CARE HOME ADULTS 18-65
Lanrick Cottage 41 Wolseley Road Rugeley Staffordshire WS15 2QJ Lead Inspector
Jane Capron Announced 25 July 2005 9.30am 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 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 Stationary 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. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Lanrick Cottage Address 41 Wolseley Road Rugeley Staffordshire WS15 2QJ 01889 585262 01889 585262 lanrickcottage@aol.com Care Services(uk)Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Maureen Holcombe CRH 3 Category(ies) of LD - 3 registration, with number of places Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: N/A Date of last inspection 5 January 2005 Brief Description of the Service: Lanrick Cottage is a three-bedded care home for residents with autism/severe learning disability who also have specialist communication needs. It has been owned by Care Services UK Ltd since November 2004 but there has been no change to the staffing or the service provided. The home is situated on a main road leading into Rugeley. The home is set back from the road with parking for a number of cars at the front. The home has an attractive garden at the front and a secure garden at the rear providing opportunities for service users to use the garden. The home is in keeping with the surrounding area. It is well located to access the town centre resources and public transport. The home has its own transport. The accommodation is well maintained and attractively decorated. The home comprises of a lounge, dining room, conservatory, toilet and kitchen and one bedroom with ensuite downstairs and two bedrooms and a bathroom upstairs. The home provides residents with the opportunty to undertake a range of independant living tasks such as helping in the house and undertaking shopping. The home has links with a local college and also provides the residents with a range of leisure activities both in and out of the home. Residents go on hoilday and out for day trips. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over a period of three hours. The inspection included discussions with the Care Manager and the two staff on duty. All residents were spoken to during the inspection. Observation took place of the staff working with the residents. All the accommodation was inspected. Care plans and residents’ documentation was examined as well as a number of environmental documentation and a sample of staff files. Additional comments were received from relatives and from the speech and language therapist that visited the home every month. The home completed a pre-inspection questionnaire providing a range of information about the home. Since the last inspection there have been no complaints and no additional visits have taken place. What the service does well:
The staff provide a good quality of service to the residents by meeting their specific individual needs and knowing their specific likes and dislikes. All the residents have some specialist communication needs and the home had developed a range of practices to help staff and residents to communicate effectively. These included a range of pictorial cards to assist in choice and to help residents to understand how to undertake specific tasks. Staff received training in makaton. The home had developed a pictorial leaflet that informed residents about the inspection and all the residents showed that they knew the inspection was to occur. The home supported and assisted residents to undertake independent living tasks such as cleaning and keeping their room tidy, doing their laundry, putting together the weekly shopping list and doing the food shopping. This provided residents with the opportunity to develop their skills and to be fully involved in the day-to-day tasks around the home. The home provided residents with a range of activities both in and out of the home including a range of board games, videos, regular trips out and at least one holiday a year. This gave residents the opportunity for a full and varied lifestyle. Staff related positively with residents and the residents got on well with the staff. There was a relaxed and friendly atmosphere. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 6 Staff received induction training and undertook the necessary health and safety training. The Care Manager provided a wide range of resources about autism to improve the staff’s knowledge. Staff received individual supervision and support. The environment was of a good standard and was domestic and homely in style and furnishings. The Care Manager had worked at the home since it opened and was very experienced and knowledgeable and had the skills to be an effective manager. She had the required qualifications in management. The Care Manager had a relaxed and open management style. Relatives felt welcomed to the home and felt that the home was effective in keeping in contact with them. What has improved since the last inspection? What they could do better:
Whilst the home was providing a good service to the residents the home needs to ensure that the residents have at least annual medical reviews and have eye checks. It is also recommended that the staff receive training in infection control and fire training once a year from an external fire specialist. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 7 It would also assist the staff in providing services to the residents if the care plans were in a more useable format and the personal care needs were put with the other elements of the care plans. Although the home undertook some review of the service benefits may be gained from developing this system further. 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. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 The home’s Statement of Purpose and service user guide provided the necessary information for prospective residents and others to know what the home offered in order to be able to make an informed decision over admission. The home’s admission procedure ensured that the needs of prospective residents were identified meaning that the home would only provide a place if they would be able to meet their needs EVIDENCE: The home had revised the Statement of Purpose to include the information over the new owners. The service user guide was in a pictorial format. Although there had been no admissions since the home opened it was the procedure for any admissions only to be considered following a full assessment both by the funding authority and the home. The staff at the home had the necessary knowledge to meet the needs of the current residents. The home was able to gain advice from the learning disability team and had a speech therapist that visited monthly. The home was able to support residents to attend specialist health appointments. The home had links with the local college and was able to provide for the social and leisure needs of the residents. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 The home’s care planning process ensured that the staff had the information to be able to meet the needs of the residents but would benefit from being presented in a more user-friendly manner. Residents benefited from being supported to make choices over their lives and from participating in a range of tasks associated with the running of the home. EVIDENCE: Each resident had a care plan that showed the needs of the resident and how these needs were to be met. However not all the elements were kept together meaning that there were not completely user friendly. The elements were reviewed every three months with a full review including all significant parties being held yearly. Residents were supported and encouraged to make choices over aspects of their daily lives. This included when to get up and go to bed, where to spend their time either in their bedrooms or in any of the communal areas. Residents were supported to make decisions over how to spend their time and what activities to undertake. Residents were provided with choices over meals and were encouraged to be involved in choosing the food shopping. Residents
Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 11 were supported to make choices over what they wore. Staff were aware of each resident’s decision making abilities and over their likes and dislikes. The home had developed a range of individual risk assessments that were up to date and had been reviewed. All the residents took part at some level in a range of household activities including keeping their bedroom clean and tidy, making their bed, doing their laundry as well as helping to plan the meals and doing the food shopping. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,17 The home provided the residents with a wide range of activities both in the home and in the community giving them a full and varied lifestyle. The home supported residents to maintain contact with their relatives and involved relatives in decisions and changes at the home that affected their relative. The meals were good providing the residents with variety and choice and responding to individual preferences and dietary needs. EVIDENCE: The home had developed a weekly schedule for each resident that outlined a number of regular activities that each resident engaged in. The schedule included independent living tasks and social and leisure activities. One resident had attended college until July and was enrolled to attend another fulltime course in September. The residents that did not attend college were involved in household tasks, and leisure activities throughout the week. Residents went out at least twice a week for social activities that could include going out on day trips. Two of the residents went out every week to do the
Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 13 food shopping. Residents also went out to buy personal items such as toiletries and clothes. Two of the residents also went out for meals. One resident went horse riding every week. The home also supported residents to get money out of the bank. Within the home the residents took part in a range of board games, educational and gaming computer programmes, videos, TV and arts and crafts. They also had regular baking sessions. The residents were supported to do a weekly paper round and the money was used to buy additional items for the residents and was put towards paying for holidays. All of the residents have been on holiday this year and two were due to go away for a weekend later in the year. All the residents had good contact with relatives and visited home. Relatives that responded to the pre inspection questionnaire felt that they were welcomed at the home and were kept informed of changes and were involved in decisions over their relative. Residents were supported to keep in touch with family members through telephone calls and letters. The home provided a varied diet for the residents taking in account residents’ individual preferences and any specialist dietary needs. Residents were involved in meal planning. The main meal was in the early evening with a snack type meal such as soup, pizza etc at lunchtime. Breakfast was a choice of cereals and toast. Breakfast was taken when residents’ got up. Snacks were available between meals. Residents were supported to undertake baking. On occasions residents had meals out or had a ‘take away’. Residents that were able helped with aspects of meal preparation, laying the table, clearing the table and filling the dishwasher. One resident was observed peeling potatoes with the support of a staff member. The individual eating preferences were responded to with residents being able to eat together or alone. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 The home supported the residents to have their personal care needs met in manner that respected their wishes and ensured that their dignity and privacy was respected. Whilst the home had identified the health care needs of the residents all residents needed to receive regular health care checks and eye tests. EVIDENCE: The health and personal care needs of the residents were identified and recorded. Each resident had their individual personal care needs and preferences over how they liked task to be completed well recorded. Their preferred daily routine was also identified. Residents’ personal care needs were being met and staff respected their privacy and dignity. Residents were supported to have daily bathes. Residents’ nail and hair care being attended to. Residents’ clothes were age appropriate. Residents were involved in choosing their own clothes. The home had a key worker system in place. The residents were registered with a local GP. One resident received specialist health care services and the staff undertook action to promote their health care needs. There was evidence that residents received dental care but no evidence to indicate that all residents received regular health checks and had eye tests.
Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home had a complaints procedure in place that was suitable to respond effectively to any complaints made. The procedures and staff’s knowledge of adult protection led to a higher level of protection for the residents and should lead to any incidents being responded to in an appropriate manner. EVIDENCE: The home had a complaints procedure and this was provided in a pictorial form. Relatives were aware of the complaints procedure. The home had details of the advocacy service if needed. The home had received no complaints over the last year. The staff had knowledge of adult protection issues. Those that undertaken NVQ training had completed training in this area and the Care Manager had provided all the other staff with relevant information. A staff member spoken to confirmed that they had received the training and was alert to issues of adult protection. Staff spoken to were aware of the individual behavioural management issues of the residents and were understanding of these issues. Files showed the actions staff needed to take to respond to any incidents of aggression. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30 The standard of the accommodation was good providing residents with attractive and homely communal and private accommodation. The procedures for cleaning and laundry provided residents with a hygienic environment that reduced the likelihood of the spread of infections. However staff would benefit from training in infection control EVIDENCE: The home was suitable to meet the needs of the current residents. The premises were in a four bed roomed house that was indistinguishable from other properties in the area. The home was well maintained, and decorated and furnished to a high standard. The decoration and furniture was domestic and homely in style. The home had suitable communal areas. There was a dining room, lounge and conservatory. The home had a domestic style kitchen that was large enough for staff to support residents to undertake tasks such a meal preparation and making drinks. Externally there was a good-sized attractive garden providing the residents with seating and with the opportunity to engage in outdoor activities.
Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 17 All bedrooms were of an adequate size and were suitable for the residents. Bedrooms were well decorated in a suitable manner and had adequate storage facilities. Bedrooms were well personalised reflecting the interests of the occupant. The home had adequate toilet and bathing facilities. The downstairs bedroom had ensuite facilities and there was a separate toilet. Upstairs there was a bathroom with toilet. All were lockable. The home was clean and tidy throughout. The staff along with residents undertook a range of domestic task including keeping the home clean. The home provided adequate supplies of gloves and aprons. The home had laundry facilities in the garage and recently had bought a new washer and drier. The washer was able to wash laundry to disinfectant levels. Staff would benefit from undertaking training infection control. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35,36 The staffing levels were sufficient to provide the residents with the support they required to meet their personal, health and social needs. Staff were provided with the training and support to be able to work in a positive manner with the residents to provide them with a good quality of life. The residents were supported and protected by the home’s recruitment processes. EVIDENCE: The homes’ staffing levels allowed for a minimum of two care staff to be on duty at any time during the day. At times there were three care staff on duty allowing staff to take all the residents to go out together and for more individual work. The home had some bank staff that could cover for holidays, ill health and vacancies. These staff were well known to the residents some having worked at the home previously. The Care Manager was suoernumery and would provide additional support and supervision. There was a sleep-in staff member although there were two people at times to ensure there was always a female staff member available to the female resident. This level of staffing allowed for staff to undertake individual work with residents and to take residents out into the community. The home had one staff vacancy at the time of the inspection.
Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 19 All staff were provided with training in communication skills in order to communicate effectively with residents. The home had a range of pictorial methods for communication and staff received training in makaton All new staff undertook comprehensive induction training and had a programme of ongoing training. This was well recorded. Staff received regular individual supervision. The home undertook the necessary pre employment checks including two written references and a CRB and POVA check. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 The home was being well led and managed, providing residents with a good standard of care where their needs and preferences were being met. The home reviewed and evaluated aspects of its performance however there could be benefits for residents if this process of review was further developed. The home’s health and safety procedures protected and promoted the welfare of residents. EVIDENCE: The home was well run. The Care Manager had been at the home since it opened and had a high level of commitment to providing a high standard of care and in supporting the staff. She had the necessary skills, knowledge and experience to run the home. She had the required qualifications. She maintained daily contact with all the residents. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 21 The home had a number of quality checks in place including checking environmental issues and undertaking surveys of relatives’ views. There was scope for further development particularly in assessing the care practices. The home undertook the necessary servicing of equipment. Staff had received training in first aid, food hygiene, lifting and handling and internal fire training. Regular fire drills took place and residents were involved in these drills. The home provided security for the residents. The home had controls in place for the use and storage of hazardous substances. The home had a range of risk assessments in place for safe working practices. Hot surfaces were covered. The home had procedures in place for the control of the legionella bacteria. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 4 4 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 4 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 4 4 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Lanrick Cottage Score 3 2 x x Standard No 37 38 39 40 41 42 43 Score 4 x 3 x x 3 x E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 23 no Are there any outstanding requirements from the last inspection? 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 19 Regulation 13(1)(b) Requirement To ensure that all residents receive medical reviews and undertake eye tests. Timescale for action 1/9/05 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. 3. 4. Refer to Standard 6 39 42 42 Good Practice Recommendations To considering altering the format of care plans to make them more user friendly To consider further developments to the system for the review of the quality of the service. To provide staff with training in infection control To have one fire training session a year provided by a fire specialist. Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Lanrick Cottage E51-E09 S62392 Lanrick Cottage V237177 25.07.05 Stage 4.doc Version 1.40 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!
