Inspection on 25/11/05 for Hayleigh

This inspection was carried out on 25th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Hayleigh 13/03/08

Hayleigh 05/10/06

Hayleigh 31/05/05

Hayleigh 30/11/04

Hayleigh 26/06/04

Hayleigh 27/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hayleigh Myrtle Street Bedminster Bristol BS3 1JG Lead Inspector Sandra Garrett Unannounced Inspection 25th November 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hayleigh Address Myrtle Street Bedminster Bristol BS3 1JG 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) 0117 9039983 0117 9039984 Bristol City Council Barbara Ann Cairns Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate one named person aged 64 years with Physical Disabilities. Registration will revert to OP when named person leaves. May accommodate one named person with Learning Difficulties. A specific condition is added to the Certificate of Registration for the Home in respect of this named person being accommodated there. The registration will be permanent, to lapse only when the named resident leaves the Home. Hayleigh care staff must undertake training in the care of older people with Learning Difficulties. This must be a rolling programme of regular training, to include any new care staff taken on after the service user is admitted. 31st May 2005 3. Date of last inspection Brief Description of the Service: Hayleigh is a purpose built care home registered with the Commission. It is operated by Bristol City Council Social Services & Health (SS&H). The home is capable of housing forty residents and is registered in the older persons category. A variation of its registration is in place in order to provide accommodation for one older person with learning difficulties. This resident now occupies the area that used to be the staff flat. Hayleigh is situated close to the busy shopping area of Bedminster. It is close to local bus routes and community facilities. The home is fully accessible with a lift to the first floor. The home has extensive mature gardens with trees and a patio. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. Ten residents and one visitor were spoken with and all expressed satisfaction with life in the home. However information had just been received about the home’s possible closure within the next two years. A range of different records were examined including care files, training, personnel, financial and health and safety records. It was pleasing to note that all two of three requirements made at the last visit in May were met. What the service does well: What has improved since the last inspection? Two requirements had been met. These included: A requirement in respect of ensuring the Commission received a copy of the Quality Assurance Survey report, was met. A copy of the report was sent to the Commission in July, following the survey that had been carried out in May ’05. Of particular note was 88 satisfaction with the home’s environment. It is disappointing to note therefore the plans for closing Hayleigh in the future. Following requirements made at the last two inspections in respect of care records, it was pleasing to note clear improvements in the way these are written. Residents’ daily progress records were clear, person-centred and nonjudgemental. Further, activities records showed clear improvement and gave good information of residents’ enjoyment of any activity, outing or entertainment provided for them. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 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 the following standard(s): 3 Satisfactory admission arrangements ensure residents’ needs can be met or action is taken quickly to find a more suitable placement. EVIDENCE: It was noted that nine residents had transferred to Hayleigh from another local authority home that had recently closed. Care records had been transferred and new care plans put in place. The manager said she was continuing to assess a new resident with mental health impairments who had been transferred from another home and whose behaviour had deteriorated since admission. The manager was clear that a more suitable placement should be found if the resident was unable to settle or her/his assessed needs were unable to be met. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 9 Social work care plans developed prior to admission were available to demonstrate potential residents’ assessed needs. The manager confirmed that these are used as a basis for the home to assess and develop its own plans in consultation with the resident or their relatives. However see Standard 7 below for more information about this. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 10 & 11 Care plans need attention to ensure residents’ assessed needs are met and changing needs are identified and regularly monitored. Residents are well looked after in respect of healthcare needs and are treated with dignity and respect by staff. Records written in respect of dying residents need attention to demonstrate the quality of care given towards the end of life. EVIDENCE: Three care records were examined. For 2 recently admitted residents, both of whom had mental health impairments, pre-admission social work care plans were seen. However the home had not prepared its own care plans or put them in place following the four-week trial period. The lack of care plans at the visit made it difficult to see if all needs identified from the social work care plan were being met. It was therefore pleasing to note that the manager submitted a comprehensive care plan in respect of one of these residents during the inspection period. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 11 New monthly review sheets were seen for each resident. Evidence of review including any comments were seen but examination showed that some care plans were not being reviewed monthly i.e. for one resident the care plan showed review on 6 Oct but nothing for November. Some reviews showed sporadic review e.g. weekly then stopped, or two weekly then stopped, or monthly. The requirement is therefore carried forward with a short timescale. Health and social care staff were seen visiting the home at this visit. Records gave details of visits made by social workers, GP’s, district nurses and the chiropodist. Positive relationships were noted between the visiting staff and the management team. Care records clearly demonstrated awareness of residents’ health issues and prompt action to ensure GP’s or paramedics were contacted was noted. Residents had received flu vaccinations in October and this was recorded. Staff were observed knocking on residents’ bedroom doors and waiting to be invited in. Staff announced themselves to residents clearly and in a confident and relaxed manner. For one resident who was losing weight due to an underlying medical condition, daily records showed that a food chart had been kept for 3 weeks. However this was not available for inspection that made it difficult to know what and how much the resident was eating, or how staff were managing the situation. Weight records were seen but didn’t clearly show the extent of the weight loss or any gains. Further, records revealed that due to the resident’s confusion as to day or night, s/he may not be offered food at a time that suits her/him. Records need to show that the resident is offered something to eat regularly whatever the time of day/night. The manager was therefore advised to continue keeping a food chart that clearly shows what the resident is offered to eat and when. This issue must also be added to the resident’s care plan as an assessed need. Records in respect of care given prior to a resident’s recent death were examined. From these clear information about personal and healthcare needs were seen. Appropriate contact was made with GP who visited shortly before the resident’s death. Clear recording of this visit was seen that documented staff concerns about the difficulty of administering medication and advice from the GP in respect of ‘tender loving care’ (TLC). However most of the recording was health or personal care oriented. Records didn’t clearly reflect the undoubted quality of care given as described by the manager that demonstrated TLC i.e. whether staff sat with the resident, talked to her/him and how s/he was made comfortable. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 12 One resident spoken with said that s/he likes living at the home ‘but I don’t want to die here’. The resident further expressed the idea of a ground floor flat with a garden. This idea should be further explored if appropriate during future consultations to be held in respect of the home’s possible closure. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 12 & 15 Improvements to activities record keeping shows that residents’ need for stimulating and enjoyable social and leisure pursuits are met. Residents’ benefit from high quality meals that offer lots of choice and meet their needs. EVIDENCE: It was a busy day at this visit with lots of visitors, including district nurses, relatives and others. No activities were taking place. However the activities record book gave better recording of not just activities/entertainment but how residents enjoyed them. Good clear records of a variety of activities and entertainment e.g. DVD’s, reminiscence, bingo, dominoes, an Hawaiian dancer, church services and card games, were seen. Records showed that residents enjoyed each session and their requests for future activities were recorded i.e. one resident said ‘she wanted to go to Weymouth’. A couple of records stated how residents opted to talk about Christmas past and present. The second inspector attending at this inspection took lunch with the residents. The quality of meals provided at Hayleigh has scored highly at previous inspections and residents confirmed this i.e. ‘ really good food, we have a choice’ and: ‘ Always know what’s on the menu as the staff tell you. If you don’t want the choice staff are always happy to make you something else’ Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 14 A coffee morning was held on 3 December that the inspector attended. It was noted that a wide range of home-made cakes were on offer that residents and visitors were observed enjoying. A large raffle was set out in the entrance hall and sale of tickets was brisk. The manager said the raffle would be drawn at the residents’ party to be held close to Christmas. Lots of residents and visitors attended the coffee morning that was held to raise money for the residents amenity fund. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 16 Satisfactory complaints management and recording ensures residents can feel confident in raising concerns about any aspect of their care. EVIDENCE: Copies of the Social Services and Health complaints poster and leaflet were seen in various places around the home. Complaints leaflets were also seen in residents individual care files. Lots of cards and letters of thanks were seen at the front of the comments, compliments and complaints file. These showed clear satisfaction with the home and the way residents had been cared for. Since the last inspection one complaint had been received and dealt with by the manager. The complaint, about care practice was appropriately recorded and resolved the following day. This is good practice. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 & 26 Residents’ benefit from living in a well decorated and maintained home that is accessible to them and meets their needs. Attention must be given to replacing carpeting that is unhygienic to ensure residents live in a fresh smelling and pleasant environment. EVIDENCE: The physical environment of Hayleigh is well maintained. The home is kept in a good state of repair and décor and it was noted that residents expressed satisfaction with their bedrooms and communal spaces through the quality assurance survey. The home was clean throughout at this visit and domestic staff were seen working in several areas. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 17 It was noted that more work to make the environment more accessible to disabled people had been completed since the last inspection. New automated self-opening entrance doors were now in operation. A newly refurbished toilet, fully accessible to wheelchair users was seen on the ground floor close to the entrance hall. However this needs to have a sign put on it to ensure people can find it easily. Although the home showed clear evidence of being clean and hygienic, there was an unpleasant odour throughout the ground floor main areas and corridors. A member of domestic staff confirmed that carpets are regularly shampooed but the smell doesn’t go away. It was noted that carpeting in corridors was older, dingy and in need of replacement. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 Residents’ benefit from well trained staff who are able to meet their needs. Attention is needed to ensure newly recruited staff undergo rigorous checks to ensure residents are kept safe. EVIDENCE: The second inspector met staff on duty. Staff comments were positive about working at the home, feeling that it is a ‘nice place to work’ and they get good support. One staff member commented that the most important aspect of the work is ‘to make sure the residents are happy – that’s the main thing’. Appropriate numbers of staff were on duty at this visit and some new staff had been recruited since the last visit. For the two new staff that started work in February and June ’05, few records relating to their employment were seen. The only records available were Criminal Records Bureau disclosures. However from both it was not clear whether the disclosures, including relevant Adult Protection checks, were received before the staff started work. Proof of identity was seen in only one of the new staff files and neither record included a photograph. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 19 Staff training records were reviewed at this visit. It was noted that three staff attended ‘working with people with learning difficulties’ training in January ’05 and a number of care staff attended ‘effective recording skills’, also in Jan ‘05. Two staff attended loss & bereavement training in February ‘05. Five staff attended ‘behaviour that challenges’ training in June ‘05. It was noted that ongoing mental health training was held during the week of inspection with three staff attending. Two new staff attended manual handling training in May and November ‘05. All the above is good practice. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Residents and staff benefit from having a well-trained and experienced manager. Suitable mechanisms for enabling residents to comment about their satisfaction with life in the home ensures their views are taken into consideration. Supervision records need attention to ensure staff opportunities to reflect on their work for residents’ benefit. get appropriate Residents’ benefit from well managed procedures in respect of looking after their monies. Improvements in recordkeeping ensure residents are respected and the quality of their lives within the home is regularly monitored. Well-managed health and safety and fire procedures ensure that residents are kept safe from harm. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 21 EVIDENCE: The manager said she had completed and been awarded the Registered Managers Award in June. The manager and her staff were welcoming and open to the inspection process. Contact between residents and management staff was observed and clear, respectful and person-centred attitudes were noted. The manager and staff had just been informed that Hayleigh is on a list for possible closure but this is unlikely to happen until 2008. Letters to relatives/representatives about the proposed closure had been sent out. The manager was heard discussing the situation with relatives who had telephoned the home for further information. The inspector spoke with a visitor who was a relative of a recently admitted resident. He said that he was very happy with the home and it was the first one he had looked at. A requirement made at the last inspection in respect of ensuring the Commission received a copy of the Quality Assurance Survey report, was met. The manager had sent a copy of the report to the Commission in July, following the survey that had been carried out in May ’05. The survey showed that over 80 satisfaction was recorded in each of the six categories surveyed. The manager confirmed how she would be taking action in respect of individual comments from the report that can be addressed in the home’s development plan. Of particular note was 88 satisfaction with the home’s environment. It is disappointing to note therefore the plans for closing Hayleigh in the future. The second inspector carried out a check of residents cash held at the home. He also had the opportunity to observe the interaction between the manager and a resident who wanted to withdraw a sum of money. The manager acted appropriately in counting the money with the resident and enabling her/him to take control of it. A sample of residents’ cash sheets was examined. Cash balances were checked against the sheets and all found to be correct. Two staff signatures were seen for all entries. Supervision dates for all care staff were examined at this visit. It was noted that a number of staff had only received one supervision session this year instead of the recommended six sessions. Other staff had received two sessions. It was disappointing to note a downward trend i.e. that over the past few years supervision had tailed off from five sessions in 2003 down to one this year. A good practice recommendation is therefore made to ensure that staff get ongoing, adequate supervision in respect of the work that they do with residents. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 22 Appropriate use of respectful language e.g. ‘declined’ instead of ‘refused’ was seen as good practice. The requirement is therefore met. The second inspector reviewed the health and safety files and noted that fire safety is given priority within the home. A rigorous system of weekly checks is in place with dates and times. Lots of information from the Fire Service was seen in the file together with checks on other major equipment and facilities such as the lift, window restrictors, central heating and water temperatures. Staff spoken with demonstrated their understanding of Control of Substances Hazardous to Health (COSHH) products and procedures and gave examples of safe working practices. Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X 3 X X X 2 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X 3 2 3 3 Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2)(b) Timescale for action Monthly reviews of care plans 31/12/05 must take place not met from (Timescale 31/05/2005 inspection) Care plans must be put in place at the end of the four-week trial periods that demonstrate how assessed needs are to be met Changes in residents’ physical condition or behaviours must be identified and put into updated care plans The carpeting throughout the 31/03/06 ground floor main areas of the home must be replaced Proof of identity and 31/12/05 photographs of each staff member must be kept in personnel files. New staff must not take up their post until evidence that an adult protection check through Criminal Records Bureau has been received. Requirement 2 3 OP26 OP29 16(2)(k) 19(1)(b)(i )Sch 2 Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 2 Refer to Standard OP36 Good Practice Recommendations Staff should have supervision at least 6 times a year Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Hayleigh DS0000036207.V263621.R01.S.doc Version 5.0 Page 27 - 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!