Inspection on 17/06/08 for Hinton Grange

This inspection was carried out on 17th June 2008.

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

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

Other inspections for this house

Hinton Grange 21/12/09

Hinton Grange 17/08/09

Hinton Grange 04/08/09

Hinton Grange 03/09/07

Hinton Grange 01/08/06

Hinton Grange 20/12/05

Hinton Grange 05/07/05

Hinton Grange 04/01/05

Hinton Grange 16/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Hinton Grange Bullen Close Cambridge Cambridgeshire CB1 4YU Lead Inspector Alison Hilton Unannounced Inspection 17th June 2008 07:15 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 Hinton Grange DS0000024273.V366791.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 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. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hinton Grange Address Bullen Close Cambridge Cambridgeshire CB1 4YU 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) 01223 246360 01223 246361 manager.hintongrange@careuk.com manager.burroughs@careuk.com Care UK Community Partnerships Ltd Sharlene Van Tonder Care Home 60 Category(ies) of Dementia (60), Mental disorder, excluding registration, with number learning disability or dementia (60), Old age, of places not falling within any other category (60), Physical disability (60) Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - code OP Dementia - Code DE Mental Disorder, excluding learning disability or dementia - Code MD Physical disability - Code PD The maximum number of service users who can be accommodated is: 60 3rd September 2007 2. Date of last inspection Brief Description of the Service: Hinton Grange is a purpose built home registered to provide accommodation, support and nursing care for up to 60 people over the age of 65 years, some of whom have a mental disorder or have been diagnosed with dementia. It is a two-storey building, surrounded by safe, well maintained enclosed gardens, and is situated in the suburbs of Cambridge close to local amenities and shops. Public transport to the city of Cambridge is readily available. Hinton Grange Care Home provides 52 single and 4 double occupancy bedrooms some of which have en-suite facilities. There are 4 separate bathrooms, 4 separate shower facilities and ten toilets. The home is on two floors. The ground floor has the extra care unit, which caters for residents with dementia or other mental health diagnoses. The first floor can be accessed by lift or stairs and provides residential and nursing care. Carers and nurses provide 24hr care in the home. Copies of inspection reports are kept in the foyer at Hinton Grange. The cost of placement is between £700.00 and £750.00 per week. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We, the Commission for Social Care Inspection (CSCI) carried out a key unannounced inspection of Hinton Grange on Tuesday 17th June 2008 at 07:15 hrs using the Commission’s methodology described below. This report makes judgements about the service based on the evidence we have gathered. Staff (including night staff), people who live at the home, visitors, deputy manager and the manager were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission prior to this inspection. Inspections completed by the provider (Regulation 26 visits) were used as part of this inspection. Surveys were sent to care workers, relatives and people living in the home. Information they provided will be in the body of the report. A number of records were seen, together with two staff personnel files and two files of people living in the home. There were no requirements or recommendations made following this inspection. What the service does well: What has improved since the last inspection? Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 6 There was one requirement and one recommendation from the last inspection. These have now been met. All checks are completed on staff prior to the commencement of their employment ensuring the safety of those living in the home. Where there was information in the home relating to day and date (on boards in each area) this was correct preventing confusion for those living in the home. There has been a major decorating and refurbishment programme since the last inspection, which has created a light, fresh and clean environment for all those living and working in the home. There are raised garden beds that those living in the home can help cultivate and grow flowers and vegetables. 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. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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 Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5,6 Quality in this outcome area is good. People who live in the home have had their health and social care needs assessed before admission so that the home can ensure these can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Hinton Grange does not offer intermediate care. Details in the AQAA showed that the activity co-ordinator has been encouraged to show people who may wish to move into the home and their relatives around, and there are senior staff who are available at weekends to do the same. The manager said she is exploring the idea of having a weekend receptionist to support families who want to view the home then and this would free the time of care staff. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 9 Some of the people spoken to said they had viewed the home before they came to live here, whilst others said it was a relative who chose the home. A copy of the homes statement of purpose, inspection reports and complaints procedure are kept in the entrance hall. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Care plans set out the health and socail care needs of people in the home so that staff have the information they need to meet them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home uses a computer system so that all information in relation to care plans and risk assessments is kept on line. The system also reminds staff on overdue reviews. There were comprehensive details of most health and social care needs in the care plans and they had been reviewed. There was evidence that the GP and District Nurse are involved with the healthcare of people in the home after accidents or incidents as well as reviewing medication. Risk assessments are completed, however on the file for one person there was no risk assessment in relation to his behaviour, which has a direct impact on other people living in the home as well as staff. There was also no information Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 11 on when medication noted as PRN (which means it is given when needed) should be given. Both these risk assessments had been completed before we left the home. Each person in the home is weighed at least monthly and details are kept in a folder to allow easy access as well as the information being put on computer. Both types of record were seen during the inspection, and staff said that if there was a significant weight loss or gain noted the dietician would be contacted. Staff complete daily notes on the computer, which makes them readable and automatically details who wrote them. The manager is providing English training to those who need it to make sure the notes are well written. When staff were asked about the individual care needs of people in the home, they were knowledgeable, and could provide the inspector with details set out in the residents plan of care. As a result of the care taken by staff, pressure areas that people had arrived at the home with had healed or were well on the way to being healed. There were details in individual rooms of when a person had been turned. The details on one chart did not appear to be in line with what was in the care plan but the deputy manager showed the inspector that there had been a change when a new ‘profile’ bed had been purchased and the tissue viability nurse had confirmed the requirement for turning could be less frequent. Information of the residents’ wishes in the event of their death continues to be recorded or noted that further discussions with relatives are needed. The home has a key worker system both for carers and nurses in relation to each person living in the home and the manager said that the home encourages input from them in the development of individual residents care plans. Staff spoken to confirmed this. As at the last inspection staff were seen to knock on bedroom doors before entering and treated people with dignity and respect. They were heard to encourage them in various daily life tasks, which helps maintain their independence as far as possible. Information in the surveys showed that there was sometimes an issue over cleaning teeth. The manager was aware of this and is being dealt with. Details in the AQAA showed that management in the home is not complacent in relation to improving communication within staff teams. There are staff meetings and regular training. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Residents are able to choose the activities they wish to participate in and keep in contact with friends and family, which ensures their interests and social contact are maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are activities co-ordinators employed in the home and they provide a number of activities. It was discussed with the manager that the week’s activities appeared to be limited because one of the co-ordinators was on holiday. She explained that care staff undertake some activities and the part time co-ordinator would still be doing some one to one sessions as well as more organised things to do. This needs to be detailed on the activities schedule displayed in the two units so that people know what is happening. People living in the home said they took part in some things such as the church service, gardening, nail painting, hairdresser, PAT dogs, sporting chance (a mini Olympic style activity with medals and certificates awarded) and some sing-a-longs, but could refuse to take part if they wished. The home has a Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 13 shop that provides a variety of free goods to everyone living there as a result of fundraising. Comments from those seen during the day included “ it’s full of activities. People come and play music, play bowls and skittles. A good lady comes to give us exercises. We have made ourselves a garden.” “ They switch my TV on. I can change channels.” “They do put on activities like skittles and prayers, and you can choose to join in.” From the surveys one person wrote that they were not interested in activities. Relatives spoken to and some people living in the home said they thought the food was good and they had a choice. One person commented that “I can only swallow certain things and they puree food for me. There is a choice but it is not always nice.” The manager is aware there are mixed feelings about the food and is looking at how to improve it. The home has regular input from a dietician for those with special dietary needs. Fresh fruit is provided at coffee and tea breaks together with cakes and biscuits. The dining rooms provided pleasant, clean and companionable areas in which to eat. Lunch on the day of inspection was asparagus soup, beef bolognaise, chicken and pasta and vegetables. Dessert was Eves pudding or ice cream. Those who needed assistance to eat were helped on a 1-1 basis, and others were encouraged. There was a concern where a member of staff was assisting someone and was not waiting for the person to empty her mouth before more food was put in. This was discussed with the deputy manager on the unit and he dealt with it. Details provided in the surveys returned to the commission showed people felt there was good hygiene and good food in the home. Another said that the food was awful although their relative had not lost weight. Staff were seen as friendly but since a lot were not English this made conversation more difficult. During the inspection people in the home said staff were friendly but there were times when they did not understand what was said and times when the staff did not understand what was said to them. The manager is aware and is looking at training for staff to look at language and culture. Details provided in the AQAA showed that there have been young people on work experience in the home and that they are popular with those living there. Staff have had training in activity based care (ABC) which promotes person centred care and enhances the lives of people involved. Each home in the company was allocated £500 and the manager said they had bought a variety of games, a bread maker and stereo system amongst other things. A newsletter is printed several times a year, the last in May 2008 giving news of changes, activities etc. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. People living in the home are protected from abuse by the training of staff and the homes policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission has not received any complaints about the service. The manager said she had received one written complaint and this was seen and had been dealt with according to the homes procedure. There were other minor complaints that had been recorded, which had also been dealt with. The manager said she tries to ensure that any minor issue is dealt with immediately and she encourages people in the home and their relatives to say if there is a problem. This means it can be dealt with promptly and this stops it becoming a major issue. All six staff spoken to during the inspection said they had undertaken adult safeguarding (also known as Protection of Vulnerable Adults) training and they were able to say what they would do in the event of an issue taking place. One person living in the home often gets into arguments with other people and has on occasion ended up with black eyes. On speaking to his wife she said she was always informed when something happened and understands the Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 15 problems. The manager said the incident had not been discussed with the adult safeguarding team in social services and she was advised to do this. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22,23,24,25,26 Quality in this outcome area is excellent. People benefit from a home that is clean and has a maintenance programme. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been a major refurbishment and decoration of all areas in the home. This has made it bright, airy and easier to clean. New curtains, duvet covers, towels and some furniture have been bought. There were new pictures hanging in the corridors and the home had an altogether brighter look. Everyone spoken to including staff and those living in and visiting the home said how much difference this had made and how much lighter and clean it was. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 17 Relatives and people living in the home have individualised bedrooms with new matching curtains and duvet covers. New towels have been purchased. People are encouraged to bring in small pieces of furniture and this was evident when speaking to people in their rooms. People said they were very happy with the new decoration and liked their rooms and had pictures and photos on the walls. People sitting in their rooms were able to reach the call bells. This was significant on the day of inspection as work was taking place on all bedroom doors and the system that held them open had to be disabled. This meant that most doors were closed although some were wedged open where there was a significant risk to the occupant. The manager had checked with the fire service that this was acceptable and had been told it was as the fire doors in the corridors would still close in the event of a fire. Each floor has three hoists and the manager is ordering two new midi hoists. Commodes are also going to be replaced. The gardens are being used more and a relative said it was nice to see people growing flowers and vegetables out there. Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. There are sufficient and quailified staff on duty to meet the needs of those living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff files seen during the inspection had all the necessary information, including Criminal Record Bureau (CRB) checks prior to the commencement of employment. The number and skill mix of staff on duty was sufficient to meet the needs of the people living in the home. There were seven staff on each floor including at least one registered nurse. There was also one member of staff who provided the drinks, assisted at meal times and was used as a ‘float’. This person was able to spend time with each person as they gave them their drinks and this meant good individual contact with those living in the home. Other staff including administrators, cleaners, laundry staff and deputy manager were also in the building. Staff said they had received the necessary statutory training including moving and handling, fire, infection control and safeguarding training. The home has a Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 19 system of computer training for statutory courses, where information is given and then there is a test at the end. The staff cannot go to the next level until they have passed the test and staff on duty confirmed this. There are also some practical tests for things such as moving and handling. In house training and external courses support this training. Some staff said they had reached National Vocational Qualification (NVQ) Level 2 and the AQAA showed that some are going on to Level 3. The AQAA also showed that staff whose first language is not English will receive training that will include support to write and read English. It was discussed with the manager that this process could involve some of those living in the home. Available training such as Safeguarding 4th June, Impact training 18th June and communicating with people with dementia 25th June was displayed in the units. There are team meetings for the different units and different staff. There are also occasions when the staff have team building get togethers, which have proved popular according to the manager. Some comments from people in the home were “ the staff are very good and kind”, “ if I want to stay in bed I can”,“You sometimes have to wait to be taken to the toilet.” “ Sometimes staff are very busy and they are slow to answer the bell.” “I feel safe in the home and I’m called by the name I want to be.” “I find it difficult to understand some of the staff and I suppose they do us too.” “Lovely staff but don’t understand some of them, particularly night staff.” Surveys that were returned showed that ‘new staff have a good attitude to their work and work alongside more experienced staff’. ‘The staff are very caring and make you feel welcome.’ ‘ Staff listen.’ ‘They are all dedicated to look after the residents and they have time for everyone.’ Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. The home is being managed in an open way with evidence of leadership and guidance to ensure residents receive consistently high levels of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager will be leaving the home soon and the new person has not yet been appointed by the company. Information from the AQAA and files seen during the inspection showed that tests are completed including PAT tests, fire drills, Legionella report, additions Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 21 to COSHH files, daily/weekly lighting and fire checks, accident and incident forms. The home has regular monthly unannounced visits from the provider and the reports (Regulation 26 visits) were seen. These comment on all aspects of care in the home and show where improvements need to be made. There are staff meetings, relative support meetings and resident meetings, although the manager said that these have not been as regular as she would have wished, although she now has a deputy, so this will improve. Staff said they received supervision and there was evidence of this on files. One comment on a relatives survey said “management always approachable by telephone and respond to our queries.” Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 22 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X 3 3 4 3 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE 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 Hinton Grange DS0000024273.V366791.R01.S.doc Version 5.2 Page 25 - 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!