Inspection on 10/10/06 for Kelvedon Project

This inspection was carried out on 10th October 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kelvedon Project 14/09/07

Kelvedon Project 19/12/05

Kelvedon Project 05/09/05

Kelvedon Project 21/03/05

Kelvedon Project 21/05/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Kelvedon Project 43a & 43b Morley Road Tiptree Colchester Essex CO5 0AA Lead Inspector Ray Finney Key Unannounced Inspection 10th October 2006 09:30 Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 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 Kelvedon Project DS0000017860.V316277.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 Adults 18-65. 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. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kelvedon Project Address 43a & 43b Morley Road Tiptree Colchester Essex CO5 0AA 01621 815224 01621 815224 s.ashman@scope.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) SCOPE Ms Sarah Lyndsey Ashman Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability who may also have a physical disability (not to exceed 6 persons) 19th December 2005 Date of last inspection Brief Description of the Service: The Kelvedon Project consists of two self-contained bungalows, each accommodating three service users with physical and learning disabilities. The home is situated in the village of Tiptree, which is readily accessible by public transport to the towns of Colchester and Maldon. There are local facilities and shops. Service users have access to a large garden and patio area, including the addition of a conservatory that is easily accessed from both bungalows and used by all service users. The manager also oversees another establishment locally. Her time is managed efficiently between both units, with both staff teams being kept informed of her whereabouts at any one time. Information about the service may be obtained by contacting the manager. The home charges between £494.34 and £634.37 a week for the service they provide. This information was given to the Commission in October 2006. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to compile this report. Documentary evidence was examined, such as staff rotas, service users’ care plans and staff files. A visit to the home took place on 10th October 2006; this included a tour of the premises, discussions with service users, members of staff and the manager and observations of interactions between service users and members of staff. On the day of the inspector’s visit the atmosphere in the home was lively and welcoming and the inspector was given every assistance from the registered manager, Sarah Ashman, and members of staff. What the service does well: What has improved since the last inspection? What they could do better: Although service users rooms are well maintained, the general standard of cleanliness could be better. Refurbishment of the laundry floor and some of the tiling in the shower room would improve the environment for service users. Some improvements have been made in record keeping since the last visit, but not all care plans have been signed by service users or their representatives and some risk assessments did not show evidence of recent review. Overall a more structured approach to maintaining records would benefit service users. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 6 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. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the information they need to make an informed choice about where to live. The home ensures service users are admitted on the basis of a full assessment. EVIDENCE: The home has a Statement of Purpose and Service User Guide that meet National Minimum Standards. As part of the ongoing Quality Assurance process, the manager is reviewing the Service User Guide and this is being discussed at monthly service user meetings. This is a slow process as the service user group has limited enthusiasm for the subject, so only a little at a time is looked at. There have been no new admissions to the home for some time but the manager discussed the assessment process with the inspector on the day of the visit. The information and evidence provided shows that the manager has a good awareness of assessment and the documentation around the process is appropriate. Three service users’ records examined show full assessments of need are in place. The assessments include communication needs, daily routines, continence, finances, mobility and self-image. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs and goals are reflected in their Individual Plans. Service users are supported to make decisions about their lives and are supported to take risks within the limitations of their capacity to understand. EVIDENCE: A sample of three service users’ care plans that were examined on the day of the inspection visit all contain detailed, comprehensive information. Overall care plans are well organised and contain clear guidelines for staff about the way service users like to have care carried out. There is evidence that care plans are reviewed regularly. Some care plans have been signed by key workers and service users or their representatives, although one was only signed by the key worker. Observations of interactions between staff and service users show that staff encourage service users to make decisions. One service user chose to spend time with the inspector and was seen to be consulted about what the service user wanted to do, such as what and when to eat. Staff displayed patience Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 10 and listened and responded appropriately. Care plans examined show evidence of how the manager and staff encourage service users to make decisions and choices. One service user has been supported in their choice to move to a flat; the move was due to take place within the month following the inspection visit. The inspector spoke to the service user, who was ‘excited’ and ‘looking forward to’ the move. Service users’ records examined show that risk assessments are in place. Risk assessments cover vulnerability, communication, moving and handling, continence and epilepsy. Risk assessments examined set out existing precautions taken to reduce risk and additional precautions that may be required. However, not all risk assessments showed evidence of recent review. The manager said that review of care plans and risk assessments is an ongoing process, although records examined show that this is not always formally recorded. The review of risks is important because it ensures that service users are protected and that their rights are not infringed; tightening up on the recording process will provide evidence that this is happening. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to take part in a range of age, peer and culturally related activities and are part of the local community. Service users are supported to maintain appropriate relationships. The home ensures service users’ rights are protected. Service users are offered a varied and healthy diet that they enjoy. EVIDENCE: Service users living in the home are not able to access paid employment because of their complex needs. However, the home supports service users to take part in a range of activities. As previously reported, the home supports service users to access local day services and activities such as swimming, dancing and a social club. Service users use local community facilities and are supported to use local shops. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 12 The home ensures family links are maintained; evidence of this is to be found in the files that were examined. Discussion with the manager demonstrates that information provided by service users’ families is taken into account when planning care. The home supports service users to maintain family links by letter, telephone and visits. Observations on the day of the inspection visit show that service users are encouraged to be involved in the day-to-day running of the home. Staff said that service users are encouraged to take part in menu planning and food shopping. This is done on a rota basis so that all service users can be involved in the process. Evidence was seen that monthly service user meetings take place. Positive interactions between service users and staff were observed and service users appear happy and relaxed. Menus were examined and show that a variety of nutritious food is offered. The small size of the home and the domestic nature of the premises ensures that service users individual wishes around meals are taken into account. There are no set meal times and service users are free to choose when and where they prefer to eat. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures service users receive personal support in the way they require and their physical and emotional needs are met. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Records examined show evidence of the way service users prefer to have personal care carried out (see evidence for standard 6). The home operates a key worker system and staff are able to demonstrate an awareness of service users’ preferences. Service users’ records examined show individual preferences around daily routines such as getting up, going to bed and preferences around personal care. On the day of the visit staff were observed to maintain service users’ privacy and dignity when carrying out personal support. Care plans examined show evidence of health appointments such as speech & language therapy, dentist, chiropodist and optician. As previously reported, all service users are registered with a G.P. at the local medical centre. Consultations with medical professionals visiting the home take place in the privacy of service users’ rooms. Care plans examined contain a Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 14 “red/amber/green” hospital assessment so that important information is taken to hospital should the service user need to be admitted. This assessment details conditions that must be taken into account for the service user’s health and well-being as well as preferences around healthcare. Records examined show that staff receive training relating to service users’ health needs such as the use of a ‘Fresenius pump’. The home operates a monitored dose system for medication. There are currently no service users living in the home with the capacity to self medicate. Medication is stored individually in service user’s bedrooms. Each service user has a secure wall mounted, locked metal cupboard for the storage of their personal medication. Medicine Administration Record (MAR) sheets were examined on the day of the inspection visit and are completed appropriately. Evidence of staff training around medication was examined. Procedures and practices around the administration of medication are good. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident their views are listened to and acted on. Arrangements are in place to help protect service users from abuse, neglect and self-harm. EVIDENCE: The home has an appropriate complaints policy and procedure in place. Records of complaints were examined on the day of the inspection visit. Two complaints have been recorded, both of which have been dealt with appropriately. As previously reported, service users have access to SCOPE’s complaints policy and procedure, which is available in an appropriate format for the service users living in the home. Records examined show that the home has policies in place for the Protection of Vulnerable Adults (POVA). There is a whistle blowing policy in place so that staff may be assured that they will be protected if they feel the need to raise concerns about practices. As part of the recruitment process, the home carries out POVA checks and Criminal Records Bureau (CRB) enhanced disclosure checks to ensure the protection of service users. On the day of the inspection visit, staff training was being carried out. A member of staff facilitating the training was spoken with and was able to demonstrate a good knowledge of Health & Safety and the Protection of Vulnerable Adults. Staff records examined show that staff received an update on POVA training in November 2005. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable and safe environment and service users’ have bedrooms that promote their independence. Shared spaces are appropriate to meet the needs of service users. The home provides the specialist equipment necessary to maximise service users’ independence. Overall, service users can expect the home to be clean and hygienic. EVIDENCE: From a tour of the premises the inspector observed that overall the environment is comfortable and the home is well maintained throughout. Both bungalows have living areas that are homely with domestic furniture of good quality. The premises are accessible to all service users with wheelchair access to all communal areas. Service users’ bedrooms that were examined all had plenty of evidence of personal property and are decorated to meet individual tastes. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 17 In addition to the living area, there is a large conservatory to the back of the bungalows that can be used as a private lounge for entertaining visitors. Throughout the home there is evidence of aids, adaptations and overhead tracking for hoists. Both bungalows have a bathroom and shower room containing assisted baths. The laundry room is situated to the side of the car park and contains an industrial washer and dryer, with appropriate programmes to ensure infection control. Although the laundry is clean, the flooring is worn and needs to be replaced. The bathroom in one of the bungalows could be improved by having the grouting around the tiling replaced as it is showing signs of mould growth. Otherwise bathroom facilities are clean and appropriate. Kitchens in both bungalows are domestic in nature and are clean. Although generally the home is hygienic, cleaning could be slightly better. The manager explained that they have not had a cleaner for some weeks but have now managed to recruit to the position. The cleaner will be starting within a few weeks. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Overall service users are supported by competent and qualified staff who receive appropriate training, although the manager should ensure staff are supported to complete NVQ awards. Service users are protected by the home’s recruitment policy and procedures. Service users benefit from wellsupported and supervised staff. EVIDENCE: Overall the staff team are competent and qualified to carry out their roles. Out of a team of 13 care staff, 4 have completed a National Vocational Qualification (NVQ) at level 2 or above and a further 3 members of staff are currently working towards the award. Although this falls short of the National Minimum Standard recommended 50 , the manager is committed to increasing the numbers of staff with an NVQ qualification. Two members of staff are currently working towards the assessor’s award, which eventually will help to increase the number of staff with NVQ. Two members of staff are currently working on the Learning Disability Award Framework (LDAF) award. Staff spoken with were complimentary about training in the home. A sample of 3 staff records were examined and contain evidence of recent training in Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 19 Makaton, Food Hygiene, Moving & Handling, Health & Safety, POVA Awareness, First Aid, Fire Prevention, Deaf Awareness and Medication training. There was evidence of work in progress around LDAF. Records examined also contain evidence of staff induction. The home has a robust recruitment process in place to ensure the protection of service users. Staff files examined contain all the required documentation including application forms, two written references, appropriate evidence of ID and enhanced Criminal Record Bureau (CRB) checks. Staff spoken with feel well supported; one said there are “good systems of support”. Staff said that turnover of staff is lower than in the past. Supervisions take place regularly, at least every six weeks or more frequently if required. There are team meetings approximately monthly. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well run and had policies and procedures in place to safeguard the rights of the service users. Overall service users views are taken into account through the Quality Assurance process, although further development is needed. The home ensures the health, safety and welfare of service users are promoted and protected. EVIDENCE: The registered manager has a number of years management experience. She holds a nursing qualification and has completed the Registered Manager’s Award. The home has a range of policies that the manager implements to ensure the home is well run in the interests of service users. Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 21 As part of the home’s Quality Assurance process, questionnaires have been distributed to service users and members of staff. Questionnaires have also been distributed to relatives and other professionals involved with the home. The manager is in the process of collating the information received, although a final report has not yet been produced and made available to all stakeholders and other interested parties. The home has appropriate policies and procedures in place around infection control, fire safety, first aid and Health & Safety. On the day of the inspection visit a full Fire Drill was planned and this was carried out successfully. One service user helps test the fire alarm on a weekly basis. Records examined show that appropriate Health & Safety checks are carried out. Kelvedon Project DS0000017860.V316277.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 Adults 18-65 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 3 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 X Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes 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 YA9 Regulation 14(2)(a) Requirement The registered person must ensure that the assessment of service users’ needs is kept under review and revised at any time when it is necessary. The registered person must make suitable arrangements to prevent infection, toxic conditions and the spread of infection in the home. Particular attention needs to be paid to the flooring in the laundry. Timescale for action 30/11/06 2. YA30 13(3) 31/01/07 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. 2. Refer to Standard YA32 YA39 Good Practice Recommendations The registered manager should continue to support staff to obtain an NVQ qualification at level 2 or above. The registered manager should continue to develop the Quality Assurance system and ensure that a report is available for inspection Kelvedon Project DS0000017860.V316277.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Kelvedon Project DS0000017860.V316277.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!