Inspection on 08/11/06 for Hyde Valley House

This inspection was carried out on 8th November 2006.

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

Hyde Valley House 06/11/08

Hyde Valley House 17/01/06

Hyde Valley House 26/09/05

Hyde Valley House 10/02/05

Hyde Valley House 06/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Hyde Valley House Hyde Valley Welwyn Garden City Hertfordshire AL7 4ND Lead Inspector Mrs Jan Sheppard Unannounced Inspection 8th November 2006 11:00 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 Hyde Valley House DS0000019436.V306405.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. Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hyde Valley House Address Hyde Valley Welwyn Garden City Hertfordshire AL7 4ND 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) 01707 379 700 01707 379 760 hyde@quantumcare.co.uk www.quantumcare.co.uk Quantum Care Limited Elizabeth Anne Cook Care Home 46 Category(ies) of Dementia - over 65 years of age (46), Old age, registration, with number not falling within any other category (46), of places Physical disability over 65 years of age (46) Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: Hyde Valley House is a care home providing personal care and accommodation for 46 older people, who may also have a physical disability or dementia. The home, which is owned by Hertfordshire County Council, is run by Quantum Care, a voluntary organisation and is situated in a residential area of Welwyn Garden City, close to shops, pubs, a post office and other amenities. The home provides accommodation in single rooms without en-suite facilities; these are located on two floors, which are both fully accessible by lift. The accommodation is arranged in three separate units each with their own lounge, dining room and small kitchen along with toilets and assisted bathrooms. One unit accommodates residents who have dementia care needs. There is a separate day care facility on the ground floor of the home. Hyde Valley has small gardens with flowerbeds patios and secluded sitting places that residents can easily access. The current fees range from £430 to £490 per week. Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day when staff and managers on duty residents and visitors were spoken with. A tour of the building was made and records examined. This report reflects the observations made in the home at the time of this inspection and also takes account of the information gathered from the pre inspection questionnaire recently completed by the homes manager and of other information periodically sent to the Commission from the home. Twenty-three key standards were examined during this inspection. The requirements and recommendations made following the last inspection have been met. No requirements are made following this inspection. There have been no concerns raised with the Commission by relatives or other health or social workers between inspections. On the day of this inspection the residents looked happy and appeared to be well cared for. What the service does well: What has improved since the last inspection? The activity programme has been greatly improved since the appointment of an Activities Organiser; the range of activities has been increased and a regular pattern of consultation with the residents as to their choices of activities has been established. Since the last inspection the home has benefited from various works of refurbishment including redecoration and the provision of new carpets and seating, these works all following the homes planned routine maintenance programme and have contributed to the high physical standards now found throughout this attractive home. A new, MDS; monitored dosage, medication storage and administration system has recently been introduced into the home. All the staff that administer Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 6 medication undertook re-training for this new system. A new medication room created to accommodate this system offers better working space, improved security and temperature regulation. Since the last inspection work has continued to further improve the way in which care is arranged and delivered to best meet the needs of residents on the dementia care unit. Improvements have been made to the care planning process and to the activities offered. Specialist training for this area has also been increased for all the staff. A new information booklet explaining the company’s policy of care to meet dementia care needs has recently been compiled and this is included in the general information pack sent to all prospective new residents and to their families. 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. Hyde Valley House DS0000019436.V306405.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 Hyde Valley House DS0000019436.V306405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Standard 6 is not applicable to this home, as intermediate care is not offered. Information given to prospective residents and their families is comprehensive and informative enabling an informed decision about admission to be made. All prospective residents and their families are given the opportunity to visit the home before admission arrangements are discussed. EVIDENCE: There have been no changes to the information given to prospective residents nor in the pre admission assessment procedures carried out by the home since the last inspection. Good information is available so that prospective residents can make an informed choice about whether the home is right for them. One of the homes managers carries out a personalised needs assessment in the prospective residents own home or hospital setting which means that people’s diverse needs are identified and planned for before they move into the home. Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 9 The records relating to three recently admitted residents were case tracked. These evidenced that the manager had visited them in their own home or in hospital, had consulted with their social worker and with their relatives and had invited them to visit the home to view the vacant room and to spend some time getting to know the other residents on the unit. The new residents spoken with all confirmed that their admission to the home had been managed sensitively and had proceeded at a pace that suited them. One visiting relative from the north of Scotland commented positively on the inclusive way in which his mother’s admission had been handled and how quickly and happily she had settled into the home. Hyde Valley House DS0000019436.V306405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, 10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Detailed care plans are maintained and these are regularly reviewed. The home has a robust medicines administration and storage policy and procedures. Care was seen to be being delivered by experienced and trained staff in a kindly unobtrusive manner enabling individual need to be met whilst maintaining dignity and respect for the resident. EVIDENCE: All the care plans examined were found to be well maintained with records kept up to date, risk assessments were reviewed and varied to meet changes in residents needs. Regular reviews of these plans are undertaken of which good records are kept Evidence could be seen of the involvement of the residents and their families with these reviews; they are invited to sign the care plan. Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 11 The home maintains good working relationships with its local GP practices where all the residents are registered. The manager commented that the home is lucky to have such cooperative local doctors who are willing to take on all new residents even those who are only in the home for a short stay, they being registered as temporary residents. A district nurse who was visiting the home during this inspection confirmed that her team also maintain close working relationships with the home. She commented that the residents always look to be very well cared for and that the home always consults with them very promptly if any problems arise thus ensuring that treatment can be delivered quickly to ensure a swift outcome. The home is well service by other allied medical services and has a visiting chiropodist, optician and dentist. The Manager reported that the recent change over to a new, MDS, monitored dosage system of medication storage and administration was achieved smoothly. Training about the new system was given to all the staff with specific training for staff that administer the medication. The records checked during this inspection were all found to be being correctly maintained. A fresh medication room created to house this new system offers considerable improvement including bigger administration space, greater security and a controlled temperature system all this to ensure a safe system. Details of resident’s wishes concerning last illness and funeral arrangements were noted on most care plans. Since the last inspection a number of residents have spent their last days in the home and staff told the inspector of special arrangements that had been put in place to facilitate this including offering accommodation to relatives who were visiting from a distance, enabling relatives to help with the care of their loved one and increasing the homes staffing so as to offer a continuous sitting service. A number of appreciative letters from relatives were noted. Hyde Valley House DS0000019436.V306405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. An increased range of activities within the home and outings into the local community gives the residents every opportunity for a stimulating and motivating life style. Visitors are welcome in the home at any time and several were seen to be visiting during this inspection. They were offered refreshments and private areas in which to speak with their relatives if they wished. The home provides a varied and wholesome diet prepared in a manner and in quantities that are appropriate for the needs and abilities of each individual resident. EVIDENCE: The appointment of a new activities organiser has enabled the home to increase the range of in-house activities and also the number of outings into the local community. A regular pattern of consultation and review with the residents about these activities is now well established. Residents and relatives spoken with were clearly very pleased with these developments. One Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 13 resident told the inspector “ there is always something interesting to look forward to now but I don’t feel that I have to attend anything unless I want to “, another commented how much she enjoyed going out into the countryside in the bus whilst another explained to the inspector about her love of singing and then, from her keyboard, led an impromptu sing-a-long with many of her fellow residents joining in. The homes activity programme includes various planned activities for every weekday usually led by the organiser. In addition other staff also facilitate activities and during this inspection they were seen to be doing this with both small groups (discussing the days news with the papers), and with individual residents (playing cards). One recently admitted resident who told the inspector that she had always enjoyed sporting activities expressed her wish to go swimming and the manager immediately spoke with her as to how this might be arranged. The manager discussed with the inspector her intention to further increase the activities offered particularly over the weekends. The home continues to benefit from the fund raising activities organised by a number of senior staff. A programme of their activities is advertised in the home and recent events have included a charity fund raising event. Various other seasonal activities are planned over the next few weeks. A number of visitors were spoken with during this inspection and they were, without exception, very complimentary about the care and services offered by the home. One commented particularly on the kind manner in which the staff tried to ensure that the individual wishes of each resident were taken into consideration giving them the option to exercise choice and control over their own life style to the greatest extent that they were safely able. Since the last inspection a new chef has been appointed and several residents told the inspector that he often comes to talk with them and is more than willing to try any new dishes that they suggest. All the residents’ relatives and staff spoken with were entirely complimentary about the food. One resident said “ the food is delicious the only problem with it is that I am putting on weight! “ Lunch was observed during this inspection it looked and smelt appetising, residents reported it to be served at the correct temperature, differing sized portions were served according to individual need and choice and the meal was seen to be taken in a leisurely manner. Each unit has its own dining room with dedicated staff that serves the food individually. The tables were attractively set with matching crockery and flowers with water or juice freely available. Residents tended to dine together in threes or fours, but one resident who was seen to be eating separately from the others in her own area, indicated that she did this by her choice. Hyde Valley House DS0000019436.V306405.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good this judgement has been made using available evidence including a visit to the service. The home has a robust complaints procedure and follows the adult protection procedures as set out in Hertfordshire’s Joint Agency guidelines. EVIDENCE: The home has a comprehensive complaints procedure with a good system for recording any issues that arise. There have been no formal complaints since the last inspection. One issue concerning dissatisfaction with the laundry service that was raised by one relative but not as a complaint was however fully investigated and a formal meeting held to ensure that the matter was resolved to the relative’s satisfaction. Staff spoken with were familiar with the complaints procedure and residents consulted said that they felt confident that any issue they had would be dealt with effectively. “ If I have any problems I speak directly to the manager and she sorts it out”, one resident told the inspector. A system of recording compliments is also in place and was seen to have been added to since the last inspection. Several very appreciative letters had been received from relatives following the recent deaths of residents in the home. Staff spoken with demonstrated a good awareness of the subject of Adult Protection and the homes records evidenced that training about this subject is on going, next course with nominated attendees planned for January 2007. Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 15 Staff seemed confident that they would know what to do if any suspicions arose. The Hertfordshire County Council joint agency Guidelines were seen to be displayed and available for all staff. Body charts found on the care plans were seen to be being used to record injuries appropriately. The documentation relating to a recent allegation that had been dealt with under these joint agency Adult Protection procedures demonstrated that the correct measures had been taken by the home and that the matter had been resolved. Hyde Valley House DS0000019436.V306405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home and its surroundings offer a pleasant comfortable and homely environment for its residents. The building, which meets the space requirements, is well appointed, safe and well maintained. EVIDENCE: On the day of this unannounced inspection the home was found to be clean and well maintained. Equipment and facilities are provided to meet the individually assessed needs of the residents. The residents occupy single rooms which are well personalised and comfortably furnished with specialist furnishings and equipment provided to meet their individually assessed needs. Several residents told the inspector that they found the home to be comfortable and homely. All said that they had been helped by the staff and sometimes by their families also to personalise their rooms. “ I have everything I need here,” one said, “ and I don’t have to worry about a thing” Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 17 Since the last inspection a number of works of refurbishment, redecoration and the provision of new furnishings have been carried out. Some hallways and communal areas have been redecorated and re-carpeted. New security measures including more external lighting improved window locks and a new front door entry system have been installed followed recent incidents with intruders. A safety locking system has been installed on to a corridor door immediately at the top of the stairs. Patio areas in the gardens have been relaid to ensure that they are level and pose no risk to the residents. The home has a rolling maintenance and refurbishment programme and visitors from the company maintenance department were at the home on the day of this inspection planning future works. Where ever possible residents are consulted about the colours and patterns of furnishings to be provided in their communal areas. Hyde Valley House DS0000019436.V306405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. On the day of this inspection the home had adequate staff on duty to meet the needs of the residents. Staff are qualified, experienced and undertake regular training. Robust staff recruitment procedures are in place to ensure the safety of the residents. EVIDENCE: The records relating to three new staff recruited since the last inspection evidenced that the correct procedures and CRB checks had been carried out to ensure the residents safety. The recruitment processes followed the company’s procedures and the manager confirmed that she was well supported by the company’s human relations department when any difficulties arise. On the day of this unannounced inspection the number of staff on duty appeared adequate to meet the needs of the residents. The home is fortunate in retaining a very stable core group of staff that are experienced and qualified carers. The numbers of staff holding an NVQ qualification has risen by over twenty percent, to 63 , since the last inspection. Two staff recently recruited from another local home that closed both hold NVQ qualifications at levels 2 and 3. Staff spoken with all confirmed that they have good training opportunities and the homes records evidenced that each staff member has an Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 19 annual training needs programme with dates for future training courses planned well ahead. Since the last inspection training concerning dementia care has been given priority with many staff having completed a two and a half day training with final exam. One care team manager has completed the year long course, “Champion of Dementia Care” and another is currently part way through this course. Hyde Valley House DS0000019436.V306405.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is managed by a qualified and experienced manager who is assisted by a stable. Qualified and experienced staff groups many of whom have worked at the home for several years and who regularly undertake training. EVIDENCE: In all areas of the home the staff were observed to be working well together with good team working and one told the inspector that the best interests of the residents was their priority. Staff was clearly well motivated and appeared to enjoy their work so that a relaxed and happy atmosphere was evidenced throughout the home. Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 21 Staff confirmed that they receive regular supervision and are well supported by the homes managers. The staff supervision records examined evidenced that this was so. Other records examined, including fire, residents financial records, health and safety, water temperature, accidents incident recording, demonstrated that the residents interests and safety are supported by the good maintenance of the homes records and the following of procedures and regular checks concerning risk and safety. The homes manager who has now been working at Hyde Valley House for just over two years told the inspector that she was very happy working at the home. “ I love it here, I feel really comfortable now, I know the staff and it took a while but now my ideas and standards are being carried out and together we can really deliver good quality care for the residents” she said. “Of course there are still things that I wish to improve further, the continual improvement of care delivered to our dementia residents and the improvement of activities available at the weekends, to mention just two, but these are planned.” Hyde Valley House DS0000019436.V306405.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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 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 x 3 x 3 3 x 3 Hyde Valley House DS0000019436.V306405.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 Hyde Valley House DS0000019436.V306405.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hyde Valley House DS0000019436.V306405.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!