Inspection on 01/03/06 for Hilbre Court

This inspection was carried out on 1st March 2006.

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

Hilbre Court 12/02/08

Hilbre Court 20/06/07

Hilbre Court 20/02/07

Hilbre Court 21/06/06

Hilbre Court 07/11/05

Hilbre Court 01/02/05

Hilbre Court 28/06/04

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

CARE HOMES FOR OLDER PEOPLE Hilbre Court 2 Barton Road Hoylake Wirral CH47 1HH Lead Inspector Leila Mavropoulou Unannounced Inspection 1st March 2006 12:30 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 Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hilbre Court Address 2 Barton Road Hoylake Wirral CH47 1HH 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) 0151 632 2220 Mrs Delrose Haynes-McManus Miss Tracey Dawson Care Home 14 Category(ies) of Dementia - over 65 years of age (14) registration, with number of places Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number of persons for whom residential accommodation (with both board and care) is provided at any one time is fourteen (14). Only elderly persons with mental disorder may be accommodated. Date of last inspection 7th November 2005 Brief Description of the Service: Hilbre Court is large detached property with secluded gardens to the rear of the property. Shops, the seafront and public transport are easily accessible from the home. The home provides twenty-four hour care and personal support for fourteen older persons that have a mental illness. The accommodation is provided in both single and shared bedrooms with most having an en-suite toilet facility. The home has various aids and a passenger lift to promote the safety and independence of the service users. On the ground floor, there are two lounges and a separate dining room. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted four hours. During which time two staff and the manager were spoken to regarding the care provided at Hilbre Court and three service users. In addition service users bedrooms were inspected and various records such as: fire records, service users and staffing records etc. What the service does well: What has improved since the last inspection? Staff supervision has been implemented to ensure that the staff and the manager have the opportunity to discuss issues regarding staff needs and how their work could be improved. The record keeping in the care home has improved. Records are well maintained and information is easily accessible. Pre- admission assessment of service users information has improved and initial service user plans and risk assessments are devised on admission to ensure that the service user needs would be met. An additional bath chair has been purchased to promote service users choice and safety. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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 Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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): 1,3,4,5, Prospective service user needs are assessed before admission to ensure that the service has the resources to meet the assessed needs of service users. EVIDENCE: The service has a Statement of Purpose, which gives prospective service users information about Hilbre Court such as: facilities, staffing, visiting times etc. This must be reviewed to show changes in the staff qualification and staffing structure at the care home. Discussion with the manager and new service user file seen showed that a preadmission assessment was carried out to ensure that the service is able to meet the assessed needs of the service user and their compatibility with existing service users. Initial service user plans and risk assessments were being devised from the information obtained in the pre-admission assessment to ensure continuity of care to service user. Some of the staff have many years experience of working with the older people with mental health. However, many staff have not received formal training in understanding mental health needs of older people. Training in understanding the various aspects in mental health in older people would improve the quality Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 9 of care provided at Hilbre House, as staff would have a better understanding of how to manage and provide suitable care for service users. Service user file and discussion with the manager showed that the service user and their representative visited the care home before making a deciding to accept a place at Hilbre Court. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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): 7,8,9,10,11 Detailed service users plans and risk assessments are in place showing how service users needs would be met to promote their health and welfare. EVIDENCE: Service users plans seen were detailed and showed how service users identified needs would be met. There was evidence that the manager review the service users plans at regular intervals. Discussion with the manager indicated that she discusses with the service users family changes in their needs when they visit. Service users family are now being asked to sign the service user plan after discussion with the manager, as the service user is unable to do so due to their lack of capacity. Record of significant conversation with service users family is to be implemented to show that families are made aware of significant changes to service user’s care or health. Service users files showed that they have a nutritional assessment and where necessary advice is obtained from the service user’s GP or the dietician. Service users are weighed regularly and a record of their weight kept to monitor changes in their dietary intake. The staff monitors closely service users health needs and where necessary advice is sought from health professionals. Many of the service users receive regular visits from the Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 11 psycho-geriatrician who review the service user medication and monitor their mental health. Service users continence needs are assess by the continence adviser and suitable aids are provided to promote service users dignity. The service maintains a record of all service user medication received into the care home, administered to service users and returned to the pharmacist. The registered manager must ensure hand written entries on service users medication records are countersigned and that the strength of the medication is recorded. Observation of staff assisting service users with personal care showed that service users rights to privacy and dignity are respected. Privacy screen are provided in bedrooms, which are shared by service users. However, one bedroom still requires a privacy screen. Information is kept wherever possible on service users wishes should they become terminally ill or after their death to promote their rights. The service has a policy on aging and dying and service users would be cared for at Hilbre Court as long as their needs could be met. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15 Service users social and emotional needs are met through regular visitors and activities provided at the care home. EVIDENCE: The staff at the care home maintains a record of activities offered at the care home. Currently, the range of activities provided which service users enjoy include sing-a-long, looking at videos, books, make up etc. The service has a hairdresser that visit once a week to provide hair care for service users. Observation and discussion with staff showed that they engage service users in conversation about their past e.g. their work, childhood, where they lived, their family etc, as the service users short term memory is poor. Staff would take service users to the local shops and promenade to enable them to maintain contact with community activities. The registered person should consider nominating staff specifically for providing social activities for service users and to provide the necessary training to enable them to carry those responsibilities effectively. The service has an unrestricted visiting policy and service users or their representatives are able to choose where to spend their visiting time. Many of the service users receive regular visitors as indicated by staff and observation during the inspection. The staff at the care home manage service users personal allowance as they are unable to do so themselves. A secure place is provided for the storage of service users monies and records are kept of income and outgoings of service Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 13 users monies. Service users are encouraged to bring into the care home their personal belongings, so that they are surrounded by familiar things from their past. The service users at Hilbre Court require prompting and sometimes encouragement at mealtimes. Currently, one service user requires assistance at mealtime. The existing staffing level allows staff to provide the necessary assistance to the service user. Records are kept of food provided to service users. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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 the following standard(s): 16,17,18 The service has various policies and procedures to protect service users from abuse. EVIDENCE: The service has a complaint procedure. This needs to be reviewed to reflect the change of name of the regulation authority. The service has not received any formal complaints since the last inspection. Discussion with the manager indicated that any concerns that service users or their families many have are dealt with promptly before the complainant feel that their concerns should be formalised by implementing the service complaints procedure. It is recommended that a record should be kept of concerns raised by service users or their families to identify if there are aspects of the service, which should be improved. The service has information on independent advocacy services which staff would access when necessary to promote service users interests. Staff would support service users to vote if they wish to do so. The service has policies and procedures to protect service users and staff from abuse. A recent incident demonstrated that appropriate regulatory bodies are contacted as required to obtain information and support to protect service users. Discussion with the manager indicated that training has been booked for two staff to attend a training course in May 2006 on Managing Challenging Behaviour and information obtained by those staff would be cascaded to other staff until all staff have attended training. It is recommended that when an incident of challenging behaviour occurs the manager and staff should reflect Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 15 on the incident and to identify if any lessons could be learnt to improve the management of a similar situation in the future. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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): 19,20,21,22,23,24,25,26 Hilbre Court benefits from routine maintenance and refurbishment to promote the safety of service users. EVIDENCE: The grounds of the care home were clean and well kept on the day of the inspection. The property benefits from regular routine maintenance and items of furnishings are replaced as required. However, many of the bedrooms and the communal areas require redecoration to improve the physical environment for service users. Some of the bedroom furniture should be replaced through a planned renewal programme as they are worn. The service has two lounges and a separate dining room. The ceiling in quiet lounge must be repainted as it is stained and discoloured from the leakage of water pipes on the first floor. The communal rooms especially the quiet lounge is very homely though the quality of the domestic furniture, ornaments, plants etc. All of the communal rooms could be used for a variety of activities. The service users are able to access all parts of the care home easily by using the passenger lift. Even though Hilbre Court is not designed specifically for Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 17 service users with mental health needs, service users are able to find their way around the building independently as observed. There is an enclosed garden to the rear of the property which is easily accessible to service users. Most of the bedrooms have a toilet en-suite to promote service users independence and dignity. There are communal bathrooms on both the ground and first floor both with bath chairs to assist service users in and out of the bath safely. All service users bedroom have a call system, which is used by service users and staff when they require assistance. Grab rails are provided in toilets to promote service users independence. There is a passenger lift to enable service users easy access the bedrooms on the first floor. Service users bedrooms were clean and free from malodour. Many of the bedrooms are personalised with service user pictures and other small personal items. One of the shared bedrooms does not have a privacy screen to promote the service user privacy. The service is centrally heated and the rooms are bright and well ventilated. Emergency lighting is provided throughout the building, which is tested regularly as evidenced in the fire logbook. The hot water at outlets in service users bedrooms runs cold for a long time because of the location of the hot water tank/boiler. Therefore, staff have to wait a considerable time before they are able to assist service user with washing. Record of storage of hot water must be maintained and tested regularly to prevent risks of Legionella i.e. the hot water must be stored at 60 degrees centigrade and distributed at 50 degrees centigrade. The laundry is sited away from the food preparation area and procedures are in place to minimise the spread of infection. The service has an independent contractor to collect their clinical waste. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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): 27,28,29,30, The health and safety of service users could be improved through improvement recruitment procedures and staff training. EVIDENCE: The staffing levels at the care home meet the needs of the service users. Some of the staff have completed their NVQ level2 qualification in care and others are awaiting their certificates as they have completed their NVQ level 3 care qualification. Observation of staff showed that they had a good rapport with service users and that they have a good understanding of service users daily needs. Domestic staff are employed to maintain the cleanliness of the building. The chef post is vacant and staff are working additional hours to meet the catering needs of the service. The manager has started to review existing staff files to show that two written references, a job description, terms and conditions of employment and a Criminal Records Bureau check are obtained. Also, staff training records are being reviewed to identify staff training needs. Discussion with staff indicated that they are inducted into their role. Some of the staff files showed induction forms were completed and countersigned by staff. The registered person should ensure that staff induction complies with the specification of the TOPPS induction. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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 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 The management of the service has improved in recent months to improve the quality of care provided to service users. EVIDENCE: The record keeping at the care home has improved over the past twelve months and there has been ongoing improvement in the recording of service users needs and the implementation of systems to improve accountability in the care home. The manager is awaiting confirmation regarding her NVQ level3 Care Award from the training agency. There are clear lines of accountability with the external management of the care home who continues to support the manager’s ongoing training and personal development. A reservation has been made for the manager to attend a training course in Challenging Behaviour in May 2006. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 20 Regular staff meetings are being held and minutes are kept of issues discussed. The manager is accessible most days when service users, staff and visitors are able to discuss any issues they may have. The service has not yet developed its quality assurance system to monitor the continuous improvement in the service. The registered person visits the service regularly. However, reports of their monthly visit as required by the Care Homes Regulation 2001 are not being forwarded to the Commission as required. The manager maintains a record of incoming and outgoing monies of service users. A safe place is provided for service users monies. The manager has recently introduced individual staff supervision. This was confirmed with discussion with staff. The service promotes the health and welfare of staff by ensuring equipment are serviced regularly and routine checks are carried out. However, the health and safety of service users and staff could be improved by ensuring that all staff training in food hygiene, first aid, fire awareness and moving and handling are current. A current risk assessment and fire risk assessment must be completed. Discussion with the manager confirmed that even though the building and fire risk assessments have not been completed, efforts have been made in addressing the issues by considering risks throughout the building and to assess the most effective way of recording the information. A current electrical wiring certificate was not available at the time of the inspection. The registered manager maintains a record of accidents/incidents in the care home for staff and service users and where necessary the Commission and other agencies are notified. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 2 2 3 3 3 X 2 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 1 3 3 3 2 2 Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 22 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 OP1 Regulation 4 Requirement The registered person shall ensure that the home’s Statement of Purpose is reviewed to reflect the current staffing structure, staff qualification and details of the Commission for Social Care Inspection. This was not met from the previous inspection. The registered person must ensure that where medication is hand written on service user medication record that the information is countersigned and the strength of the medication recorded. This is outstanding from the last inspection. The registered person must review the home’s complaints procedure to show the current regulatory body: The Commission for Social Care Inspection. This is outstanding from the last inspection. The registered person must ensure that all staff receives DS0000018895.V286392.R01.S.doc Timescale for action 20/05/06 4. OP9 13 30/04/06 6. OP16 22 30/04/06 7. OP18 18 30/05/06 Hilbre Court Version 5.1 Page 23 training on managing physical and verbal aggression and understanding abuse. This is outstanding from the last inspection. 8. OP19 23 The registered person must ensure that the following repairs are carried out: The ceiling in the quiet lounge needs repainting and the communal rooms need redecorating. Some of the bedroom furniture is looking a little worn and should be replaced through a planned renewal programme of furnishings to maintain the quality of the environment. The registered person must provide privacy screens for service users in shared bedrooms to promote their privacy and dignity. The registered person must ensure that hot water is stored at 60 degrees centigrade and distributed at 50 degrees centigrade to prevent the risk of Legionella. The registered person must ensure that two written references are obtained and Criminal Record Bureau check are obtained prior to staff commencing work in the care home. Outstanding from previous inspection report. The registered person must ensure that a quality assurance system to review the quality of care provided at the care home at regular intervals. Outstanding from previous inspection report. DS0000018895.V286392.R01.S.doc 30/05/06 9. OP21 12 30/04/06 11. OP25 13 30/01/06 12. OP29 17 20/05/06 14. OP33 24 30/05/06 Hilbre Court Version 5.1 Page 24 15. OP33 26 17. OP37 17 The registered person must ensure that where a manager is appointed for the day-to-day management of the home that a monthly visit is carried out to monitor aspects of the service provided and provide a report of their findings to the Commission. Outstanding from previous inspection report. The registered person must ensure that accurate records are maintained in accordance with the requirements of the Care Homes Regulation 2001. 30/04/06 30/01/06 18. OP38 13,18,23, The registered person must 30/04/06 ensure that staff are appropriately trained to carry out their roles and responsibilities. The registered person must ensure that fire assessment and a building audit are carried out at regular intervals to promote the health and safety of the service users. The registered person must ensure that the care home has a current electrical wiring certificate. 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 OP12 Good Practice Recommendations The registered person should nominate specific staff to be responsible for activities and to provide appropriate training to enable them to carry out their roles and responsibilities. The registered manager should maintain a record of all DS0000018895.V286392.R01.S.doc Version 5.1 Page 25 2 OP16 Hilbre Court 3 OP18 concerns raised by service users or their representative to identify if specific areas of the service could be improved. The registered manager should reflect with staff incidents of challenging behaviour to identify if any lessons could be learnt to improve the management of a similar situation in the future. Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Hilbre Court DS0000018895.V286392.R01.S.doc Version 5.1 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. 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