Inspection on 28/11/07 for Kersal Dale

This inspection was carried out on 28th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Kersal Dale 05/07/07

Kersal Dale 31/10/06

Kersal Dale 18/03/06

Kersal Dale 03/11/05

Kersal Dale 08/02/05

Kersal Dale 19/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Kersal Dale 48 Vine Street Salford Gtr Manchester M7 3PG Lead Inspector Helen Dempster Unannounced Inspection 28th November 2007 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 Kersal Dale DS0000008347.V353643.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. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kersal Dale Address 48 Vine Street Salford Gtr Manchester M7 3PG 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) 0161 792 3166 0161 792 3166 kersaldaleresthome@hotmail.co.uk Mrs N Akram Mr U Akram Miss Chrisden Williams Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home provides accommodation to a maximum of 35 service users who require care by reason of old age, not falling within any other category. The home must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 5th July 2007. Date of last inspection Brief Description of the Service: Kersal Dale is a residential care home, which has thirty-five places for older people. The home has extensive grounds with landscaped gardens to the front and rear of the property and a parking area to the side of the building. The home is situated in a residential area of Salford. Internally, there is a large lounge and dining area running down the centre of the building, which leads to a large glazed patio style lounge. There are twenty-five single rooms and five double rooms, on the ground and first floor. The home has good disabled access at the front of the property, and both floors are accessible via a passenger lift, which also goes to basement level. The range of fees is between £364.41 and £373.54 per week, with additional charges for hairdressing, personal toiletries, newspapers and magazines. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second key inspection conducted this year and focused on assessing progress made to address concerns identified at the earlier key inspection, which took place in July 2007. The inspection was conducted by gathering lots of information about how well the home was meeting the National Minimum Standards for Older People. This included questionnaires being returned by seven residents and seven staff members, from which information about the way that the service is run was obtained. The inspection also included carrying out an unannounced site visits to the home on 28 November 2007 and 30 November 2007. During these visits, lots of information about the way that the home was run was gathered and time was taken in talking with residents, the owners, the manager, and the staff team about the day-to-day care and what living at the home was like for the residents. The main focus of the inspection process was to understand how the home was meeting the needs of the people who use the service and how the staff were supported to meet residents’ needs. The term preferred by the people consulted during the visit was “residents”. This term is, therefore, used throughout the report when referring to those people living at the home. What the service does well: The owners, manager and staff were warm and welcoming to residents and visitors. One resident’s relative talked about the “excellent care”, the service provided, and another relative said that the owners, manager and staff were, “very caring, attentive and approachable”. The manager was found to be competent and receptive to positive change and was well supported by the owners. Mealtimes were flexible to meet residents’ needs and choices. One resident’s relative said that the owners of the service had, “checked likes and dislikes from the start and take them into account”, for their relative. Residents live in clean and homely surroundings and one resident said, “The home is very clean. They are always cleaning. The beds are lovely and clean and my room is always fresh and clean”. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 6 Residents were happy with the staff. One resident said, “the staff are really lovely and help me with anything I ask for”, and staff felt that they were supported to provide a good level of care. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kersal Dale DS0000008347.V353643.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 Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from access to information to allow them choice and from having their needs assessed before admission. EVIDENCE: Copies of the Statement of Purpose and Service User Guide were held in the office. These documents had been reviewed and a further review was planned for January 2008. All residents have a copy of the Service User Guide on their files. The files of the three residents who had been admitted to the home most recently were seen. Their needs had been assessed by a Social Worker. Since the previous inspection, the manager had developed a comprehensive pre admission assessment tool and this had been used to assess the needs of these three residents before their admission, with family involvement. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments had improved greatly since the previous inspection. This ensured that staff had clear guidance on how to meet residents’ needs and choices and promote their’ well being and safety. EVIDENCE: The files of three residents were seen. Care plans had been reviewed since the previous inspection. The manager explained that she had devised a new template to record care plans, which was linked to the new assessment template. It was seen that the template was very well organised, detailed and comprehensive and addressed all areas of assessed need. The template included a personal profile, reason for admission, language spoken, background and life history, eating and drinking, likes and dislikes, activities, medication, pressure care, nutritional assessment and weight monitoring. The care plans exceeded the standards. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 10 Care plans addressed diversity very well. Examples included the detail in the personal care needs of an Asian resident who was a Muslim, which advised staff on this person’s needs and preferences concerning clothes and included the Asian name for the items of clothing with a translation in English. Other good practice included a reference to a resident being “proud” and providing details of how residents should be given choice, including preferred clothes, and how staff should explain what they are doing and reassure residents when helping them with personal care. The manager held detailed records of visits from doctors, chiropodists, nurses etc. It was also evident that the manager made sure that residents’ were assessed by health care professionals, including a speech and language therapist and dietician, when one resident became frail. This resident had a low body weight and associated medical issues and the nutritional plan for this person was clear and detailed. This assessment included preferred foods and portion sizes and a risk assessment concerning the risk of malnutrition and dehydration, which was linked to the care plan. It was seen that all residents were being weighed each month and had clear and detailed nutritional assessments. Another resident had fragile skin and was prone to injury. The manager had introduced body mapping and this resident’s was body mapped when bathing and after every fall or injury and the exposed skin was checked on a daily basis. Risk assessments concerning falls were clear and detailed for each resident, including this person, and accident records were in place. It was recommended that staff be given further guidance in the completion of accident reports so that they state what was actually seen, rather than what they believed had happened. Risk assessments were well organised by providing an initial tick list of the risks assessed. Risk assessments completed covered a number of areas of assessed risks to individual residents and were also cross referenced to care plans, which is good practice. One example was a choking risk assessment, which referred staff to this resident’s eating care plan for further detail. Good use was made of cross referencing so care plans and risk assessments were seamless. The new templates for care plans and risk assessments, included sections which prompted a review. The monthly reviews had prompts of issues which needed to be reviewed to support staff and included the weight recorded, and any hospital or medical intervention that month. Daily records about residents were made twice daily. There was some good practice, including good staff observation of residents who had poor verbal communication, which noted the resident’s mood and body language. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 11 One resident’s relative who filled in a questionnaire was pleased with the “excellent care”, they said that the service provided. There were also examples of positive ways in which the staff sought to maintain the privacy and dignity of residents, including knocking on doors before entering a room. All interactions between the manager and staff and residents were seen to be positive. Medication was stored in a locked trolley, secured to the wall in a communal area. Since the previous inspection medication was dispensed from a monitored dosage ‘bubble pack’ system. All the senior carers and the manager had undertaken medication training in August 2007 and medication practice had improved since the previous inspection. This included drafting care plans for all residents, which gave details of the precautions/side effects of all medication and individual’s needs when administering medication. One example was a resident who was said to, “open (their) mouth and keep it open as they want all of them at once”. Staff were instructed to give tablets one at a time and with water. A clear photograph had also been placed on each medication record. Controlled drugs were checked and the balance was correct and the record was double signed with full signatures. Despite evidence of regular monitoring by the manager, some errors were seen, including one tablet, which appeared to have been administered, but the record was not signed accordingly, this appeared to relate to the fact that monitored dosage packs were started on different dates and weeks. By the time of the second visit to the home, the manager had addressed this issue with the supplying pharmacist to avoid further confusion. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ social needs and choices were respected and assessments of preferred activities and access to activities had improved. EVIDENCE: Care plans had been reviewed since the previous inspection to include an assessment of preferred activities. The manager said that residents enjoy visiting singers and that residents also enjoy watching television and videos, playing bingo and taking part in the healthy hips and hearts class on Tuesday each week. The manager said that one Asian resident was about to attend a day centre for Asian people and that this person is provided with Halal food. A local church minister visits the home every week and says mass and gives communion to residents who wish to take part. At the time of the visit, the local church volunteers were hosting a Christmas party at the home and an entertainer was provided. Volunteers from the church supported the residents Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 13 and helped to serve party food. Residents were seen to enjoy the party and said that the entertainer was good. Some staff, who completed questionnaires, said that care in the home was good, but that residents would benefit from more entertainment. One staff comment was that they would like to, “help some residents to go out to have fun” and another member of staff said that residents, “sometimes should be taken out for sight seeing”. Overall, residents’ relatives were positive about activities and one resident’s relative said that the owners of the service had “organised exercises to help with mobility” of their relative. It was recommended that activities were further reviewed in the light of staff comments. Mealtimes were flexible to meet residents’ needs. Menus showed that the main meal at lunchtime is soup (often home made) and a main course and residents have a cooked meal and pudding at teatime. The manager holds a record of residents’ daily choices and residents spoken to expressed satisfaction with the food for which they were offered at least 2 choices at each meal. One resident’s relative said that the owners of the service had, “checked likes and dislikes from the start and take them into account”, for their relative. The cook was interviewed and was pleased to be doing a “personal cookery apprenticeship” course and was found to be knowledgeable about residents’ needs and personal preferences. Care plans had clear details of residents’ needs concerning food and drinks and included a full list of preferred meals, meal times and portion sizes, and gave details to staff to enable them to support residents with limited communication. This included one resident whose care plan stated that they were, “unable to ask when (they) want to eat or take fluid”, and clear instructions were provided accordingly. Staff were advised through care plans to note any refusal of food or change in normal eating habits. This is good for the residents. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Practice in dealing with complaints and protection had improved so that residents and their relatives were confident that any issue they raised would be dealt with and residents were safeguarded by the staffs’ knowledge of adult protection procedures. EVIDENCE: The manager had reviewed the complaints record since the previous inspection, and a separate sheet was held in each resident’s file to record complaints. The service had a copy of the Salford Council’s Protection of Vulnerable Adults Policy. There had been one referral under this policy since the previous inspection, and this had been dealt with by the service in an open and professional manner. Six staff had received training in the implementation of the Protection of Vulnerable Adults Policy since the previous inspection and the remainder of staff were booked on this training for February 2008. The manager and cook were also booked to go on advanced safeguarding training in Feb 2008. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in clean and homely surroundings, which meet their needs and residents are protected by excellent staff hand hygiene. EVIDENCE: The home was clean, homely and free from unpleasant odours. Communal areas were very spacious and were well furnished and decorated. All residents’ rooms seen were clean and personalised. Relatives and friends of residents, who filled in questionnaires, were also pleased with the standard of hygiene and one resident said, “The home is very clean. They are always cleaning. The beds are lovely and clean and my room is always fresh and clean”. This is good for the residents. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 16 The standard of kitchen hygiene was high. On 15/06/07 the home achieved Salford Council’s 5 star rating (Gold award) for kitchen hygiene. Since the previous inspection, the owner had fitted liquid soap dispensers, paper towel dispensers and alcohol gel dispensers in every room, including residents’ bedrooms. This is excellent practice as it reduces the risk of cross infection. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for training care staff ensure that the needs of residents are met and recruitment practice had improved to better protect residents. EVIDENCE: The manager holds a staff-training audit, which was being updated at the time of the visit. Training undertaken since the previous inspection included the Protection of Vulnerable Adults (six staff) and all the senior carers and the manager had undertaken a Medication Course in August 2007. Six of the 15 staff had NVQ Level 2. Some staff induction records were seen and the manager was about to introduce the Skills for Care programme. Staff said that they were happy at the home. In questionnaires staff were very positive about care given to residents, and some were pleased with access to training. Some staff said that they like training and would like more. The recruitment files for the two most recently recruited members of staff were seen. Recruitment practice had improved since the previous inspection and appropriate Criminal Records Bureau (CRB) checks had been made for these staff. At the time of the visit, the manager was reviewing the application Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 18 forms, as the ones in use did not have enough space for full employment histories, so full employment histories had been attached to the forms for these two staff. The new application form was seen at the time of the visit, and was found to be much improved. Residents were happy with the staff. One resident said, “the staff are really lovely and help me with anything I ask for”, and staff felt that they were supported to provide a good level of care. One member of staff said, “Residents can always approach staff and managers at any time who will take time to listen and care about that person, whatever is worrying that person”. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is competent and caring and manages the home in the best interests of residents. Fire safety practice had improved to better protect residents. EVIDENCE: It was clear from discussions and observations that the owners and manager foster an open and friendly atmosphere in the home, and that residents, their visitors and staff find them approachable. One resident’s relative said that the owners, manager and staff were, “very caring, attentive and approachable”. This person added that they were, “extremely happy that (they) found the perfect place” for their relative. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 20 The manager had almost finished her NVQ Level 4 Registered Manager Award. There was evidence that the manager continually seeks to make improvements in the home for the benefit of residents and had a very good knowledge of their individual personalities and preferences. Since the previous inspection, the manager had been supported to raise standards and meet requirements made previously, which is good for the residents. Since the previous inspection, the manager had designed questionnaires for residents and their relatives to complete to obtain their views and to use these views to identify improvements for residents. Fire safety practice had also improved. This included making regular checks of the fire alarm and updating the fire risk assessment. Records of the management of residents’ finances were clear and included records of contact/discussion with residents, their relatives and the funding council about their finances. It was recommended that double signatures, a numbered receipting system and regular balance checks be incorporated into residents’ financial records. Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 22 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. 1. Refer to Standard OP8 Good Practice Recommendations It was recommended that staff be given further guidance in the completion of accident reports, so that they state what was actually seen, rather than what they believed had happened. It was recommended that activities were further reviewed in the light of staff comments. It was recommended that double signatures, a numbered receipting system and regular balance checks be incorporated into residents’ financial records. 2. 3. OP12 OP35 Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Manchester Local Office 11th Floor Westpoint 501 Chester Road Manchester M16 9HU 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 Kersal Dale DS0000008347.V353643.R01.S.doc Version 5.2 Page 24 - 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!