tired and worn” in places. Both homes had many homely features such as interesting pictures, framed poems and sayings and photographs. House parents and the manager said that any maintenance or redecoration work the houses needed was carried out as part of an ongoing refurbishment programme. Property inspection visits were carried out, which included a health and safety audit. DS0000065227.V337457.R01.S.doc Version 5.2 Page 20 The inspector visited three bedrooms; these were very personalised to people’s individual preferences. The driveway outside one house was uneven and could present a tripping and slipping hazard to anyone using or visiting the home. DS0000065227.V337457.R01.S.doc Version 5.2 Page 21 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): Standards 32, 34, 35 and 36. People who use the 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 get support from staff who understand their roles and can give safe and competent support. The recruitment process helps to keep people safe. In the main staff training and supervisions were provided which helped staff improve their knowledge and skills. EVIDENCE: House parents interviewed said that they enjoyed the work that they did and got a lot of job satisfaction. House parents were interested, motivated and committed to providing a high standard of care to people. They were responsive to any suggestions for improvements and enthusiastic about undertaking training to equip them with further skills and knowledge. They were able to talk about the various training courses that they had attended, which included all of the mandatory training, for example, Food Hygiene, Adult Protection, First Aid and Fire. Some had also undertaken more advanced training in essential topics, for example medication, equality and diversity and nutrition.
DS0000065227.V337457.R01.S.doc Version 5.2 Page 22 House parents said they had not undertaken NVQ training, as the existing courses were not suitable to their work role. The manager said that the organisation was currently working towards setting up a training academy and designing their own syllabus so that staff were qualified to care for young people with a learning disability. This would take time but be of much greater benefit to both the staff and the young people that use the service. The recruitment records of three house parents were checked. The staff had provided employment histories and any gaps had been explored and recorded on their application form. Two written references, one from their previous employer had been obtained for each of them. These were satisfactory. Protection Of Vulnerable Adults (POVA) checks had been made and Enhanced Criminal Record Bureau (CRB) checks had been obtained for the staff members. Staff induction took place, and house parents spoken with confirmed that this included all of the relevant aspects. At the previous inspection a requirement was issued that staff were provided with moving and handling training, the manager said that they had purchased a training DVD which staff would be using in the near future. House parents said that they were offered supervision on both a formal and informal basis. Recently a planned and structured supervision had commenced for each house parent, which they said they were finding useful and beneficial. DS0000065227.V337457.R01.S.doc Version 5.2 Page 23 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): Standards 37, 39 and 42. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager’s leadership approach benefited people and staff. Quality assurance systems, staff supervision and house meetings meant that the home was run in the best interests of everyone. In the main people’s health and safety had been promoted and protected in all areas. EVIDENCE: The registered manager had good skills to manage the home well. House parents said that the manager was supportive and approachable and they were able to contact him at any time for guidance and advice. DS0000065227.V337457.R01.S.doc Version 5.2 Page 24 The organisation had a number of ways in which to assess the quality of the service and make improvements. Young people had recently completed questionnaires, giving their opinions of the service and the neighbourhood head said that a summary of the results was available. Each house held their own ‘house meetings’, usually over a meal, where people were given the opportunity to express their views about living in the home and also plan their schedules for the coming week. The manager said that the organisation will recruit for September further staff, two neighbourhood heads, a neighbourhood co-ordinator and a college nurse; all who would contribute to improving the service. A health and safety policy was in place and staff had been provided with health and safety training as part of their induction. The equipment at the home was serviced and maintained. Fire records evidenced that weekly fire alarm checks took place. Staff said fire drill training took place on a regular basis; however, support staff had not participated in any practice drill. DS0000065227.V337457.R01.S.doc Version 5.2 Page 25 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 3 2 3 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 3 X 3 X X 2 X DS0000065227.V337457.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA18 Regulation 18 Requirement Staff must be provided with training in personal care so that they are able to give appropriate care according to individual assessed needs. To ensure the health, safety and welfare of people staff must be provided with medication administration training. (Previous timescale of 01/12/06 partly met) So that people feel they are being listened to a record of all complaints/concerns must be kept in the home. To ensure that people visiting and using the home the driveway of 112 Brincliffe Edge Road must be free from any tripping or slipping hazard. All staff must be provided with moving and handling training. (Previous timescale of 01/11/06 not met) Support staff must participate in a practice fire drill at least twice each year. (Previous timescale of 30/09/06 not met). Timescale for action 30/09/07 2. YA20 13 30/09/07 3. YA22 22 30/09/07 4. YA24 23 30/09/07 5. YA35 18 30/09/07 6. YA42 13,18 30/09/07 DS0000065227.V337457.R01.S.doc Version 5.2 Page 27 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 YA32 Good Practice Recommendations 50 of the staff team should be trained to NVQ level 2 in care (or equivalent). DS0000065227.V337457.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 DS0000065227.V337457.R01.S.doc Version 5.2 Page 29 - 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!
