Inspection on 06/02/09 for Homeleigh Residential Care Home

This inspection was carried out on 6th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homeleigh Residential Care Home 19/02/07

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Homeleigh Residential Care Home 52 Eglinton Hill Shooters Hill London SE18 3NR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: James OHara     Date: 0 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Homeleigh Residential Care Home 52 Eglinton Hill Shooters Hill London SE18 3NR 02083314343 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Lovestar Limited care home 5 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 5 The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Homeleigh is a five bed roomed bungalow situated in the Shooters Hill area providing support and rehabilitation to five adults with mental health problems. Homeleigh provides specialist care for people who may have challenging behaviour and forensic psychiatric history and may be on a supervision register and are recovering or have recovered from mental illness.The accommodation is clean and decorated and furnished to a high standard and comprises of five bedrooms, a large communal area, dining area, kitchen, bathroom, quiet room, laundry and games area. The house is well situated for local amenities within the Woolwich area and local transport. The currents fee for a placement at Homeleigh range between £1000.00 and £1450.00 per week. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. We spent four and a half hours at the service and talked with three people who use the service, a visiting NVQ assessor and the registered provider who is also the registered manager. Records and documents examined during the inspection included care plans, activities, medication, staffing and training and health and safety records. The registered provider completed an Annual Quality Assurance Assessment (AQAA) to Care Homes for Adults (18-65 years) Page 6 of 28 tell us about the service provided, how it makes sure of good outcomes for the people using it and any planned developments. What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose could be reviewed. Care Homes for Adults (18-65 years) Page 8 of 28 Peoples medication administration records must include a recent photograph. We would like to thank the people who use the service, staff, the NVQ assessor and the registered provider for their comments and support during the inspection process. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People planning to use the service can be sure that the service can support them because their needs are fully assessed before they move in. Evidence: There is a Statement of Purpose and Service Users Guide. The Statement of Purpose gave good information about the service however lacked some details on the number, qualifications and experience of staff. People who use the service had recently reviewed the Service Users Guide. Three new people moved in since the last key inspection. We looked at two new peoples files. The files included referrals and assessments from social workers, care coordinators, reports from psychiatrists and an assessment carried out by the registered provider detailing how the service would meet the persons needs. Records showed that both people had a number of visits to the service and a number over night stays before deciding to move in. Both people completed a trial period to Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: consider if the service was suitable and could meet their needs. People have a contract detailing the terms and conditions, house rules and fees charged by the service, these have been agreed and signed by the individual and the registered provider. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be sure that they are properly supported and safe because care plans and risk assessments give good information about their support needs and how the service can meet these needs. Evidence: We looked at two peoples files. The files included a care plan that was reviewed on a monthly basis, these were comprehensive and involved people and their representatives, including family or advocates and other professionals. People had clearly been involved in the setting up of their care plans and had signed them. Care plans covered areas such as the persons mental health stability, social and community activities, anger management, personal hygiene, rehabilitation, compliance with the mental health act, medication and a contingency management plan. The plans included goals for development and how staff could support people to achieve them. The registered provider produced monthly clinical review reports completed by the Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: service, these included the views of people who use the service and are passed on to community psychiatric nurses and care management. Files included clinical risk assessments carried out before admission and reviewed on a monthly basis. Where risks were identified procedures and care plans reflected how these were being managed. Independence is promoted where possible. Any restrictions placed are minimal these are recorded in the care plan and would be for the safety and welfare. People are encouraged to make personal decisions wherever possible in respect of activities, food, domestic tasks, the decoration and layout of their rooms, their personal appearance and clothes they choose to wear. Two people showed us their bedrooms, both had music centres, televisions, and telephones and had personalised the rooms to reflect their tastes. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be sure that their social and leisure needs are met because they are offered a varied programme of activities that reflects their individual interests. People are part of the local community. Appropriate arrangements are made so that people can have contact with their friends and families. Evidence: People attend a range of activities according to their individual needs. One person attends a day centre once a week accompanied by a member of staff, this person cooks under staff supervision, has recently started knitting and enjoys taking part in games and puzzles. Another person has completed an NVQ level 2 in customer care, works as a volunteer at a registered charity and is currently seeking paid employment; Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: this person attends computer sessions at college and is learning to drive. One person had edited the January issue of Homeliegh House, The Bungalow Newsletter. The Newsletter included information on new staff, the new mini bus, poems from people who use the service, residents and visitors survey analysis and days out and activities. The editor stated in the editors message, since the first time I set foot in the home I knew it was the place for me to live, I like the cleanliness, variety of food and the act of eating together and helpful and supportive staff. I particularly like the way my key worker handles issues and all of the residents are friendly and helpful to me, and , I thank the staff for helping me when I was ill, if I were in my flat I would be dead. The registered provider told us that this person is currently staying with a friend and is being supported by their care manager and the service to find an alternative placement in the Greenwich area that would support them with their personal circumstances. People can attend organised in house activities such as dominoes, board games, group discussions, relaxation, and cooking and current affairs. People have access to a communal television, computer and a purpose designed games room as well as their individual rooms when privacy is required. We observed people coming and going throughout the day to attend planned activities and personal shopping. People are encouraged to maintain family or other significant relationships were appropriate, one person receives regular visits from their family, one person works with their family and has regular arranged overnight stays and another person is working with their care manager to try to create links with their family. The registered provider told us that family and friends are welcome to visit people between the hours of 7am and 11pm. The registered provider told us that they have developed a four weekly menu planner that included a variety of food chosen by people who use the service. People are encouraged to participate in the preparation of food at any time, but particularly in the evening. People told us that they were pleased to be involved in the preparation of food in order to promote their independence. The registered provider produced minutes from regular residents meetings, these indicated that people are encouraged to make decisions about the day to day running Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: of the service. The minutes also indicated that people regularly review the choice of food on the menu planner. Care Homes for Adults (18-65 years) Page 17 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are receiving flexible personal support in a way that they prefer and their physical and mental healthcare needs are being met. The medication system is well organised and managed. Evidence: None of the people who use the service require physical assistance with their personal care other than some prompting for one person. This person was being provided with counselling and encouragement by staff to boost self esteem and personal appearance. Another person expressed very positive views of how supportive staff is towards them. Evidence was available in peoples files that they are enabled to manage their own health care through regular contact with psychiatric health professionals. All of the people who use the service are registered with a local General Practitioner and one person receives an injection at the local surgery bi weekly. People told us that they were happy for staff to assist them with their medication. One Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: person has been diagnosed with diabetes. This person uses a nova pen to self administer their insulin. This medication is stored in a fridge in the office. The registered provider is a Registered Mental Nurse and holds a Degree in Mentorship and Training, they told us that they had attended a lecture given by a diabetic nurse on the condition, following this the registered provider had trained the staff team on diabetes. The registered provider produced a pack containing information and leaflets on diabetes. The registered provider told us that one person had previously been diagnosed with epilepsy however this person has not had a seizure since they moved in. They told us that this persons condition was being reviewed by their consultant and General Practitioner to establish if they had epilepsy. It is recommended that if the person is diagnosed with epilepsy then all staff should attend training on the condition. A risk assessment should be drawn up in the meantime. The medication system was examined and was appropriately organised, medication was stored in a locked cabinet. None of the people who use the service require controlled medication however the medication cupboard has a lockable container should the need arise. A local pharmacist provides medication. Medication is obtained mainly in a blister pack system. Medication administration records were up to date and accurate however the medication administration records did not include a recent photograph of the individual. Medication administration records must include a recent photograph of the individual. Medication administration records included reasons for non administration of medication for example C = hospital or L = leave. The registered provider told us that the reasons for non administration of medication are recorded in peoples daily records. The reason for people receiving as required medication is recorded on the back of the medication administration record. Records show that people are taking their medication consistently ensuring that their physical and mental health is maintained. The registered provider produced a record of medication received into the service and returned to the pharmacy. There is a policy and procedure for medication that was comprehensive and only staff that had received training can administer medication. Staff training records showed that all staff had attended training on the administration of medication. Care Homes for Adults (18-65 years) Page 19 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Adequate procedures are in place to make sure complaints are managed and to protect people from abuse. Evidence: There are policies and procedures in relation to complaint management. A system was in place to record complaints made about the service. The registered provider told us that one person made a complaint since the last inspection. This complaint had been investigated by the registered provider and resolved to the satisfaction of the person concerned. People who use the service have the capacity to raise concerns and when we asked two people about making complaints they told us that they were very happy with the service and had no complaints. There are policies and procedures in relation to adult protection, there is also a whistle blowing policy. No allegations of abuse had been made to the registered provider or the Commission since the last inspection. As recommended at the last key inspection the registered provider has obtained a copy of the London Borough of Greenwich Adult Protection Procedures and has shown this to staff to make sure that the services policy matches the requirements within the local authority procedures and all staff has attended training on adult protection. Care Homes for Adults (18-65 years) Page 20 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable safe environment that was spotlessly clean and tidy on the day of inspection. Evidence: The premises were clean, bright and comfortable. Bedrooms were spacious and highly personalised, this is commendable, and there was ample communal space for people who use the service. As previously stated two people showed us their bedrooms, both had music centres, televisions, and telephones and had personalised the rooms to their personal tastes. Furniture and fittings and the decoration of the environment are of a high standard and people told us that they enjoyed their surroundings. Liquid soap and towels was available in the bathrooms and toilets. The kitchen work surfaces were clean and tidy with utensils and equipment appropriately stored. All cleaning materials were locked away and subject to control of substances hazardous to health, COSHH, procedures. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be sure that they are safe because there are enough competent well trained staff on duty at all times. They can have confidence in the staff because checks have been done to make sure that they are suitable to care for them. Evidence: We spoke to three people who use the service, one person told us, I love it here, I get on with the other people who live here and the staff, another person told us, its nice living here, I have a nice room with an en suite shower, the staff are very good. Training records for individual staff showed that a good level of training had been provided and was being planned for the future. Staff had attended training on food hygiene, fire safety, adult protection, medication, health and safety, infection control and managing violence and aggression. All staff had received induction and foundation training and had an individual training and development plan. As well as the registered provider two other staff are Registered Mental Health Nurses. Three staff holds NVQ level 3, another member of staff is completing NVQ level 3 and the registered provider has trained staff on mental health. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: The registered provider told us that they had facilitated the placement of a number of nursing students from Greenwich Community College. The registered provider produced Criminal Record Checks for these students. The college awarded a certificate of appreciation to staff in recognition for their valued support and training. A visiting NVQ assessor told us that they thought the place was very homely and they had, over a number of visits, observed that staff treated people in a very respectful way. We looked at all of the staffs personnel files. The files included Protection of Vulnerable Adults and Criminal Record Checks, proof of identity and photos, two written references, passports, qualifications and evidence as to their physical and mental fitness. The files also included completed application forms, job descriptions, interview questions and their answers. Records show that staff is receiving regular formal supervision and regular staff team meetings are being held. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be sure that their needs are met and their wishes are taken into consideration because the service is well managed. People can be sure that are protected from harm because good health and safety arrangements are in place. Evidence: The registered provider manages the service, is a Registered Mental Health Nurse and is very experienced and competent having a comprehensive background in various areas of National Health Service psychiatric provision. The registered provider also holds a Degree in Mentorship and Training and told us that they are continuously developing their skills. People were all very positive about the way the service was managed and appreciated the support and advice afforded to them by the registered provider. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: It was very evident during the course of the site visit that peoples views are very important and taken into consideration for the day to day running of the service. As previously stated registered provider showed us feedback from surveys sent to relatives, care managers and health care professionals. All of the feedback was positive. As well as the previous comments a relative commented that staff had amiable and pleasant dispositions and there was a good feeling at the service and a person who uses the service commented that very good communication improvements can be seen after talks with residents and staff and there is always someone to talk to. The Homeliegh House, Bungalow Newsletter included an analysis of residents and visitors survey analysis. Residents and staff meetings are taking place on a regular basis. The registered provider produced quarterly monitoring audits for the service. The registered provider told us in the AQAA that all of the services policies and procedures had been reviewed in 2008. The registered manager told us in the AQAA that engineers had checked the fire alarm, electrical and gas systems within the last twelve months. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Medication administration records must include a recent photograph of the individual. To ensure the safe administration of medication. 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 It is recommended that the Statement of Purpose is reviewed and updated to include the number, qualifications and experience of staff. It is recommended that if the person is diagnosed with epilepsy then all staff should attend training on the condition. A risk assessment should be drawn up in the meantime. 2 18 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!