Inspection on 06/09/07 for Hollycroft

This inspection was carried out on 6th September 2007.

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

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

Other inspections for this house

Hollycroft 23/10/09

Hollycroft 05/12/06

Hollycroft 06/12/05

Hollycroft 23/06/05

Hollycroft 08/12/04

Hollycroft 05/05/04

Hollycroft 15/05/03

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Hollycroft Hebers Ghyll Drive Off Grove Road Ilkley West Yorkshire LS29 9QH Lead Inspector Steve Marsh Key Unannounced Inspection 7th September 2007 09:00 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 Hollycroft DS0000001218.V346702.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. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollycroft Address Hebers Ghyll Drive Off Grove Road Ilkley West Yorkshire LS29 9QH 01943 607698 01943 601609 hollycroft@fshc.co.uk 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) Acegold Limited (a wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Susan Enid Walters Care Home 30 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (30), Physical disability over 65 years of age (3) Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the category of MD(E) be used for the person named on the application signed on 12 May 2004 5th December 2006 Date of last inspection Brief Description of the Service: Hollycroft Care Home is situated on Hebers Ghyll Drive, about one mile from Ilkley town centre with its variety of shops, restaurants and other amenities. The home a former private residence is a large Victorian property, which has had an extension and conservatory added to the existing building in recent years. The home stands within well-maintained grounds and there is limited parking to the front and side of the property. Hollycroft is registered to care for thirty people in both single and double bedrooms located on all three floors of the property. Many of the rooms have en-suite facilities and there is a passenger lift available to the upper floors. All the communal areas including the lounges and dining room are situated on the ground floor of the home, and there is ramped wheelchair access to the building. Current fees are £364:70 per week minimum to £550:00 per week maximum with additional charges for hairdressing, private chiropody, toiletries etc. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between the hours of 9:00am and 5:30 pm. The purpose of this visit was to assess how the home is meeting the needs of people who live there. The methods I used included looking at records, watching staff at work, talking to people living at the home and talking to the manager and staff. I also left questionnaires for people living at the home, relatives, staff and other healthcare professionals so that they can share their views and opinions of the service with us. The manager had completed an Annual Quality Assurance self-assessment form and the information provided has been used as evidence in the body of the report. What the service does well: What has improved since the last inspection? The Manager has completed the Registered Managers award (RMA) and is just waiting for verification. The home has implemented and updated policies and procedures in line with new guidance received from Four Seasons Health Care. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 6 Funding has been secured to provide a sensory garden and paved walkway to the rear and side of the building for people to enjoy. 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. Hollycroft DS0000001218.V346702.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 Hollycroft DS0000001218.V346702.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): 1,3,4 and 5 – Standard 6 is not applicable to this service. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are provided with sufficient information to enable them to make an informed decision about the home. However, the admission procedure is not thorough enough leading to people being admitted with needs that the staff are unable to meet. EVIDENCE: The manager confirmed that no changes have been made to the home’s statement of purpose or service users guide, which are made available to all people considering using the service. The records show that pre-admission assessment visits are carried out before people are admitted and the needs identified during this visit form the basis for the initial care plan. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 9 The only exception to this is if a person is admitted as part of a planned programme of short stay visits. Under these circumstances the family or referring agency would be contacted before admission to make sure that there had been no significant changes in their physical or mental health. I raised concerns with the manager about the number of people being admitted to the home on a short stay basis exhibiting signs of dementia or behavioural problems, which the staff are not adequately trained or experienced to deal with. This matter was also highlighted in three questionnaires returned by staff who felt that they or their colleagues were at times finding it difficult to provide the level of care and support required by some people admitted to the home. The manager was concerned that information provided by other agencies involved in the assessment process is not always accurate, which has lead to the home admitting people whose needs they have been unable to meet. In addition to the pre-assessment visit, people are encouraged to visit the home before admission to view the accommodation and meet the staff and other people living there. The manager confirmed that people offered a place at the home are always supported throughout the admission process and care is taken to make sure they settle in to their new environment. People spoken with said that they had been given sufficient information about the home before admission and were pleased they had chosen to live at Hollycroft. Comments included “I am pleased with the overall care and facilities provided at the home and “I was reluctant to come into a care home but I was made to feel very welcome and have settled in well.” Hollycroft DS0000001218.V346702.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 and 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s personal healthcare needs are met. EVIDENCE: Care plans have been completed for all people living at the home and cover all aspects of their social and healthcare needs. The manager confirmed that care plans are reviewed on a regular basis and reflect the current level of care and/or support required by the individual. However, I had difficulty in finding some information in the care plans I looked at and found that information that should have been in the care plans had instead been recorded in the monthly evaluation report or other supporting documentation. The care plan is the working document and should provide clear guidance to the staff on how the individual’s needs are to be met. The manager confirmed that she is to attend a care planning training course later in the year and will Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 11 make sure that the plans are brought up to date and provide accurate information. All people living at the home are registered with a general practitioner and are supported in having access to the full range of NHS services. The input of other healthcare professionals is clearly recorded in the documentation available, which shows that staff are seeking advice if they have concerns about an individual’s health. Questionnaires returned by three General Practitioners showed that they felt the home was meeting people’s healthcare needs and had no concerns about the standard of care provided. People living at the home said that they were very pleased with the care and attention they received and comments included “the staff always treat me with kindness and respect” and “you couldn’t get better staff – they are all very caring.” However, questionnaires returned by four relatives indicated that the home was slow to inform them of significant changes in people’s health, although generally they were pleased with the standard of healthcare provided. On reviewing the medication system no concerns were raised, which indicates that people are receiving their medication as prescribed. Hollycroft DS0000001218.V346702.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 and 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are encouraged and supported to participate in a range of activities, which helps to improve their quality of life. The home responds to individual needs and choices and encourages people to exercise control over their daily lives. EVIDENCE: People confirmed that they are encouraged to make as many decisions and choices as possible about their daily lives and how they want to spend their time. The home employs a part time activities co-ordinator who is responsible for organising activities and outings for people on a regular basis. The home has a mini-bus, which is used at least weekly for trips out to places of interest. People said that generally the level of activities provided was adequate although questionnaires returned by two people indicate that more could be done to improve their social and leisure time. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 13 Throughout the visit staff were observed to interact well with the people in their care and people were relaxed and clearly felt comfortable in their presence. Staff confirmed that the daily routines of the home were flexible and people could get up and go to bed when they want and generally plan their day. However, I raised concerns with the manager about the present staff shift pattern, as at the time of the inspection only two night staff were on duty after 8pm. This is relatively early for the night staff to be on duty and feedback from people living at the home clearly indicated that at times they felt rushed or had to wait for assistance if staff were busy. I also raised concerns about there being no handover period between the day and night staff and therefore no opportunity for them to discuss specific issues relating to the care of people living at the home. Following the visit I was contacted by the Regional Manager for Four Seasons Health Care who confirmed that action had been taken to address this matter and the senior care assistant on the evening shift now works until 9:30pm. People said that they were able to see visitors in their own room if they wished to do so and family and friends were always made to feel welcome and offered light refreshment. Feedback from people living at the home confirmed that the food is good and their preferences are taken into account when menus are planned. People have input into menu planning through the meetings with staff, which are held at regular intervals during the year. However, questionnaires returned by three relatives showed that they were disappointed with the standard of meals provided and felt that people should have more choice and the overall quality of the food should be better. The manager confirmed that following consultation with people living at the home and guidance from the Executive Chef/Food Safety Advisor employed by Four Seasons Health Care new menus are to be planned and introduced in the near future. Hollycroft DS0000001218.V346702.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 and 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Thorough complaint and adult protection policies and procedures make sure that individuals are listened to and protected from any form of abuse. EVIDENCE: There is a complaints procedure in place and questionnaires returned by people living at the home and their relatives showed that they would have no problems approaching the manager if they had any concerns about the standard of care being provided. The annual quality assurance assessment completed by the manager indicates that the home have received six complaints since the last inspection five of which have been referred to the Bradford Social Services Adult Protection Team. Four of the five referrals investigated were found not to be substantiated but there was sufficient evidence in the fifth case for a member of staff to be placed on the Protection Of Vulnerable Adults (POVA) register, which means that she will no longer be able to work with vulnerable people. Out of the six complaints received at least two were not resolved within a twenty-eight day period although it is acknowledged that extensive investigations had to be carried out in both instances. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 15 Adult protection policies and procedures are in place at the home and all staff have completed training using the workbooks provided by Four Seasons Health Care. Feedback from staff clearly indicates that while they feel the workbooks are useful they would benefit from attending an appropriate training course. The Annual Quality Assurance Assessment completed by the manager also identifies that the home could do better in this area of work, by providing staff with more in depth training. On discussing the matter with the manager she confirmed that by the end of November 2007 all staff will have received further training in the recognition and reporting of abuse as the part of the home’s commitment to reducing the number of complaints recently received. Hollycroft DS0000001218.V346702.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 and 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home continues to provide people with a pleasant and comfortable environment in which to live. EVIDENCE: A full tour was not undertaken on this visit, however internally the home is generally well maintained and there is an ongoing programme of refurbishment and renewal. The home is to be re-wired in the near future, following which areas that have been affected by the work will be decorated or re-carpeted as required. The manager is aware this will cause some disruption to the day-to-day running of the service however, every effort will be made to minimise the disruption to people and maintain a safe environment while the work is in progress. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 17 On the day of the visit the standard of hygiene and cleanliness throughout the home was good and no unpleasant odours were noted. People said that they were pleased with both their private accommodation and communal areas. Comments included “the home has a nice warm and friendly atmosphere” and “the home is always kept clean and tidy.” Externally the building and grounds are well maintained and the manager has recently secured funding to build a sensory garden and paved walkway to the rear and side of the building for people to enjoy, weather permitting. Hollycroft DS0000001218.V346702.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 and 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People that use the service are protected by the agency’s recruitment and selection procedures. More emphasis needs to be placed on providing staff with NVQ training; so that people living at the home can be sure they are being cared for by experienced and skilled staff. EVIDENCE: The home has a thorough staff recruitment and selection procedure, which includes obtaining at least two satisfactory written references and a Criminal Record Bureau check before new staff start work. All staff are provided with written job descriptions, which outline their roles and responsibilities and a copy of the staff handbook. Following the increase in staffing levels on the evening shift the home now employs sufficient staff to meet people’s needs. Feedback from people living at the home and relatives about the skill mix within the care staff team was positive and they felt that manager and senior staff provided good leadership. Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 19 New staff receive induction training and additional training relevant to the post they hold is encouraged by the manager. Feedback from staff was generally positive about the standard of training provided although there was concern that for some training they had to travel quite long distances, which people found difficult if they had to use public transport. The Annual Quality Assurance Assessment (AQAA) form shows that currently only four care staff have achieved a NVQ at level two or above and no staff are currently studying for the award. Questionnaires returned by staff showed that they had mixed feelings about the value of NVQ training. Comments included “I would like to study for a NVQ but have not been given the opportunity” and “I don’t want to do NVQ training – I have worked in care homes for years.” The manager is aware that more emphasis must be placed on providing NVQ training for both new and long serving staff, so that people can be confident that they are being cared for by experienced, skilled and trained workforce. Hollycroft DS0000001218.V346702.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): 31,32,33,35,36,37 and 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The manager works hard to make sure that people are supported in making decisions and exercising choice. Effective quality assurance monitoring systems are in place, which allow people to share their the views of the service. EVIDENCE: Mrs Susan Walters the registered Manager of the home has many years experience in the caring profession and has recently completed the Registered Managers Award (RMA). Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 21 Feedback from staff shows that the manager has an open and approachable management style and ensures clear channels of communication within the home by holding regular staff meetings. All staff also receive formal one-toone supervision with the manager on a regular basis to discuss care practices, training needs and personal development. Policies and procedures are available relating to the storage and processing of personal information relating to both people living at the home and staff, which comply with the Data Protection Act 1998. However, the main files held for people living at the home would benefit from reorganising and old paperwork archiving so that relevant information is easier to find. Quality assurance monitoring systems are in place and the manager is proactive in seeking the views and opinions of people living at the home and their relatives about the service provided. Since the last inspection the system of assisting with people’s finances has changed and the home now no longer hold money in safekeeping for anyone. Instead people are invoiced for any additional services, which are not included in the fees such as hairdressing and private chiropody. Policies and procedures are in place to ensure the health and safety of the people living at the home, visitors and staff and they are audited on a regular basis to make sure that they meet present legislation. Information provided in the Annual Quality Assurance Assessment (AQAA) form also indicates that all equipment in use at the home such as hoists and the passenger lift is serviced in line with the manufacturers guideline, so that people can be sure that they are in good working order. However, the manager confirmed that the fire risk assessment for the home is out of date and therefore this matter must be addressed with some urgency so that people are not put at risk. Hollycroft DS0000001218.V346702.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 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X X X X X X 3 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 4 3 X 3 3 3 2 Hollycroft DS0000001218.V346702.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. 1. Standard OP3 Regulation 14 Requirement The assessment information received for new admissions (including admitted on a short stay basis) must be accurate so that staff can be confident that they can meet their needs. Staff must have the training skills and experience to meet the needs of people living or admitted to the home. All relevant information must be recorded in the care plans and not in supporting documentation. So that up to date information about people is easily accessible to staff and care plans can be used as working documents. The fire risk assessment for the home must be updated to make sure that people are not put at risk. Timescale for action 31/10/07 2. OP4 18 30/11/07 3. OP7 15 30/11/07 4. OP38 23 (4) 30/11/07 Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 24 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 OP28 Good Practice Recommendations More emphasis needs to be placed on providing NVQ training for both new and long serving staff so that people living at the home can be confident in their ability to carry out their duties. The main files held for people living at the home would benefit from reorganising and old paperwork archiving so that relevant information is easier to find. 2. OP37 Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Hollycroft DS0000001218.V346702.R01.S.doc Version 5.2 Page 26 - 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!